Navigating vaccine discussions  

When I was a pediatrics resident, I told a patient’s mother that her child was due for vaccines. She was concerned, afraid that the vaccines would cause crying and prolonged fussiness. We discussed that they may cause temporary discomfort, but most children don’t have significant symptoms after vaccination. We also talked about how parenting is constantly weighing long-term impacts against short-term discomforts. I provided the example of telling a 16-year-old that they need to study before going out with friends. My patient’s parent agreed to vaccines and connected to the idea of prioritizing her child’s long-term safety.  

As healthcare professionals, many of us have taken care of patients who have become critically ill with vaccine-preventable diseases. The child who developed Hemophilus influenzae meningitis or the young adult with respiratory failure and influenza. These experiences underscore the importance of effective vaccine communication. But it can be challenging—many often feel stressed or anxious when talking with patients about vaccination.  

For me, it got easier when I recognized that I needed grieve for patients who suffered from a vaccine-preventable illness and then let go of these emotions when talking with patients and caregivers. When a patient or a family member is questioning a vaccine, they’re often making a statement about what’s important to themselves, such as protecting their child or not missing a day of work due to post-vaccine muscle pain. In my experience, most people who express vaccine concerns are open to a genuine conversation about vaccines and their benefits. 

When I talk with a patient or family who is hesitant about vaccination, I try to do the following: 

1. Directly recommend vaccines.

“Billy is due for his annual influenza vaccine.” The American Academy of Pediatrics recommends the “presumptive” format of vaccine recommendations. The American Academy of Pediatrics RedBook has excellent information on communicating vaccine recommendations. 

2. Acknowledge my own feelings.

It’s easy to remember patients for whom vaccination would have been lifesaving. Although I’ll never forget these patients, I try not to bring my grief for them into the conversation. 

3. Every conversation is an opportunity.

I use vaccine conversations as an opportunity to understand what is important to my patient and/or caregiver and provide them with accurate and helpful information.  

4. Be kind to myself.

If a patient or a caregiver declines vaccination, it’s easy to feel like I failed to protect my patient. I try to take a moment after these interactions to find the positives. Was I able to convey helpful information? Were we able to agree on influenza vaccination even if COVID-19 vaccination was declined? These small moments help me learn about how I can be a better doctor and better communicator.   

This piece expresses the views solely of the author. It does not necessarily represent the views of any organization, including Johns Hopkins Medicine.