Clinician-parent discussions about influenza vaccination of children and their association with vaccine acceptance

Abstract

Objective To examine how clinicians communicate with parents about influenza vaccination and the effect of these communication behaviors on parental vaccine decision-making. Study Design We performed a secondary analysis of data obtained from a cross-sectional observational study in which health supervision visits between pediatric clinicians and English-speaking parents of young children were videotaped. Eligible visits occurred during the 2011–2012 and 2013–2014 influenza seasons, included children ≥6 months, and contained an influenza vaccine discussion. A coding scheme of 10 communication behaviors was developed and applied to each visit. Associations between clinician communication behaviors and parental verbal vaccine acceptance and parental visit experience were examined using bivariate analysis and generalized linear mixed models. Results Fifty visits involving 17 clinicians from 8 practices were included in analysis. The proportion of parents who accepted influenza vaccine was higher when clinicians initiated influenza vaccine recommendations using presumptive rather than participatory formats (94% vs. 28%, p<0.001; adjusted odds ratio 48.2, 95% CI 3.5–670.5). Parental acceptance was also higher if clinicians pursued (vs. did not pursue) original recommendations when parents voiced initial resistance (80% vs. 13%, p<0.05) or made recommendations for influenza vaccine concurrent with (vs. separate from) recommendations for other vaccines due at the visit (83% vs. 33%, p<0.01). Parental visit experience did not differ significantly by clinician communication behaviors. Conclusion Presumptive initiation of influenza vaccine recommendations, pursuit in the face of resistance, and concurrent vaccine recommendations appear to increase parental acceptance of influenza vaccine without negatively affecting visit experience.

Early Childhood Vaccination Status of Preterm Infants

“…Further exploration is warranted given data demonstrating the critical importance of provider vaccine communication in pediatric populations. [44][45][46] Varied health care use patterns also could contribute to undervaccination of preterm infants. Authors of a small study from Switzerland reported that some parents of preterm infants desired a "rest" after hospital discharge.…”

Parental Vaccine Hesitancy and Declination of Influenza Vaccination Among Hospitalized Children

“…For example, they could use evidencebased approaches, such as a presumptive vaccine recommendation or motivational interviewing, for parents who are identified as vaccine hesitant. [38][39][40][41] They also could address concerns raised in response to individual survey items. In this study, the association of some PACV items (eg, recommended number of vaccines) but not other items (eg, vaccine-preventable infection severity) with influenza vaccine declination suggests that certain topics may be more relevant to parental decisionmaking about influenza vaccination during the child' s hospitalization.…”

Knowledge Base and Perceptions of Inpatient Providers and Parents About Influenza Vaccination in Hospitalized Children

“…10 Studies have shown that parental acceptance of influenza vaccine was higher when clinicians discussed vaccination using a presumptive format (presume acceptance) rather than a participatory format (parents asked questions about vaccination rather than presume that they will accept the vaccine). 11,12 Teaching providers a presumptive format to initiate a vaccine discussion will be an important step to improve vaccination during future influenza seasons. It is interesting that admission of the child to the PICU or the presence of chronic medical conditions did not have a significant impact on parental decision to vaccinate their child.…”