How to Communicate With Vaccine-Hesitant Parents

Healy, C. Mary; Pickering, Larry K.

doi:10.1542/peds.2010-1722s

Cited by 165 publications

(131 citation statements)

References 50 publications

(61 reference statements)

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“…This question is difficult to answer. For instance, while some have advocated that health professionals engage in dialogue with vaccine-hesitant parents, [19][20][21] relatively little is known about which messages are effective in overcoming parental reluctance to vaccinate.…”

Section: Resultsmentioning

confidence: 99%

Effective Messages in Vaccine Promotion: A Randomized Trial

et al. 2014

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OBJECTIVES: To test the effectiveness of messages designed to reduce vaccine misperceptions and increase vaccination rates for measles-mumps-rubella (MMR). METHODS: A Web-based nationally representative 2-wave survey experiment was conducted with 1759 parents age 18 years and older residing in the United States who have children in their household age 17 years or younger (conducted June–July 2011). Parents were randomly assigned to receive 1 of 4 interventions: (1) information explaining the lack of evidence that MMR causes autism from the Centers for Disease Control and Prevention; (2) textual information about the dangers of the diseases prevented by MMR from the Vaccine Information Statement; (3) images of children who have diseases prevented by the MMR vaccine; (4) a dramatic narrative about an infant who almost died of measles from a Centers for Disease Control and Prevention fact sheet; or to a control group. RESULTS: None of the interventions increased parental intent to vaccinate a future child. Refuting claims of an MMR/autism link successfully reduced misperceptions that vaccines cause autism but nonetheless decreased intent to vaccinate among parents who had the least favorable vaccine attitudes. In addition, images of sick children increased expressed belief in a vaccine/autism link and a dramatic narrative about an infant in danger increased self-reported belief in serious vaccine side effects. CONCLUSIONS: Current public health communications about vaccines may not be effective. For some parents, they may actually increase misperceptions or reduce vaccination intention. Attempts to increase concerns about communicable diseases or correct false claims about vaccines may be especially likely to be counterproductive. More study of pro-vaccine messaging is needed.

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Section: Resultsmentioning

confidence: 99%

Effective Messages in Vaccine Promotion: A Randomized Trial

et al. 2014

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“…Although the linguistic format of how a topic is introduced has received attention in other medical settings, [31][32][33][34] it has not yet been explored in the context of vaccine discussions. In fact, no previous reference on how to communicate with VHPs [35][36][37][38][39][40] includes mention of how a provider should initiate the vaccine recommendation.…”

Section: Discussionmentioning

confidence: 99%

The Architecture of Provider-Parent Vaccine Discussions at Health Supervision Visits

et al. 2013

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WHAT'S KNOWN ON THIS SUBJECT: An increasing number of parents have concerns about childhood vaccines. Parents consistently cite their child' s provider as influential in their vaccine decision-making. Little is known about how providers communicate with parents about vaccines and which communication strategies are important.WHAT THIS STUDY ADDS: How providers initiate the vaccine recommendation at health supervision visits appears to be an important determinant of parent resistance. Also, when providers pursue their original vaccine recommendations in the face of parental resistance, many parents subsequently agree to vaccination. abstract OBJECTIVE: To characterize provider-parent vaccine communication and determine the influence of specific provider communication practices on parent resistance to vaccine recommendations. METHODS:We conducted a cross-sectional observational study in which we videotaped provider-parent vaccine discussions during health supervision visits. Parents of children aged 1 to 19 months old were screened by using the Parent Attitudes about Childhood Vaccines survey. We oversampled vaccine-hesitant parents (VHPs), defined as a score $50. We developed a coding scheme of 15 communication practices and applied it to all visits. We used multivariate logistic regression to explore the association between provider communication practices and parent resistance to vaccines, controlling for parental hesitancy status and demographic and visit characteristics. RESULTS:We analyzed 111 vaccine discussions involving 16 providers from 9 practices; 50% included VHPs. Most providers (74%) initiated vaccine recommendations with presumptive (eg, "Well, we have to do some shots") rather than participatory (eg, "What do you want to do about shots?") formats. Among parents who voiced resistance to provider initiation (41%), significantly more were VHPs than non-VHPs. Parents had significantly higher odds of resisting vaccine recommendations if the provider used a participatory rather than a presumptive initiation format (adjusted odds ratio: 17.5; 95% confidence interval: 1.2-253.5). When parents resisted, 50% of providers pursued their original recommendations (eg, "He really needs these shots"), and 47% of initially resistant parents subsequently accepted recommendations when they did. CONCLUSIONS:How providers initiate and pursue vaccine recommendations is associated with parental vaccine acceptance. Pediatrics

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“…18,[106][107][108] Because health professionals are the most trusted source of information on vaccination for the majority of patients, many tools and tips have been presented to help providers in their discussions with vaccine-hesitant or vaccine-refusing patients. 20,29,33,109,110 Although the approaches presented in these articles vary, they do share some common characteristics, such as the importance of maintaining a trustworthy patient-provider relationship and the importance of tailoring the communication to specific patients' concerns and doubts. risk was only theoretical and that it was recommended to pursue vaccination during the transition period, was communicated to health professionals, "vaccine providers across the nation in fact withheld hepatitis B vaccination of newborn infants, premature or not, in a mistaken belief that they were preventing mercury poisoning of these infants."…”

Section: The Role Of Public Health and Vaccine Policiesmentioning

confidence: 99%

“…This is known as the "omission bias." 109 When looking at individual risk perception regarding vaccination, it is important to note that risk is perceived differently by lay people than by experts. 141 An epidemiological perspective of risk is based on a rational approach (or a probabilistic view) where risk is objective and measurable.…”

Section: Risk Perceptionsmentioning

confidence: 99%