Takeaway
When discussing vaccines with patients, start with curiosity. Try saying, “Tell me more about what you’re thinking” to discover their specific concerns.
Lifelong Learning in Clinical Excellence | October 10, 2025 | 2 min read
By Brandon Smith, MD, Johns Hopkins Medicine
“All of that sounds good . . . except for the flu shot.” “Nah, we aren’t doing vaccines today.” “We don’t do the COVID vaccine.”
Voices emanate from the exam room and circle in my head. As a primary care pediatrician, I’m here to provide recommendations for picky eating, asthma, difficulties in school, and much more. I’m also here to recommend vaccinations to prevent serious infections in children. When speaking with parents who are hesitant of vaccines, I need to take a few small steps to meet them where they’re standing.
In the age of misinformation and vaccine hesitancy, this scenario is all of us. Obstetricians are monitoring high risk pregnancies and discussing the importance of the new respiratory syncytial virus (RSV) vaccine to protect newborns. Emergency medicine physicians are caring for trauma-related injuries and counseling about the tetanus shot. Increasingly, all healthcare professionals are confronted with patients and caregivers skeptical of vaccines.
To provide the best care possible, we need to meet patients and families where they’re at. It’s something that we’re already used to doing every patient encounter. We listen to history, perform the exam, and make a recommendation. The family listens and appraises that information, and then makes a decision—which may or may not align with our recommendation.
Opportunity lies in that gap. We can all take the time to inquire about what’s missing the mark and what more can we share to best understand our patients’ and families’ motivations. We become trusted sources of information through honest conversations, open dialogue, and transparent recommendations. We rely on principles of well-tested patient and family-centered care to maintain those trusting relationships.
To effectively communicate with patients and their caregivers who are hesitant of vaccines, here are three things I’ve found helpful:
1. Try saying, “Tell me more about what you’re thinking.”
Everyone’s thoughts are valid and based in their own lived experience and knowledge. Acknowledge their opinions and ask questions to learn more about their source of knowledge, motivations, and hesitations.
2. Use the truth–myth–truth sandwich to ground your recommendations in evidence, while acknowledging the myths.
Patients and families are exposed to a daily flood of misinformation they have to wade through. Help them navigate those waters with evidence and facts. For example, “Vaccines don’t cause autism. Many people think that because of old studies that turned out to have false data. The truth is that vaccines are safe and haven’t been found to cause autism.”
3. Leave space for follow-up.
Some patients may change their mind in the moment, but many won’t. Leave the conversation open and ask to continue it during the next time you’re together. Meeting people where they’re at requires us to put in the work and stay consistent over multiple visits.
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This piece expresses the views solely of the author. It does not necessarily represent the views of any organization, including Johns Hopkins Medicine.