Tag: vaccine hesitancy

How Pediatricians Should Talk to Vaccine Hesitant Parents

Vaccine hesitant parents sometimes don’t get time to talk with a pediatrician about vaccines.

They might not even get an appointment with their new baby if they express doubts about wanting to vaccinate their kids or about wanting to skip or delay some vaccines.

That’s unfortunate, as I think many would choose to vaccinate and protect their kids if they got answers to the anti-vaccine talking points that scare them.

Myth busting by itself doesn’t always seem to work though.

How Pediatricians Should Talk to Vaccine Hesitant Parents

It is understandable that pediatricians get frustrated talking to some anti-vaccine parents.

Pediarix, Hib, Prevnar, and Rota vaccines have been prepared for an infant at her well child visit.
Pediarix, Hib, Prevnar, and Rota vaccines for my daughter at her 2 month well visit 10 years ago. Photo by Vincent Iannelli, MD

One strategy that might work includes asking open ended questions about why the parent is hesitant to vaccinate their kids. Next, while responding to a few of their biggest concerns, be sure to affirm what the parent is saying and use reflective listening.

How might these vaccination-focused motivational interviewing techniques work during a typical visit at a pediatrician’s office? Instead of getting frustrated and accepting a copy of Dr. Bob’s alternative schedule, you might ask them:

  • What specifically are you afraid of?
  • You are really worried that your child might get sick after their vaccines.
  • It sounds like you think kids get too many shots.

Now, address a few of those concerns.

Pediatricians often feel like they don’t have enough time to have long discussions about vaccines, when they also need to talk about many other important topics at each visit, including nutrition, development, and safety, etc. The vaccine talk doesn’t have to be extensive though. Just get it started and come back to it again at the next visit.

You can also recommend some good vaccine books and websites to help parents do more research.

Talking About Vaccines

It is not enough to simply tell your vaccine hesitant parents to read a book, visit a website, or offer them some handouts though. It is important that pediatricians also talk to parents about vaccines.

Study after study show that pediatricians are the most influential, most convincing, and most used source of information about vaccines for many parents.

“How providers initiate and pursue vaccine recommendations is associated with parental vaccine acceptance.”

Opel et al on The Architecture of Provider-Parent Vaccine Discussions at Health Supervision Visits

Just remember, when you have these talks, to:

  • Use vaccination-focused motivational interviewing techniques for vaccine-hesitant parents.
  • Avoid using scientific and medical jargon.
  • Help parents who may have a skewed perception of the risks of vaccines vs risks of vaccine preventable diseases, by emphasizing that vaccines are very safe.
  • Avoid simply minimizing or dismissing a parent’s concerns about vaccines without providing a fact based explanation for why they shouldn’t be worried.
  • Highlight the benefits of vaccines, including all of the social benefits.
  • Avoid a “data dump,” in which you might overwhelm a vaccine hesitant parent with too much information all at once and in what they might see as a lecture about accepting vaccines.
  • Always use presumptive language and high-quality recommendations when you talk about vaccines.
  • Include stories and anecdotes about kids who have gotten sick and parents who regret not vaccinating their kids.
  • Become familiar with the anti-vaccine talking points that may be scaring your patients away from getting vaccinated on time. Why is this important? If they are concerned about glyphosate, you might not sound too convincing telling them not to worry if you don’t even know what glyphosate is.
  • Try the CASE Method for talking about vaccine concerns.

Are your kids fully vaccinated? Talk about that too.

There is much more to all of this than simply letting parents follow non-standard, parent-selected, delayed protection vaccine schedules and arguing with them about getting caught up.

What to Know About Talking to Vaccine Hesitant Parents

Learning new ways to talk to vaccine hesitant parents, including the use of vaccination-focused motivational interviewing techniques, presumptive language, and high-quality recommendations, might help pediatricians have more success and get less frustrated.

More About Talking to Vaccine Hesitant Parents

Who’s Who in the Anti-Vaccine Movement

No, this isn’t another article about Andy Wakefield or Jenny McCarthy.

Defining the Anti-Vaccine Movement

The great majority of people know that vaccine work and that they are safe and necessary.

And then there are the folks who don’t.

“The term movement as a description for vaccine deniers is also very misleading. A movement implies the image of a powerful, coordinated group, united by a shared collective identity.”

WHO on How to respond to vocal vaccine deniers in public

It is important to understand that this minority of people who do not believe in vaccines do not have uniform beliefs. Calling them a movement is simply for convenience, as a way to group them all together.

Who’s Who in the Anti-Vaccine Movement

So who are the different types of people that you might come across in various discussions about vaccines?

More importantly, why do you want to know?

You don’t want to think that everyone who questions the safety or efficacy of vaccines is totally anti-vaccine and is going to refuse some or all vaccines. Some of these parents really do just have questions, want to get educated, and may have just been scared by misinformation. On the other hand, others won’t change their minds no matter what new evidence you bring to the table or how long you talk.

“Although many may characterize all individuals who eschew vaccines as “anti-vaccine” or “vaccine deniers,” in reality there is a broad spectrum of individuals who choose not to have themselves or their children vaccinated.”

Tara C Smith on Vaccine Rejection and Hesitancy: A Review and Call to Action

However you characterize the groups, you will be much less frustrated when talking about vaccines if can quickly recognize if you are talking to someone who is:

  • a go along to get along immunization acceptor – this type of cautious acceptor understands and accepts that vaccines work and that they are safe and necessary, but still may have some doubts about one or more vaccines.
  • an immunization advocate – understands, accepts, and helps teach others that vaccines work and that they are safe and necessary.
  • a vaccine denier – someone who does not accept the process of vaccination while denying scientific evidence and employing rhetorical arguments to give the false appearance of legitimate debate. These are the vaccine rejectors who are “unyieldingly entrenched in their refusal to consider vaccine information.”
  • vaccine hesitant – usually a classic fence-sitter, who has doubts about whether vaccines are really safe or necessary or has simply been scared and influenced about something they read on the Internet. They may skip or delay some vaccines, but are typically willing to listen to why getting their child fully vaccinated is their best and safest option.
  • a vaccine refuser – doesn’t vaccinate their kids or themselves, but unlike the vaccine denier, probably doesn’t have very strong beliefs in conspiracy theories and may be willing to listen if you address their concerns about vaccines. They are also sometimes called the vaccine resistant. Often seem to put aside their beliefs against vaccines in special circumstances, like during outbreaks or other high risk situations.
  • a vaccine skeptic – this term is often misused, as classically, a vaccine skeptic would be defined as a person who has questions about vaccines, but then accepts that they are safe and necessary once they have examined all of the evidence. As a skeptic, they would also question all of the “science” of the anti-vaccine movement too, and would find it lacking. Folks who question vaccines, but then ignore all of the evidence that supports their safety and effectiveness are in denial – they are not vaccine skeptics.
  • a vocal vaccine denier – a vaccine denier who influences others, especially on the Internet.
  • one of the worrieds – often immunization acceptors who are still a little worried about vaccine side effects.

What about those who say that they are pro-safe vaccines or pro-choice about vaccines?

Don’t be fooled, these are simply anti-vaccine arguments of a vaccine denier or refuser.

Jenny McCarthy and Jim Carrey went on a mission to Green Our Vaccines in 2008.
Jenny McCarthy and Jim Carrey went on a mission to Green Our Vaccines in 2008. How would you classify them?

Still having trouble telling the groups apart?

Try asking the person you are talking to what would change their mind about vaccines.

Would new evidence work? Or would they dismiss any new evidence as being biased, just as they already dismiss all of the evidence that  so strongly supports that vaccines are safe and necessary?

It is important to identify who’s who, because while you will likely not change the mind of someone who is at the stage of being a vaccine denier, you have a much better chance to help the others get their kids vaccinated and protected.

What to Know About Defining the Anti-Vaccine Movement

The anti-vaccine movement includes a lot of different groups of people, from those who are simply hesitant because a friend or family member is scaring them on Facebook to the vocal vaccine denier, who probably wouldn’t even change their mind if they were bitten by a rabid dog.

More About Defining the Anti-Vaccine Movement

Best Books to Help You Research Vaccines

There are many books to help you get educated about vaccines and avoid getting influenced by vaccine scare stories and anti-vaccine talking points.

Some can even help you understand why you are afraid of vaccines.

Unfortunately, if you simply search Amazon for books about vaccines, you are going to be hit with a list of anti-vaccine books. These are books that push their own made-up, so-called alternative immunization schedules and misinformation about vaccines to scare you away from vaccinating and protecting your kids.

Best Vaccine Books

Which books about vaccines have you read?

Did you even realize you had so many choices?

These books about vaccines can help with your research about vaccinating and protecting your family.
These books about vaccines and vaccine-preventable diseases can help with your research about vaccinating and protecting your family.

Some of my favorite vaccine books that can help you with your research on vaccination and making the right decision for your child include:

  • Autism’s False Prophets. Bad Science, Risky Medicine, and the Search for a Cure
  • Bad Faith: When Religious Belief Undermines Modern Medicine
  • Bad Science: Quacks, Hacks, and Big Pharma Flacks
  • Calling the Shots: Why Parents Reject Vaccines
  • The Cutter Incident: How America’s First Polio Vaccine Led to the Growing Vaccine Crisis
  • Dangerous Pregnancies: Mothers, Disabilities, and Abortion in Modern America
  • Deadly Choices. How the Anti-Vaccine Movement Threatens Us All
  • Do Vaccines Cause That?!
  • Do You Believe in Magic? The Sense and Nonsense of Alternative Medicine
  • Immunity by William E. Paul, MD
  • On Immunity: An Inoculation
  • NeuroTribes: The Legacy of Autism and the Future of Neurodiversity
  • The Panic Virus: A True Story of Medicine, Science, and Fear
  • Panicology: Two Statisticians Explain What’s Worth Worrying About (and What’s Not)
  • Polio. An American Story
  • Polio Wars: Sister Kenny and the Golden Age of American Medicine
  • Pox. An American History
  • Smallpox and the Literary Imagination, 1660-1820
  • Tabloid Medicine: How the Internet is Being Used to Hijack Medical Science for Fear and Profit
  • Twin Voices: A Memoir of Polio, the Forgotten Killer
  • Vaccinated. One Man’s Quest to Defeat the World’s Deadliest Diseases
  • Vaccination: A History from Lady Montagu to Genetic Engineering
  • Vaccine. The Controversial Story of Medicine’s Greatest Lifesaver
  • The Vaccine Race: Science, Politics, and the Human Costs of Defeating Disease
  • Vaccines and Your Child. Separating Fact from Fiction
  • Your Baby’s Best Shot. Why Vaccines Are Safe and Save Lives

How many of these books about vaccines have you read?

What To Know About Vaccine Books

If you were scared away from vaccinating your kids because of a book you read or something you saw on the Internet, consider reading a few of these vaccine books that are based on evidence, not fear.

More Information on Vaccine Books:

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Vaccine Scare Stories

We know why some parents are hesitant to get their kids vaccinated and protected against vaccine preventable diseases.

“In today’s world, smallpox has been eradicated due to a successful vaccination program and vaccines have effectively controlled many other significant causes of morbidity and mortality. Consequently, fear has shifted from many vaccine-preventable diseases to fear of the vaccines.”

Marian Siddiqui et al on the Epidemiology of vaccine hesitancy in the United States

These vaccine-hesitant parents have become more afraid of vaccines than of the vaccine-preventable diseases that they have never seen – thanks to effective vaccine programs.

Although there have always been folks around pushing misinformation about vaccines, stoking those fears, there is no denying that vaccine scare stories in the media have played a very big role in the history of the modern anti-vaccine movement.

Vaccine Scare Stories

The media does a good job in helping vaccine controversies either get started or at least spreading to a lot of people.

In addition to helping to publicize the controversy in the first place, you are likely see false balance in their reporting, making it seem like many experts believe that these are real controversies.

“Many recent immunization programs have suffered setbacks from immunization scares. Children have been needlessly put into danger by frightened parents that refused immunization for their children after “scare stories” about particular vaccines.”

WHO on the Impact of rumours and crises

This was certainly true during the “media’s MMR hoax” surrounding Andrew Wakefield.

Why blame the media for Andrew Wakefield’s MMR scandal?

Did a case report about 12 kids really set off a panic about vaccines and autism? Of course, Wakefield deserves a lot of the blame too, but why were his papers so widely  publicized?

“Whatever you think about Andrew Wakefield, the real villains of the MMR scandal are the media.”

Ben Goldacre on The MMR story that wasn’t

Maybe because the British media didn’t learn anything after the pertussis outbreaks of the 1970s and 80s.

In 1973, Dr. John Wilson took to the media to scare parents because he had “seen too many children in whom there has been a very close association between a severe illness, with fits, unconsciousness, often focal neurological signs, and inoculation.” What followed was a drop in DPT vaccinations in many countries and vaccine lawsuits, even though his study was later found to be seriously flawed, with most having no link to the DPT vaccine.

When articles from daily and Sunday papers in Great Britain from the time were analyzed, they were found to be “irresponsible in their attitude” towards vaccines and often depicted “rare, negative events.”

In the United States, Dr. Robert Mendelsohn, one of the first celebrity, anti-vaccine pediatricians, was a frequent guest on Donahue and other talk shows during the 1970s and 80s.

And in 1982, Lea Thompson‘s anti-vaccine documentary DPT: Vaccine Roulette, helped start the modern American anti-vaccine movement.

“Many activists, like Robert Kennedy Jr., have blamed some vaccines for IQ loss, mental retardation and autism. I think that activists and lawyers may be killing people by frightening the public about vaccines. My own daughter got whooping cough after our pediatrician saw a 20/20 report that scared viewers about the whooping cough vaccine and didn’t give her the final vaccination. Fortunately, my daughter recovered, and she will appear on the program. I confront one of the lawyers about “scaring people for money.”

John Stossel 20/20 “Scared Stiff: Worry in America” (2007)

What followed were vaccine scare stories about DPT “hot lots,” vaccine injury stories on Nightline, and Jenny McCarthy on Oprah. There was also a lot of Wakefield on TV, from a 60 Minutes segment in 2000 to a long interview with Matt Lauer in 2009.

“The stories in the media have focused on anecdotal reports of adults and children who developed several different disorders after vaccination.”

Institute of Vaccine Safety Position on Hepatitis B Vaccines

What else have we seen? Stories about:

The New York Times did a report about the First Deaf Miss America, saying a reaction to a DPT shot - she didn't.
The New York Times did a report about the First Deaf Miss America, saying a reaction to a DPT shot – she didn’t. The revised story didn’t get as much attention though.
  • hepatitis B vaccine causing multiple sclerosis
  • DPT and other vaccines causing SIDS
  • the HPV vaccines causing autoimmune diseases and other side effects

Lately, the media seems to be doing a better job talking about vaccines, except for a few cases, including Katie Couric discussing the HPV vaccine on her show in 2013 and the TODAY Show letting Robert DeNiro talk about Andrew Wakefield’s anti-vaccine movie VAXXED in 2016.

Worldwide, most vaccine scare stories are limited to tabloid type papers these days. The mainstream media is finally learning about the damage false balance in reporting can cause.

CBS News, who previously had been credited with having a four year run of “extremist views of vaccines and autism,” even ran a story recently educating viewers that dozens of studies have confirmed that the HPV vaccines are safe and that “We need to do better at protecting our children from cancers they never need to get.”

Unfortunately, yesterday’s vaccine scare stories have been replaced by vaccine injury stories on Facebook and YouTube.

Are they the new fuel for the modern anti-vaccine movement? Or is it talk about choice and mandates, making parents fear that they will be forced to vaccinate their kids?

Get educated about vaccines so you don’t get scared away from vaccinating and protecting your kids.

What To Know About Vaccine Scare Stories

Vaccine scare stories in the media, fueled by anecdotal reports and false balance in their reporting, have helped scare parents away from vaccinating and protecting their kids.

More About Vaccine Scare Stories

50 Ways to Get Educated About Vaccines

A Board of Health quarantine poster warning that the premises are contaminated by smallpox.
Have you ever seen a quarantine sign for smallpox on someone’s home? That’s because Vaccines Work!

Have questions about vaccines and vaccine-preventable diseases?

Think you have done enough research already?

If that research has you asking for package inserts and requesting low aluminum vaccines, then you might need to rethink how you have been doing your research.

Get Educated About Vaccines

Vaccines are safe, effective, and necessary.

They aren’t full of toxins.

They have been tested together.

Pediatricians do know a lot about vaccines. What they may not know is how to counter every anti-vaccine argument that you might have heard of, read about, or with which one of your family members is scaring you.

“Pediatricians who routinely recommend limiting the numbers of vaccines administered at a single visit such that vaccines are administered late are providing care that deviates from the standard evidence-based schedule recommended by these bodies.”

American Academy of Pediatrics

You can rest assured that these arguments have all been debunked, often many years ago, but they keep coming up, over and over again. In fact, today’s anti-vaccine movement uses many of the same themes as folks used when the first vaccines were introduced over one hundred years ago.

50 Ways To Get Educated About Vaccines

So before deciding to skip or delay any of your child’s vaccines, do some real research about vaccines and vaccine-preventable diseases and:

  1. Understand the Pseudoscience Behind the Anti-Vaccine Movement
  2. Review the contraindications to vaccines and even more common, the things commonly misperceived as contraindications
  3. Examine the evidence for the safety of vaccines
  4. Get answers to the 9 Questions For The Pro-Vaxers
  5. Know that Vaccines Do Not Cause Autism
  6. Read about these Five Things I’ve Learned About Vaccines Through 21 Years of Parenting
  7. Learn the Tactics and Tropes of the Anti-vaccine Movement
  8. Know that kids do not get too many vaccines too soon and that vaccines don’t overwhelm your child’s immune system
  9. Understand these Vaccine Safety Basics
  10. Don’t listen to these anti-vaccine celebrities
  11. Get the details of Andrew Wakefield’s fraud
  12. Study why those Graphs That Show Vaccines Don’t Work are just propaganda
  13. Know that you can’t hide your kids in the herd to avoid disease
  14. Read why “Spacing Out” Vaccines Doesn’t Make Them Safer
  15. Wonder why parents misuse religious exemptions to excuse kids from vaccines
  16. See the evidence that Flu Shots Work for Kids Under Two
  17. Review these questions and answers on immunization and vaccine safety
  18. Learn Why My Child With Autism Is Fully Vaccinated
  19. Know that You Can Be the Pro-Life Parent of a Fully Vaccinated Child
  20. See how Having a baby doesn’t change the facts on vaccines
  21. Question Vaccine Injury Stories: the Sacred Cows of the Internet
  22. Read An Open Letter to Expecting Parents and Parents Yet-To-Be about Vaccinating
  23. Know that there is No Clear Evidence that Vaccines Cause Autism
  24. Learn from those who have Left the Anti-Vaccine Movement
  25. Understand why you’re wrong if you think the flu vax gives you the flu
  26. Avoid Cashing In On Fear: The Danger of Dr. Sears
  27. Realize that Almost All Religions Support Immunizations
  28. Learn which vaccines are the most important to get
  29. See that Unvaccinated Children Can Have Autism Too
  30. View Personal Stories of Families Affected by Vaccine-Preventable Diseases
  31. Know who is at risk if you don’t vaccinate your kids
  32. Read about the most common Misconceptions about Vaccines
  33. Review the Benefits vs. Risks of getting vaccinated
  34. Learn about the Ingredients in Vaccines
  35. Realize that vaccines are carefully monitored for safety, even after they have been approved, and it isn’t just by folks reporting side effects to VAERS
  36. Know that those 124 Research Papers Supporting the Vaccine/Autism Link Really Don’t
  37. Understand what Vaccine Package Inserts really do and don’t tell you
  38. See why the CDC Whistleblower really has no whistle to blow
  39. Know that the Vaccine Court did not say that vaccines cause autism
  40. What to consider if Deciding whether to alter the immunization schedule
  41. Learn why Shedding from Vaccines isn’t a danger to your kids
  42. Review even more Misconceptions about Immunizations
  43. Understand The Science Behind Vaccine Research and Testing
  44. Know that your Unvaccinated Child isn’t going to be Healthier than Vaccinated Kids
  45. Realize just how important the HPV vaccine really is
  46. Learn How to Respond to Inaccurate Posts about Vaccines on Social Media
  47. Know that vaccines are studied in pregnant women
  48. See the real dangers in following Jenny McCarthy’s advice
  49. Know that VAERS reports are often misused and understand that parents can report suspected adverse events to VAERS themselves
  50. Fill out a screening questionnaire for contraindications to vaccines

Still have questions? Read one or more of these Vaccine Books

And talk to your doctor about your concerns about vaccines.

Get Educated. Get Vaccinated.

More Ways To Get Educated About Vaccines

These websites and blogs will also help you get educated about vaccines and research any addition questions you might have: