Q&A: How pediatricians can tackle vaccine hesitancy in practice
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The federal rollout of Pfizer and BioNTech’s COVID-19 vaccine for children aged 5 to 11 years began in earnest this week, making a pediatric-sized vaccine available to millions of kids for the first time.
We asked Andrea Milne Wenderlich, MD, MS, an assistant professor of general pediatrics at the Golisano Children’s Hospital at the University of Rochester Medical Center, some lingering questions about how pediatricians can reassure patients and parents about the vaccine, and also how pediatricians can use their practice to not only vaccinate patients, but also their caregivers.
Wenderlich was the co-author — along with colleagues Cynthia Rand, MD, MPH and Jill Halterman, MD, MPH — of a viewpoint published in JAMA Pediatrics that described their experiences offering COVID-19 vaccines to eligible children and anyone accompanying the child to an appointment in the hospital’s pediatric practice.
Altogether, Wenderlich said the practice has vaccinated 750 adolescents and 200 caregivers and hopes for a 25% to 50% uptick by the end of the year.
Healio: What was the inspiration for this program?
Wenderlich: We were finding that we had a pretty high population of patients and families that were feeling hesitant about the COVID-19 vaccine. We were going to start giving it to our patients who were aged 12 to 18 years at the time when the Pfizer vaccine was approved for that age group and realized that we should be talking to caregivers for all our patients about getting vaccinated against COVID-19. While we were talking to them, taking that opportunity to be able to give it at the same time was really an important opportunity for us to seize.
I just think pediatricians are very well poised to be having conversations about vaccination because ... preventive health is what we do. The early adopters of this vaccine have already gotten it, and we have a unique opportunity to help with those who are more hesitant. So, I think it is something that we should consider and hopefully more people will be able to do.
Healio: How did the program address vaccine hesitancy? Were those working in the clinic encouraged to discuss it openly with parents and caregivers?
Wenderlich: Yes, and it was pretty organic. As pediatricians, we talk to parents about vaccines and vaccine hesitancy often. Obviously, the COVID-19 vaccine has been more controversial than other vaccines in the past. However, there's been vaccine hesitancy for a long time, and it's something that we're comfortable discussing with families of newborns and with families of adolescents, so it's a pretty comfortable thing for us to talk about with families. We ask about vaccines at every visit that we have anyway, so if a person comes in for an injury but they're due for their influenza vaccine, we will give them their influenza vaccine at that point. It was already a part of our workflow in our discourse with families. So, everyone who we work with was asked if they were comfortable to discuss it with families, but the bulk of the conversation was usually with the pediatrician or nurse practitioner who was taking care of the family.
Healio: Regarding speaking with vaccine-hesitant parents and caregivers who themselves were on the fence about it, did you find any methods that were particularly successful in reassuring them about getting vaccinated?
Wenderlich: So, I find that listening as much as possible and hearing where their hesitancy is coming from is the best way to address it. So, not coming from a perspective of “I know something that you don't know, and you should just listen to me,” because that doesn't seem to be very effective. [It’s better to ask] “What are your concerns?” and “How can I help explain to you what I know about the vaccines and why I'm strongly recommending them?”
Healio: Now that the vaccine for children aged 5 to 11 years has been authorized, do you anticipate continuing the program and do you anticipate needing more staff to support this work?
Wenderlich: Yes, we are continuing to vaccinate anyone who's eligible. So, now we're vaccinating 5- to 11-year-olds, as well as children aged 12 and older and the caregivers; we are going to continue that. We do have some increasing staffing levels during these initial, early months when early adopters of the vaccine come in in larger numbers, but then following that, we anticipate that it's just going to be like all the other vaccines that we give — it's just a part of our workflow.
Healio: What steps can a practice that is looking to implement a similar program take to get started?
Wenderlich: I think being able to work with your electronic medical record to register adults is important. We had the advantage of [working] within a larger health care system, and many of the adults are already patients. The registering part is pretty simple for us, but I think that definitely could be a challenge in smaller practices that don't take care of adults. And then just having people who are willing to take the time to talk to both adults and the entire family about the benefits of being vaccinated against COVID-19.
References:
Milne Wenderlich A, et al. JAMA Pediatr. 2021; doi:10.1001/jamapediatrics.2021.4214