Back-to-school visits offer opportunity to revisit vaccine conversations with families

Back-to-school visits can provide pediatricians with a timely opportunity to revisit vaccine conversations, particularly with families who previously had questions or declined recommended immunizations, according to Lori Handy, MD, MSCE, associate director of the Vaccine Education Center at Children's Hospital of Philadelphia and a pediatric infectious disease physician.

Rather than repeating previous discussions, Handy recommends framing vaccination around a child's changing circumstances as they enter school or return to the classroom. She also encourages pediatricians to recognize that families increasingly arrive at appointments with vaccine information gathered online and to use those conversations as an opportunity to maintain trust and direct parents toward reliable information.

How can pediatricians revisit vaccines during back-to-school visits?

For children entering kindergarten or returning to school, Handy said clinicians can connect vaccination with the new exposures children may encounter.

"I think that the first thing that's a really great opportunity for providers is to recognize that going back to school or starting school for a kindergartner is a new opportunity to talk about vaccines a little bit differently," Handy said.

Rather than approaching the discussion as a continuation of a disagreement, pediatricians can acknowledge previous conversations while explaining why school attendance changes the context.

"It's the chance to say, I know we've had these conversations before, but I'm thinking differently about the risk for your child going back to school, can we jump back into those conversations?" Handy said. "So, it is a really nice time to kind of recenter on your child doing something new in their life and make sure they're protected while they do that."

How should pediatricians communicate vaccine recommendations?

Handy emphasized that pediatricians should make their recommendation clear rather than simply presenting vaccination as one of several options.

"It's important to have a conversation, but to lead into that conversation saying, ‘I really strongly recommend that your child gets this vaccine before school to keep them protected from infections like whooping cough or pneumonia or chickenpox,’" she said.

She also recommends discussing the disease a vaccine prevents instead of relying on vaccine abbreviations that may be unfamiliar to families.

"I'm naming the infection, right? The thing that the child could get sick with, not really going to alphabet soup of, you know, make sure we're up on our DTaP because those alphabet soup vaccine names don't mean that much to families," Handy said.

Listening is another important component. Pediatricians should ask what families have recently heard and identify the question most important to them.

"If we don't address their biggest question, we can kind of do all the talking in the world, but we have to really focus on what they want to know about," she said.

How can pediatricians respond to vaccine information families find online?

Handy said clinicians should recognize that searching online for health information is a common behavior rather than immediately viewing it as resistance to medical advice.

"They've seen a lot, they've done some work to try to get an answer to their questions because maybe it's been a year since they've had an appointment with a health care provider," she said. "So, just recognize, you know, that information seeking comes from a really good place."

When a parent raises a claim that is not supported by evidence, Handy recommends first acknowledging that the question is common before introducing additional information.

"I'll usually say something like, A lot of families have asked me that, or, I wondered that myself," she said. "But then make sure you're able to transition into saying, I heard that so much, I kind of did a little more digging myself. Can I share what I found?"

She noted that a parent's willingness to raise these concerns may itself signal trust.

"If they're coming to you and engaging with this topic, it's because they trust you. It's because they want to engage with you," Handy said.

Should pediatricians steer families away from social media?

Handy said clinicians may need to reconsider automatically directing families away from platforms such as TikTok or Instagram.

"If you have a family that very much says, I get my healthcare information from TikTok or Instagram or some other social media platform, that's okay," she said. "We just have to help them find some more accounts that get them good information."

Instead of insisting that every family use a website or printed handout, Handy recommends matching educational resources to how parents prefer to consume information.

"If the family doesn't like handouts, don't give them a handout," she said. "Give them information in the form they want it."

For pediatricians, Handy's approach centers the back-to-school vaccine conversation on clear recommendations, listening to families' concerns, and helping parents find reliable information in formats they are likely to use.