Mean business when discussing vaccines

A new study has found that if you assume parents will cooperate when it comes to vaccinating their children, many will, whereas if you appear to give them a choice, many more won’t.

Researchers from Washington, California, and Oregon found that a presumptive approach (one that assumes participation) on the part of health care providers when discussing vaccines with parents is associated with greater parental acceptance of shots than a participatory one (one that asks whether they will participate).

In their cross-sectional observational study, investigators studied 111 videotaped vaccine discussions between health care providers and parents of children aged 1 to 19 months. The videos involved 16 providers from 9 different practices. Half the videos involved “vaccine-hesitant parents (VHPs),” or parents who scored at least 50 on the Parent Attitudes about Childhood Vaccines survey.

Three-quarters of the providers used a presumptive approach, saying something like, “Well, we have to do some shots,” while about one-quarter used a more participatory tone (eg, “What do you want to do about shots?”).

The investigators found that parents were about 17 times more likely to resist vaccine recommendations when the provider used a participatory approach, rather than a presumptive one,. Of the 41% of parents who voiced initial resistance to the provider’s vaccine recommendations, significantly more were VHPs than non-VHPs.

When parents initially demonstrated resistance, about half of providers dug in their heels and reiterated the importance of the vaccines (eg, “He really needs these shots”), at which point about half of the parents relented and accepted the provider’s recommendations.

For more information about how to speak with parents about vaccines, see the American Academy of Pediatrics’ “Communicating with Families” web page.

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