Overcoming parental resistance to vaccination

Many parents today are skeptical that recommended vaccinations are necessary. Data suggest that as many as 23% of parents think that children receive too many vaccinations, 29% believe that vaccines aren’t always proven safe, and 25% think that vaccination weakens the immune system.

What’s a pediatrician to do under these circumstances? Kristina Bryant, MD, FAAP, of the University of Louisville, Kentucky, speaking at the American Academy of Pediatrics National Conference and Exhibition, presented data based on reports from pediatricians that they rarely discuss vaccine risk or administer vaccinations personally, skirt issues for fear of “opening up a can of worms,” and aren’t entirely sure what their nurses tell parents about vaccines.

Instead, said Bryant, pediatricians should be following AAP recommendations, which include:

• Listening to parents’ concerns
• Taking steps to reduce the pain of injection
• Considering an alternative vaccination schedule to limit the number of injections at each visit
• Exploring cost as a potential barrier
• Documenting vaccine refusal
• And, when at all possible, avoiding discharging vaccine refusers

Other useful steps include increasing the amount of time at well child visits that vaccination is discussed, and implementing a vaccination refusal form that specifically addresses the potential consequences to the child deprived of a vaccine.

Not all resistant parents will change their mind, but Dr. Bryant recommends that providers personally explain to parents the risks and benefits, provide to-the-point written information, and project an understanding that the child is important to the parent.

Parents who are satisfied by their discussion with the pediatrician, understand vaccination as a cultural norm, have experienced positive experiences with past vaccination, and want to prevent disease are the most likely to consent to the vaccination of their child.

“The number one promoter of parents accepting vaccination is trust for the doctor,” Dr. Bryant said. “That’s important for us to remember when approaching this problem.”