When the answer to vaccines is “No”

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Applied Evidence

When the answer to vaccines is “No”

J Fam Pract. 2018 June;67(6):348-351,359-364

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From The Journal of Family Practice | 2018;67(6):348-351,359-364.

References

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Barriers to counseling. Health care providers report a variety of barriers to effective vaccine counseling (limited time and resources, lack of confidence in addressing patients’ concerns, etc).³ In addition, providers sometimes worry that strong encouragement of vaccination will create an adversarial relationship with vaccine-hesitant patients. Developing a good rapport and trusting relationship, as well as using motivational interviewing approaches, can help communicate the importance of vaccines, while leaving patients with the sense that you have heard them and respect their intentions. (See “Facilitate vaccine discussions using these 2 approaches.”^4-7)

SIDEBAR
Facilitate vaccine discussions using these 2 approaches^4-7

C.A.S.E.

Corroborate
Acknowledge concerns and find some point on which you can agree.

Example: "It sounds like we both want to keep your child healthy and safe."

About me
Describe what you have done to build your expertise on the subject.

Example: "I have been practicing medicine for 15 years and have spent a great deal of time researching the data on vaccinations."

Science
Review the data and science behind vaccines.

Example: "Vaccines are more rigorously studied and safer than almost any other intervention we have in medicine."

Explain/advise
Explain your recommendations, based on the science.

Example: "This is why I vaccinate my children, and this is why I recommend this vaccine for your child."

3As

Ask
Don't stop at a patient's first "No." Respectfully dig a bit deeper.

Example: "What questions do you have about the vaccines we are recommending today? Tell me what worries you about them."

Acknowledge
Acknowledge your patient's concerns.

Example: "You are obviously a very devoted parent, and I know that you are trying to make the best decision you can for your child. With everything we see on the news and social media, it's not always easy to know what to believe about vaccines."

Advise
Advise patients/parents of the facts about vaccines and provide a strong recommendation to vaccinate.

Example: "Depending on the year, influenza kills 12,000 to 56,000 people annually; the vast majority of those who die did not receive the flu vaccine.⁷My family and I get the flu shot every year, and I strongly encourage you and your children to get this lifesaving vaccine."

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