Addressing parental vaccine concerns: AAP provides guidance for clinicians

An AAP report addresses the concerns of parents who are hesitant about their children’s vaccination.
An AAP report addresses the concerns of parents who are hesitant about their children’s vaccination.

A clinical report published in Pediatrics outlines information regarding parental concerns of vaccination and found that many parents who are hesitant about vaccinations may have questions that could be answered by their clinician.

The American Academy of Pediatrics published the report to help pediatricians discuss the misconceptions about vaccines with parents. “The pediatrician is often the only medically trained person available to discuss vaccine matters with parents, and it is incumbent on him or her to provide scientifically based and balanced information when these questions are asked,” stated the authors of the report.

 

The researchers note that vaccines are tested in 3 phases of trials, and there are monitoring systems in place, such as the Vaccine Adverse Events Reporting System (VAERS), that detect adverse events associated with vaccines. In addition, the Vaccine Safety Datalink monitors vaccine safety in millions of individuals through a network of health provider databases that contain information about the administration of vaccines.

According to the report, the percentage of immunized individuals required to achieve herd immunity can range between 30% and 95%. Therefore, children who have not received immunization can put vaccinated children and children who are medically exempt from vaccination who live in the same area at risk.

Results from the 2009 HealthStyles survey found that 44% of parents had concerns over pain associated with multiple injections in a single visit, 34% had concerns about receiving multiple vaccines in a single visit, 26% were concerned about the development of autism after receiving vaccines, 13.5% were concerned about vaccines being associated with chronic illness, and 13.2% believed that vaccines were not tested enough to be safe to administer.

Pediatricians can help to reassure parents of their concerns about the production of the vaccine by directly providing the information, and pediatricians can use strategies to reduce pain while administering vaccines, such as holding the child upright or by providing tactile stimulation.

The most important factor in convincing parents to accept vaccinations is individual contact with an informed clinician. Pediatricians should clearly articulate to parents that vaccines are safe and effective and emphasize that children can be exposed to serious disease without immunization.

The authors of the report emphasize the importance of remaining up to date on the current recommended vaccine schedule. No alternative vaccine schedule has been found to be more safe or effective than the recommended schedule, supported by the CDC's Advisory Committee on Immunization Practices.

Another technique that pediatricians can use to help address parental concerns is to tell stories and anecdotes about the successes of vaccines to personalize the message. Clinicians can also have parents verbalize their concerns and give a focused response to personalize the communication.

There is currently no evidence regarding the outcomes of practices that dismiss patients who refuse vaccination. However, anecdotal evidence has shown that when other methods have failed, some parents who are given the choice between immunizing their child or being dismissed will choose to immunize their child.

“Providing vaccine-related information before the first immunization visit may permit parents to clearly formulate their concerns so that they can be fully addressed by the pediatrician,” the authors concluded. “Most parents need and want education about the best way to provide care for their children, including vaccinations. Dealing with vaccine hesitancy is a wonderful opportunity to continue to provide this information and education to families.”

Reference

  1. Edwards KM, Hackell JM; The Committee on Infectious Diseases, The Committee on Practice and Ambulatory Medicine. Countering vaccine hesitancy. Pediatrics. 2016;138(3). doi: 10.1542/peds.2016-2146.
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