CAUSE FOR CONCERN
While recent reports indicate an increase in childhood immunization rates, there are still a large number of parents who refuse to have their children vaccinated, and they are looking to providers for information and advice.
With the start of the school year quickly approaching, many pediatric and family practice providers are faced with the difficult task of talking to parents about the need for childhood immunizations. Over the years, there has been an increase in concerns about the relationship between immunizations and health threats such as autism and other adverse and potentially long-term effects.
Looking out for the health of all their patients, many providers struggle to educate parents, and determine how best to handle those who refuse to have their child immunized.
Parents today gather much of their information from the media and the Internet. As such, they are often confused by conflicting information. While it may sometimes seem like an uphill battle, according to the CDC “research shows that parents’ most trusted source of vaccine information is their child’s healthcare provider.“ Having information available from reputable sources can help answer parents’ questions, and help them understand the risks involved in ignoring or delaying childhood shots.
The CDC, American Academy of Family Physicians, and American Academy of Pediatrics put together a variety of tools for healthcare providers, designed to increase communication with parents.
Key information provided through their immunization tools addresses many of the prominent questions and concerns:
- MMR Vaccine and Autism – Reputable scientific studies have found no link between MMR vaccine and autism.
- Are vaccines more dangerous than the diseases they prevent? The potential to get serious diseases as a child or adult exists when you are not vaccinated. Travelers can bring in diseases that have otherwise been eliminated in the U.S., making children susceptible to diseases such as pneumococcal meningitis, and HiB, and measles.
- Vaccine side effects – Some vaccines may cause mild temporary side effects, but the potential to get a serious disease due to not being immunized is a far greater risk.
All successful communication requires an open dialogue, and healthcare providers can connect with parents more effectively by using relevant discussion strategies.
- Actively Listen – Give parents your full attention, show that you are listening by nodding and smiling occasionally, restate their concerns, provide feedback, and defer judgment.
- Ask open-ended questions to encourage parents to talk, and let them know you want to hear and address their concerns.
- Be open to reviewing the information they gathered from the Internet, and direct them to reputable, scientific sources as appropriate.
- Acknowledge benefits and risks by openly discussing known side effects, and also the potentially serious diseases that can occur without vaccinations.
- Respect the parent’s authority. They are ultimately responsible for their child’s health. By openly listening and providing caring guidance, you can provide the most assistance.
PARENTS STILL REFUSE TO VACCINATE
Parents armed with reputable information, and sound advice from their physician may still choose not to vaccinate their child. Out of concern for other children in their practice, some pediatric providers have “fired” families who refuse immunizations. However, the CDC does not support that. “Remember, unvaccinated infants did not decide for themselves to remain unvaccinated. They need your care.”
- Practices are encouraged to remind parents to call before bringing an unvaccinated child to the office so that measures can be taken to protect others.
- Have parents sign AAP’s Refusal to Vaccinate Form so that you have a record of each refusal in the child’s medical file.
- Providing parents with informative fact sheets, Internet sites, and other reliable resources can help them learn more about immunizations, and by maintaining an open dialogue; providers may assist parents in changing their mind in the future.
“The bottom line is you should try to do whatever you can to maintain the family in the best care,” said Michael Brady, chair of the pediatrics department at Nationwide Children’s Hospital in Columbus Ohio.
“Provider Resources for Vaccine Conversations with Parents.” Includes handouts for you and your practice, and materials to share with parents. Available at: http://www.cdc.gov/vaccines/hcp/patient-ed/conversations/index.html
Centers for Disease Control and Prevention. Provider Resources for Vaccine Conversations with Parents. Retrieved August 4, 2013 from http://www.cdc.gov/vaccines/hcp/patient-ed/conversations/index.html
U.S. News & World Report. Childhood Vaccination Rates Remain High, CDC says. U.S. News & World Report. Retrieved August 4, 2013 from http://health.usnews.com/health-news/news/articles/2012/09/06/childhood-vaccination-rates-remain-high-cdc-says
Wang, S. (2012). More Doctors ‘Fire’ Vaccine Refusers. The Wall Street Journal. Retrieved August 4, 2013 from http://online.wsj.com/article/SB10001424052970203315804577209230884246636.html