Tag: vaccine hesitancy

Immunization Workshops and Conferences

Can’t make it to an immunization workshop or conference?

You could have learned about the Immunity Community and much more if you had attended the 47th National Immunization Conference.
You could have learned about the Immunity Community and much more if you had attended the 47th National Immunization Conference.

They are a great way to get educated about vaccines.

Immunization Workshops and Conferences

In addition to seeing future immunization workshops and conferences that you might be interested in attending, here are many archived workshop videos, presentations, slides, and posters that you can watch and read online:

Have you been to an immunization conference this year?

What to Know About Immunization Workshops and Conferences

Immunization conferences are a great way to learn about childhood and adolescent immunizations, vaccine preventable diseases, implementing appropriate immunization communication strategies, and addressing vaccine hesitancy.

More on Immunization Workshops and Conferences

We Don’t Know How To Talk About Vaccines

There is a dirty little secret about vaccines that people don’t seem to like to talk about.

No, it’s not about toxins or autism.

“Our systematic review did not reveal any convincing evidence on effective interventions to address parental vaccine hesitancy and refusal. We found a large number of studies that evaluated interventions for increasing immunization coverage rates such as the use of reminder/recall systems, parent, community-wide, and provider-based education and incentives as well as the effect of government and school immunization policies.

However, very few intervention studies measured outcomes linked to vaccine refusal such as vaccination rates in refusing parents, intent to vaccinate, or change in attitudes toward vaccines.

Most of the studies included in the analysis were observational studies that were either under-powered or provided indirect evidence.”

Sadaf et al on A systematic review of interventions for reducing parental vaccine refusal and vaccine hesitancy

It’s that we don’t really know how to talk about vaccines to vaccine hesitant parents, at least not in a way that we know will consistently get them to vaccinate and protect their kids.

Understanding Studies About Vaccine Hesitancy

Sure, a lot of studies have been done about talking to vaccine hesitant parents.

We have all seen the headlines:

  • Study: You Can’t Change an Anti-Vaxxer’s Mind
  • Pro-vaccine messages can boost belief in MMR myths, study shows
  • UWA study shows attacking alternative medicines is not the answer to get parents to vaccinate kids
  • Training Doctors To Talk About Vaccines Fails To Sway Parents

Does that mean that you shouldn’t try to talk to vaccine hesitant parents?

Of course not.

“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 understand that these headlines are usually about small studies, which if they were about treating a child with asthma or strep throat,  likely wouldn’t change how you do things.

Why do anti-vaccine websites still post misinformation about fake recommendations to stop breastfeeding?
Why do people continue to believe misinformation about fake recommendations to stop breastfeeding?

In one study that concluded that “physician-targeted communication intervention did not reduce maternal vaccine hesitancy or improve physician self-efficacy,” the physicians got a total of 45 minutes of training!

So they shouldn’t have so much influence about how you might talk to parents about vaccines that you throw up your hands at the thought of talking to a vaccine hesitant parent and won’t even think about learning how to use the CASE method, why presumptive language might work, or about vaccination-focused motivational interviewing techniques.

The bottom line is that no matter what the headlines say, we just haven’t found the best way to talk to vaccine-hesitant parents and help them overcome their cognitive biases. And until more studies are done, none of the existing studies about anti-vaccine myth-busting should likely overly influence how you do things.

“Physicians should aim for both parental satisfaction and a positive decision to vaccinate. Researchers must continue to develop conceptually clear, evidence-informed, and practically implementable approaches to parental vaccine hesitancy, and agencies need to commit to supporting the evidence base. Billions of dollars fund the research and development of vaccines to ensure their efficacy and safety. There needs to be a proportional commitment to the “R&D” of vaccine acceptance because vaccines are only effective if people willingly take them up.”

Leask et al on Physician Communication With Vaccine-Hesitant Parents: The Start, Not the End, of the Story

If you spend any time talking to vaccine hesitant parents, especially those who are on the fence, you quickly learn that many are eager to get good information about vaccines and all want to do what is best for their kids.

It’s just hard for many of them to do what is best when their decisions are getting influenced by vaccine scare videos and many of the 100s of myths about vaccines that are out there.

“…while the drivers of vaccine hesitancy are well documented, effective intervention strategies for addressing the issue are sorely lacking. Here, we argue that this may be because existing strategies have been guided more by intuition than by insights from psychology and by the erroneous assumption that humans act rationally.”

Rossen et al on Going with the Grain of Cognition: Applying Insights from Psychology to Build Support for Childhood Vaccination

So while we need more studies on the best ways to talk to vaccine hesitant parents, don’t dismiss all of the ways that might be effective, such as:

It is also important to become familiar with the myths and anti-vaccine talking points that may be scaring your patients away from getting vaccinated on time.

Why is this important?

If a parent is concerned about glyphosate, you might not sound too convincing telling them not to worry if you don’t even know what glyphosate is.

What to Know About Vaccine Hesitancy Studies

While we learn better ways to talk about vaccines, so that vaccine-hesitant parents can more easily understand that vaccines are safe and necessary, don’t dismiss current strategies because of small studies and attention grabbing headlines.

More on Vaccine Hesitancy Studies

 

What Is Cherry Picking?

Everyone has heard of cherry picking.

If you are talking about vaccines, this probably isn’t that kind of cherry picking though.

What Is Cherry Picking?

Have you ever been to a cherry orchard?

“Pick only the cherries that are fully red (or whatever color they are supposed to be when ripe!). Part the leaves with your hands to look for hidden cherries ready for harvest.”

Cherry Picking Tips and Facts

Cherries don’t continue to ripen off the tree, so you want to pick them at exactly the right time. Not too early and not too late.

So when you go cherry picking, you are looking for the perfect cherries.

That’s what folks do when they go cherry picking for just the right information to fit their beliefs, but ignore any and all other information that might prove them wrong.

“Whatever one might think about Andrew Wakefield, he was just one man: the MMR autism scare has been driven for a decade now by a media that over-emphasises marginal views, misrepresenting and cherry picking research data to suit its cause. As the Observer scandal makes clear, there is no sign that this will stop.”

Ben Goldacre on MMR: the scare stories are back

It shouldn’t come as a surprise that most anti-vaccine folks are very good at cherry picking.

A cherry picker isn't going to save you from a bad argument.
D’oh! A cherry picker isn’t going to save you from a bad argument.

Someone is cherry picking when they:

  • uses only one or a few out-of-context quotes that seem to support their argument, but ignores the rest of the article or study that doesn’t
  • talks about the one study that supports their position, but ‘forgets’ to mention the ten that don’t
  • mentions a few years of data that support their argument, but leave out the years that don’t

Need a good example?

Have you ever heard someone say that the package insert for Tripedia vaccine proves a link to autism?

SIDS and autism are listed in Tripedia package insert, but are not causally linked to the vaccine.
SIDS and autism are listed in Tripedia package insert, but are not causally linked to the vaccine.

This is classic cherry picking because they are ignoring all of the other information in the package insert, all of the other package inserts that don’t list autism as an adverse reaction, and all of the other evidence that autism is not associated with vaccines! It is also a bad argument against vaccines because they don’t explain why it is in the package insert.

How can you easily spot when someone is cherry picking?

You have to get educated and do your own research.

What to Know About Cherry Picking

Cherry picking occurs when someone chooses to use just the right information to fit their beliefs, but ignores any and all other information that might prove them wrong.

More on Cherry Picking

Vaccine Injury Stories That Scare Parents

It is not uncommon to hear about parents having ‘panic attacks’ over the idea of vaccinating their kids.

“…many parents are inundated with horror stories of vaccine dangers, all designed to eat away at them emotionally while the medical and scientific communities have mounted their characteristic response by sharing the facts, the data, and all of the reliable peer-reviewed and well-cited research to show that vaccines are safe and effective.”

Federman on Understanding Vaccines: A Public Imperative

Or simply becoming anxious over an upcoming appointment for routine immunizations or to get caught up on vaccines.

What’s fueling all of this anxiety?

Vaccine Injury Stories That Scare Parents

Some of it is likely from the vaccine injury stories that they read  or videos they watch.

As parents get better at spotting the myths and misinformation behind the anti-vaccine movement, we are seeing more and more vaccine injury stories pop up to scare them.

“…recognizes the importance of examples—testimonials and stories—that are the lifeblood of vaccine-hesitant beliefs.”

Nathan Rodriguez on Vaccine-Hesitant Justifications

Vaccine injury stories aren’t new though.

These types of anecdotal stories were very popular when folks used to think that the DPT vaccine was causing a lot of side effects. It wasn’t though. And it was soon proven that the DPT vaccine didn’t cause SIDS, encephalitis, non-febrile seizures, and many other things it was supposed to have caused.

“Anecdotes – about a new miracle cure, a drug that is not being made available on the NHS, or the side effects of treatment, or some environmental hazard – sell product. Data, on the other hand, which take us towards the truth about these things, are less popular. Anecdotes, however many times they are multiplied, do not point the way to reliable knowledge. As the aphorism says, “The plural of anecdote is not data”.”

Raymond Tallis on Anecdotes, data and the curse of the media case study.

That anecdotes “sell” better than data may be one reason why you see them so often on anti-vaccine websites. Another is that they simply don’t have any good data to use as evidence!

Are Vaccine Injury Stories True?

Vaccines are not 100% safe, so there is no doubt that some vaccine injury stories are true.

There is also no doubt that what many people perceive to be vaccine injuries have actually been proven to not be caused by vaccines, from allergies and eczema to autism and MS.

“In the absence of a specific etiology for ASDs, and a tendency among parents of children with a disability to feel a strong sense of guilt, it is not surprising that parents attempt to form their own explanations for the disorder in order to cope with the diagnosis.”

Mercer et al on Parental perspectives on the causes of an autism spectrum disorder in their children

Also keep in mind that in addition to the many so-called vaccine induced diseases, there are many historical vaccine injury stories that have been shown to be untrue:

  • the first deaf Miss America did not have a vaccine injury
  • Johnnie Kinnear supposedly began having seizures 7 hours after getting a DPT vaccine, when he was 14-months-old, but medical records actually shown that his seizures started 5 months after he received his vaccines
  • Dravet syndrome now explains many severe seizures associated with vaccinations

And at least one of Wakefield’s own followers – a mother who claimed that the MMR vaccine caused her son’s autism, was “dismissed as a manipulative liar” by a court in the UK.

Vaccine Injury Stories are Dangerous

Do vaccine injury stories have a purpose? They might help a parent cope with a diagnosis in the short term, but vaccine injury stories are dangerous in so many ways.

We have seen how they create anxiety for many parents, which can scare them away from vaccinating and protecting their kids from life-threatening vaccine-preventable diseases.

What else can they do?

Driving a wedge between parents and pediatricians does not help autistic kids.
Driving a wedge between parents and pediatricians does not help autistic kids.

They can certainly build up mistrust towards pediatricians and other health professionals. That is one way that the anti-vaccine movement continues to hurt autistic families. They also can lead parents to think that their “vaccine injured” child is “damaged” in some way.

And they push parents towards dangerous, unproven, unnecessary, and expensive alternative treatments. It shouldn’t be a surprise that many of the sites and forums that push vaccine injury stories also promote a lot of dangerous advice.

From recommending goat milk for your baby and skipping your baby’s vitamin K shot to various kinds of detoxing “treatments,” these are not the folks you want to trust with the health of your child.

What to Know About Vaccine Injury Stories

Vaccine injury stories prey on the fears of parents, help drive a wedge between them and their pediatricians, and are considered by many experts to be the lifeblood of the anti-vaccine movement.

More on Vaccine Injury Stories

Expert Statements on Vaccines

The AAP published their first recommendations on vaccines in 1938.
The AAP published their first recommendations on vaccines in 1938.

Some parents are still confused about who they should listen to for advice about vaccines.

Is there really a controversy or a real debate going on about whether or not getting vaccinated is a good decision?

What do the experts say?

They say that:

And no, it’s not just one or two of them…

“Vaccines protect the health of children and adults and save lives. They prevent life – threatening diseases, including forms of cancer. Vaccines have been part of the fabric of our society for decades and are one of the most significant medical innovations of our time.”

More than 350 medical, professional and advocacy organizations in a 2017 letter to President Trump

It is the hundreds of thousands of experts at every major health organization around the world!

American Academy of Pediatrics

The American Academy of Pediatrics, an organization of 66,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists, has long advocated for the health and safety of our children.

“Vaccines are safe. Vaccines are effective. Vaccines save lives.

Claims that vaccines are linked to autism, or are unsafe when administered according to the recommended schedule, have been disproven by a robust body of medical literature. Delaying vaccines only leaves a child at risk of disease. Vaccines keep communities healthy, and protect some of the most vulnerable in our society, including the elderly, and children who are too young to be vaccinated or have compromised immune systems.”

Fernando Stein, MD, FAAP, President and Karen Remley, MD, MBA, MPH, FAAP, CEO/Executive Vice President, American Academy of Pediatrics

Vaccine friendly pediatricians who are pushing non-standard, parent-selected, delayed protection vaccine schedules are leaving kids at risk for vaccine-preventable diseases.

“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.”

AAP on Countering Vaccine Hesitancy

Vaccines are necessary.

“Because rare medically recognized contraindications for specific individuals to receive specific vaccines exist, legitimate medical exemptions to immunization requirements are important to observe. However, nonmedical exemptions to immunization requirements are problematic because of medical, public health, and ethical reasons and create unnecessary risk to both individual people and communities.”

AAP on Medical Versus Nonmedical Immunization Exemptions for Child Care and School Attendance

Society of Pediatric Nurses

“Immunizations are safe and effective in promoting health and preventing disease.”

SPN Position Statement on Immunizations

National Association of Pediatric Nurse Practitioners

Established in 1973, with more than 8,500 members, the National Association of Pediatric Nurse Practitioners (NAPNAP) is the professional association for pediatric nurse practitioners (PNPs) and all pediatric-focused advanced practice registered nurses (APRNs).

“NAPNAP supports the prioritization of immunization education for parents, guardians and other caregivers of infants, children, and adolescents. This education must include the most current scientific evidence related to vaccine safety, risk, benefits and current resources available to ensure that parents and caregivers receive adequate information about immunizations. This includes, when necessary, relaying the risk of not immunizing their child and potential devastation that can occur when a child is infected with a vaccine-preventable disease. It is incumbent that a PNP also be aware of misinformation in the public domain and provides the correct information to the public as well as the health care community.”

NAPNAP Position Statement on Immunizations

American College of Preventive Medicine

“Vaccine-preventable diseases were a major cause of mortality and morbidity in the United States in the 20th century. With the advent of immunizations, there have been dramatic rates of decline in these diseases. Clinical studies have shown vaccines to be efficacious and cost effective.  ”

ACPM on Childhood Immunizations

American College of Obstetricians and Gynecologists

Founded in 1951, the American College of Obstetricians and Gynecologists (The College) represents more than 58,000 members.

“Health care providers and patients should be aware that the reassuring safety data for use of the aforementioned vaccines in pregnancy are compelling, and there is no link to vaccine administration and miscarriage. An added benefit to immunizing during pregnancy is the potential for disease prevention in newborns by way of passive antibody transfer to the fetus. Hence, offering pregnant patients influenza and Tdap vaccines is an avenue to protect newborn infants at a critically vulnerable time and before neonates can be vaccinated.”

ACOG on Immunization for Pregnant Women

American Public Health Association

The American Public Health Association was founded in 1872, the APHA represents over 25,000 public health professionals.

“And further noting that the Institute of Medicine has recently released a report10 describing the U.S. immunization system as “a national treasure that is too often taken for granted” and calling for substantial increases in federal and state allocation of funds to support immunization infrastructure; therefore

Reaffirms its support for immunization as one of the most cost-effective means of preventing infectious diseases;”

APHA on The Need for Continued and Strengthened Support for Immunization Programs

American Medical Association

The American Medical Association, which was founded in 1847, has just over 240,000 members.

“The AMA fully supports the overwhelming body of evidence and rigorous scientific process used by the Advisory Committee on Immunization Practices which demonstrate vaccines are among the most effective and safest interventions to both prevent individual illness and protect the health of the public.”

William E. Kobler, MD, member of the AMA Board of Trustees.

Immune Deficiency Foundation

“The development of immunizations for common bacterial and viral infections has represented a major advance in the battle against microbial organisms that constantly threaten the welfare of humankind and particularly the pediatric population. However, the alarming increase in nonimmunized persons could lead to a return of the epidemics seen in the past.

…critical need for maintenance of herd immunity in the population at large. It is particularly important for family members of patients with defective T and B lymphocyte–mediated immunity to receive all of the available standard immunizations (excluding live poliovirus).”

Medical Advisory Committee of the Immune Deficiency Foundation on Recommendations for live viral and bacterial vaccines in immunodeficient patients and their close contacts

American Nurses Association

The American Nurses Association (ANA), founded in 1896, represents “the interests of the nation’s 3.6 million registered nurses.”

“To protect the health of the public, all individuals should be immunized against vaccine-preventable diseases according to the best and most current evidence outlined by the Centers for Disease Control and Prevention (CDC) and the Advisory Committee on Immunization Practices (ACIP). All health care personnel (HCP), including registered nurses (RNs), should be vaccinated according to current recommendations for immunization of HCP by the CDC and Association for Professionals in Infection Control and Epidemiology (APIC).

As stated in the Code of Ethics for Nurses (ANA, 2015, p. 19), RNs have an ethical responsibility to “model the same health maintenance and health promotion measures that they teach and research…,” which includes immunization against vaccine-preventable diseases.”

ANA Position Statement on Immunizations

Autism Science Foundation

“Multiple studies have been completed which investigated the measles, mumps and rubella vaccination in relation to autism. Researchers have also studied thimerosal, a mercury-based preservative, to see if it had any relation to autism. The results of studies are very clear; the data show no relationship between vaccines and autism.”

Autism Science Foundation on Vaccines and Autism

The American Association of Immunologists

The American Association of Immunologists (AAI) is the largest professional association of immunologists in the world, representing more than 7,600 basic and clinical immunologists.

“Recent outbreaks have brought increased attention to vaccine- preventable diseases and have highlighted the need for robust and timely immunization to reduce preventable sicknesses and deaths. AAI strongly urges full adherence to recommended vaccination schedules and views vaccines as efficacious for individuals and crucial to public health.

Research has repeatedly confirmed that vaccinations are safe and highly effective for all healthy children and adults, and any suggestions to the contrary have been discredited. Ongoing vaccine research continually reaffirms its safety and efficacy, including the number of vaccines administered at any one time and the recommended vaccination schedule.”

The American Association of Immunologists Statement on Vaccines

American Osteopathic Association

“The American Osteopathic Association supports the Centers for Disease Control and Prevention in its efforts to achieve a high compliance rate among infants, children and adults by encouraging osteopathic physicians to immunize patients of all ages when appropriate ; supports the HHS National Vaccine Implementation Plan; and encourages third- party payers to reimburse for vaccines and their administration.”

AOA on Immunizations

National Association of School Nurses

#TodaysSchoolNurse is “grounded in ethical and evidence-based practice, are the leaders who bridge health care and education, provide care coordination, advocate for quality student-centered care, and collaborate to design systems that allow individuals and communities to develop their full potential.”

“It is the position of the National Association of School Nurses (NASN) that immunizations are essential to primary prevention of disease from infancy through adulthood.

The school nurse is well-poised to create awareness and influence action to increase the uptake of mandated and recommended immunizations. The school nurse should use evidence-based immunization strategies, such as school-located vaccination clinics, reminders about vaccine schedules, state immunization information systems (IIS), strong vaccination recommendations, and vaccine education for students, staff, and families.”

NASN Immunizations Policy Statement

American Academy of Family Practice

“With the exception of policies which allow for refusal due to a documented allergy or medical contraindication, the AAFP does not support immunization exemption policies.”

AAFP Immunization Policy Statement

American Academy of Allergy, Asthma & Immunology

The American Academy of Allergy, Asthma & Immunology (AAAAI) is a professional organization with over 7,000 members, including allergists/ immunologists, in the United States and 73 other countries.

“Immunization is perhaps the greatest public health achievement of all time, having significantly reduced the morbidity and mortality of many infectious diseases. Routine immunization of children, adolescents, and adults provides substantial protection from a large number of infectious diseases…

Patients who have experienced adverse reactions to vaccines might unnecessarily be advised to avoid subsequent immunization, which could have important adverse personal and population health consequences. Although there are some adverse reactions to vaccines that constitute absolute contraindications to administration of future doses, most such reactions do not preclude subsequent immunization. Patients who have experienced an apparent allergic or other serious adverse reaction after receiving a vaccine warrant evaluation by an allergist/immunologist. Also, patients with preexisting health conditions that might predispose to adverse reactions to vaccines could benefit from such an evaluation. In most cases, a risk-benefit analysis will favor subsequent immunization.”

AAAAI Practice Paramater on Adverse Reactions to Vaccines

CJ First Candle

“There seems to be a common misconception that vaccines are somehow associated with SIDS deaths. This is not true! Experts warn that the risk of leaving your baby unprotected is 1,000 times greater than any increased risk for SIDS. Because infants receive many immunizations during the critical development period from two to six months of age, and 90 percent of SIDS deaths occur within this time frame, it is only logical that many SIDS victims have recently received vaccines. This does not mean that the immunization had anything to do with the infant’s subsequent sudden and unexpected death. The cause and effect of immunizations and SIDS has been comprehensively studied for more than two decades. In fact, in countries where immunization schedules are different from those in the United States, the peak incidence of SIDS is still between two to four months.”

CJ First Candle on Immunizations

Infectious Disease Society of America

Founded in 1963, the Infectious Diseases Society of America (IDSA), with over 9,000 members, represents physicians, scientists and other health care professionals who specialize in infectious diseases.

“The Infectious Diseases Society of America (IDSA) recognizes the great benefits that vaccines provide for the public health. Substantial scientific evidence demonstrates vaccines’ enormous value in protecting individuals and populations from serious and life-threatening infections. Scientific evidence also demonstrates the overall safety of vaccines. Communities are most effectively protected when all are immunized.

Studies demonstrate that the easier it is to receive an exemption, the higher the rate of exemptions in a particular state. As the number of exemptions increases, the risk of vaccine – preventable disease increases. Therefore, states must make every effort to minimize the number of its citizens exempted from immunization mandates. Such exemptions make the state legislatures who grant them, as well as the individuals who receive them, responsible for placing the remaining state population at greater risk of acquiring potentially fatal infections.”

IDSA Policy Statement on State Immunization Mandates

The Arc of the United States

“Prior to widespread immunization in the United States, infectious diseases killed or disabled thousands of children each year. The near elimination of intellectual disability due to measles encephalitis, congenital rubella syndrome, and Haemophilus influenzae type b meningitis or Hib can be contributed to vaccines.”

The Arc Facts About Childhood Immunizations

American College Health Association

“The American College Health Association (ACHA) strongly supports the use of vaccines to protect the health of our individual students and our campus communities. In recognition of the vital role that vaccine coverage plays in community immunity (herd immunity), ACHA discourages use of nonmedical exemptions to required vaccines.”

ACHA on Immunization Recommendations for College Students

What to Know About Expert Statements on Vaccines

Over the years, hundreds of organizations representing millions of families, health care providers, researchers, patients, and consumers,  have repeatedly expressed their unequivocal support for vaccines, because they understand that vaccines work and that they are safe and necessary.

More on Expert Statements on Vaccines

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