Overwhelming evidence shows that immunizations are safe and effective for preventing numerous life-threatening diseases. Yet myths about vaccines persist, and some patients hesitate to vaccinate themselves and their children.
Tony Moody, MD, the chief medical officer at the Duke Human Vaccine Institute, observes that vaccine refusals typically fall into two categories: medical-based or personal freedom/autonomy concerns. Moody finds that the best way to address both types of concerns is to listen. “It needs to come down to a discussion of: What are the beliefs? What specific objections are there? Can we find common ground to discuss the specific reason for wanting to refuse that intervention?” he says.
Reminding patients about the social contract theory can also be useful. “We can start to leverage people’s experience to encourage them to think about how their actions may have implications for people who they care for,” he adds.
Natasha Burgert, MD, a pediatrician based in Kansas City, MO, notes that there is no single response to vaccine-related concerns. “It’s hard to discern if questions are coming from a place of fear or misinformation,” she says. “When people do have questions, I answer them but also ask some questions of my own.” Thus, Burgert schedules longer visits to administer a patient’s first vaccinations because she anticipates that conversations with parents will require more time.
In her practice, Burgert mainly encounters medical-based concerns from families and often fields questions regarding “vaccine shedding”—the belief that immunizations can spread the disease itself. She addresses this myth by explaining that vaccinations aren’t created with infectious particles. Rather, they use dead or weakened antigens to cause the immune system to produce antibodies against real infections. Moreover, spreading an infection to another person isn’t a risk associated with vaccinations, she explains.
Burgert and her staff also make a point to remind patients and parents before their next visit if they will be administering a vaccine so they aren’t surprised when they return. Staff also use age-appropriate pain-reduction techniques, including distraction via virtual reality headsets for older children.
Most families vaccinate, and most families are on your side, Burgert adds. “Families just want to know information,” she says. “They trust you, and it’s important to remember that we’re health care leaders and child health experts in this family’s life, and if we take the time to genuinely hear them and answer their questions honestly, then our time is rewarded.”
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