Takeaway
When talking about vaccines with those who are hesitant, provide a strong recommendation and revisit the conversation over time.
Lifelong Learning in Clinical Excellence | October 1, 2025 | 2 min read
By Jonathan Miller, MD, Nemours Children’s Health
It was a typical day at the pediatric office, full of sniffles and well visits and diaper rashes. I had two patients left to see and then the day would be done. It turned out they were both first-time parents with two-month-old babies. I went into the first room, all was well, and the family agreed to routine vaccination for the infant—they wanted to do everything possible to keep her healthy.
Feeling energized, I entered the room of my last patient. All was well, and the family thanked me for my care but wasn’t interested in vaccinations. I tried to engage them in conversation, appealing to the shared desire for a healthy child, the strong evidence for vaccines, the safety profile, and even a desire for the greater good. But they didn’t budge.
Vaccine hesitancy
As a pediatrician, I’m frequently confronted with new parents attempting to provide the best care for their infant while facing a deluge of conflicting information about what to do. This is best exemplified with regard to routine vaccination, where misinformation and influencers have created a landscape where it’s difficult for families to separate fact from myth.
Reflecting on these conversations, I often wish I’d had the opportunity to address these concerns before the parents made up their minds—when they’re considering parenthood, or during pregnancy. Other providers, such as obstetricians, internists, and family practitioners, who interact with expectant parents earlier in the process, are in a unique position to have an impact on the decision-making process.
Over the past few years, the nature of vaccine hesitancy has become more and more political, sometimes leading to significant discomfort as clinicians attempt to engage in the immunization discussion. However, many studies have demonstrated that people trust their healthcare providers more than any other source when it comes to vaccination. This makes it critical for all healthcare professionals to play their role in promoting routine childhood vaccination.
What to do?
There are several evidence-based methods that practitioners can use when promoting vaccination:
1. Provide a strong and personalized recommendation.
Say something like, “You know how much I care about you and your family, and I know how much you want to do what’s best for your baby. I think it’s so important that you do the routine vaccinations.”
2. Be persistent.
Studies show that parents change their mind when the practitioner revisits the recommendation for vaccination even after initially declining.
3. Consider motivational interviewing.
Families respond best when you meet them where they’re at and try to bring them gradually closer to the preventive decision you’re working toward.
And remember, patients trust you and value your opinion. Leverage that.
By providing evidence-based information, listening to concerns, and building trust, healthcare providers can play a critical role in promoting routine childhood vaccination and protecting the health of our communities. It’s essential that we continue to educate and support parents in making informed decisions about vaccination, and that we work together to create a culture of trust and confidence in the safety and efficacy of vaccines.
Click here to read more about the author.
This piece expresses the views solely of the author. It does not necessarily represent the views of any organization, including Johns Hopkins Medicine.