Pediatricians play a powerful role in educating parents about vaccines’ importance and proven safety. The way they present the information can impact whether a vaccine-hesitant or opposed parent listens and ultimately approves or disapproves of childhood vaccines, according to Patricia Whitley-Williams, MD, president-elect of the National Foundation for Infectious Diseases and chief of the Division of Allergy. Immunology, and Infectious Diseases at Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey.
In the United States, pediatricians have done a remarkable job in immunizing children and largely have been responsible for the marked decrease in vaccine-preventable diseases in the last century, Whitley-Williams says. To help ensure that as many parents as possible vaccinate their children, the pediatrician’s communication strategy should include these important steps, she notes.
Steps to guide the conversation
First, pediatricians should present vaccines as part of normal, routine preventive care for children—not a question. The conversation might start like this at a visit at which a child is due for vaccines: “As part of your child’s one-year visit he [or she] will be receiving the [x, y, and z] vaccines. Here is information you can read about the vaccines. It’s part of a packet we give to all parents.” That’s as opposed to: “Your child is supposed to receive these vaccines today. How do you feel about that?”
If the parent objects or expresses hesitation, the pediatrician can then engage in a conversation asking about the parent’s specific concerns and addressing those.
“Some parents will be hesitant about giving measles/mumps/rubella (MMR) on time, at 12 months of age, because they’re afraid of autism. Or they just may not believe in vaccinations. Or they don’t want to be mandated to have their children vaccinated and see vaccination as an order from the government,” Whitley-Williams says. “Let’s say the parent is afraid of the adverse events or risks or thinks that vaccines are not safe. That gives the pediatrician an opportunity to speak with the parent and to make sure they are basing this on factual material and not on what they are reading off websites on the Internet.”
Among her talking points for the pediatrician: Present the facts and then point out that millions of doses of vaccines are given safely every year. Assure the parent that there is surveillance—there are several different sources or methods of how public health organizations monitor vaccine safety—even vaccines that have been around for years.
Offer resources other than from the government if parents are antigovernment. The Centers for Disease Control and Prevention (CDC) has a comprehensive website for the public and healthcare professionals (www.cdc.gov/vaccines/vpd/index.html) but there are also nongovernmental organizations such as the National Foundation for Infectious Diseases (www.nfid.org) that offer public education about vaccines. Others include the Immunization Action Coalition (immunize.org) and the website for Families Fighting Flu (www.familiesfightingflu.org.)
For parents concerned about the MMR and autism, the Institute of Medicine has extensively reviewed studies and confirmed there is no causal relationship between the MMR vaccine and autism.1,2
Educate parents about the consequences of refusing vaccines for their children, as well as for others. Measles is the perfect example of a disease that was eliminated thanks to vaccines 20 years ago, and now it’s back with a vengeance because of people choosing not to immunize.
Finally, Whitley-Williams says, pediatricians should convey the simple truth about what they do: “Pediatricians practice preventive medicine. That’s why adults exist. We try to prevent people in their childhood from getting preventable diseases that can cause health problems and even death in childhood.”
1. Institute of Medicine (US) Immunization Safety Review Committee; Stratton K, Gable A, Shetty P, McCormick M, eds. Immunization Safety Review: Measles-Mumps-Rubella Vaccine and Autism. Washington, DC: National Academies Press (US); 2001.
2. Institute of Medicine, National Academies of Science. Frequently asked questions: Measles-mumps-rubella vaccine and autism. Available at: http://www.nationalacademies.org/hmd/~/media/Files/Report Files/2003/Immunization-Safety-Review-Measles-Mumps-Rubella-Vaccine-and-Autism/MMRFAQ2pager.pdf. Published 2001. Accessed June 21, 2019.
3. Kowalzik F, Zepp F. Vaccination as a risk? Why people and their children do not get vaccinated [article in German]. Dtsch Med Wochenschr. 2019;144(4):254-261.