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August 12, 2019

In the ongoing debate over vaccine safety, some parents forget that the real danger for their unvaccinated child is the lack of protection against serious communicable diseases. You can play an important part in helping to educate reluctant parents and encourage them to comply with the tougher vaccine laws recently passed in New York.

 
The World Health Organization (WHO) identifies vaccine hesitancy as one of the top 10 global problems today. As the measles outbreak in New York has demonstrated, when groups of people forego childhood vaccinations, they become vulnerable to getting sick and to spreading a highly contagious disease to others, including babies and people with compromised immune systems. In the case of the measles, groups of people who refused to get their children vaccinated allowed a disease that was effectively eliminated in the United States close to two decades ago to become a serious problem again. In fact, as of the summer of 2019, The Centers for Disease Control and Prevention reports there have been more than 1,100 measles cases across the U.S., with the majority of the victims residing in New York City and Rockland County, NY.

 

The Need to Comply with Tighter Vaccine Laws

This recently prompted state lawmakers to limit vaccine exemptions to people with medical reasons only, but there are still parents who resist having their children vaccinated. There are crucial steps pediatricians can take to work with families experiencing vaccine hesitancy and help them feel more comfortable, according to Jesse Hackell, MD, FAAP, a pediatrician with Pomona Pediatrics in Pomona, NY, part of Boston Children’s Health Physicians. While the process of engaging parents can be quite time consuming, Dr. Hackell says that the investment will be worth it in keeping children safe from vaccine-preventable diseases and their complications.

Strategy #1: Understand parents’ reasoning for being hesitant about vaccines

“We’ve found that simply presenting facts about vaccines isn’t effective,” says Dr. Hackell. “You need to engage parents and find out why they’re hesitating. People have different worries and concerns about vaccines. You need to first validate their concerns and then offer a pro-vaccine message.”

In many cases, parents fear stems from the idea that vaccines can cause autism, despite this myth having been debunked. Once you know why parents are worried, you can validate their concerns and slowly try to move them towards acceptance.

“I tell parents, ‘The disease is the danger, not the vaccine,’” he says. Parents need to know vaccines are safe. They are tested before being made available and continue to be tested after they are on the market.

“If we don’t keep up the vaccination rates, we run the risk of infecting susceptible people [such as babies too young to be vaccinated and kids who can’t vaccinate due to other health problems],” Dr. Hackell says.

Strategy #2: Educate parents that the disease—not the vaccine—poses the real threat to their child.

Part of the problem today with vaccine hesitant families lies in the fact that vaccines are a victim of their own success—people no longer have first-hand experience with these diseases, and don’t realize just how serious they actually can be.

“I have been practicing medicine for 38 years and don’t remember ever seeing a case of measles, but I know the dangers,” he says. “We as physicians have to keep ourselves educated. I suggest young physicians ask people who have seen diseases like measles or polio first hand” he says.

Physicians can also suggest that parents talk to older family members who have lived through measles and polio epidemics. Studies have found that hearing stories of people affected by the disease, and seeing pictures, is much more effective in changing minds than simply giving the facts.

Strategy #3: Encourage families to stick with reliable sources of information

“There is a huge amount of incorrect medical information on the internet,” Dr. Hackell says. “If you google vaccine, the first thing that comes up will be something that scares people. Vaccines save lives, but that information is further down on the search results page.” He adds “There is absolutely no proof whatsoever that the measles vaccine causes harm. In the 90s, there was a study that looked at 12 kids [and claimed the vaccine caused developmental delays], but many studies conducted with millions of kids have not confirmed that. The bad stuff is always more dramatic and therefore seems to catch people’s attention.” What’s interesting is that although parents typically report that their pediatrician is their most trusted source of health information, many still listen to celebrities and people they don’t know to make their decisions, such as in the case of having their child vaccinated. This is a huge concern.

“As the child’s pediatrician, you are the one who sees him or her regularly and has his or her health foremost in your mind.” Therefore, you should be the expert guiding parents on making safe choices.

Dr. Hackell says that it’s important to convey this fact to parents and let them know when they see something that worries them, they should contact you for a reality check and for more information.

Pediatricians should warn parents to avoid the National Vaccine Information Center. While it looks at first glance like a credible source of information, it can be very misleading for parents. Instead, point them to the American Academy of Pediatrics or other established credible resources.

Keeping Safety Goals in Mind

While most parents hesitant about vaccines can be educated to do the right thing for their child, there will always be a few hold-outs who can’t be swayed. If you have any families in your practice that simply refuse to get their children vaccinated, you have the right to dismiss them, Dr. Hackell says.

“My practice doesn’t accept people who refuse vaccines. I will work with them if they are hesitant, but if they refuse they aren’t a good fit. To dismiss them is an option that we use only as a last resort,” he says, adding that it’s still an important option because having an unvaccinated child in the practice waiting room could put other vulnerable kids at risk, too.