Call to action: Talk to your patients about vaccine hesitancy

Vaccines have such a major impact on both individuals and public health. But somehow, as time has gone by, that has been lost.

This is partly because vaccines have been so successful that people do not see many vaccine-preventable diseases anymore.

When I was in medical school, Haemophilus influenzae type B was the scourge of pediatrics. Children who developed this disease suffered from ear infections, sore throats, pneumonia or worst-case scenario, meningitis, which is a devastating disease. It was probably the reason why I never wanted to be a pediatrician. The first person I ever saw die was a baby. Now there is a vaccine, and for all intents and purposes, Haemophilus influenzae type B is a disease of the past.

To address vaccine hesitancy, the first part is building rapport, which is not necessarily always easy to do in an outpatient clinic where time is constrained. When I talk about it, I try to put it into the context of risk and potentially bad complications of the disease. For instance, influenza is a pretty nasty disease. People who get it have high fevers, their muscles ache, they are down and out for a good week. Some people get pneumonia and end up in the hospital. So, it is important to establish relationships with patients and inform them of what their risk factors are.

Then be honest about the effectiveness of vaccines. Getting an influenza vaccine, ideally, should prevent patients from getting influenza. However, that is not necessarily always true, depending on the strain and different factors like the patient’s immune system and how much they respond to the vaccines. Vaccine hesitancy has to be addressed on an individual level. Let patients know that while they may still get the influenza after a vaccine, they may not get quite as sick. And importantly, if the patient has other health conditions that put them at risk, the vaccine will help prevent them from ending up in the hospital.

We should also be honest about what we know about vaccines and how they work. Influenza, again, is a good example. The vaccines change every year because the viruses mutate and change. We are seeing that with COVID-19, as well. The facts are important.

Be honest about what to expect. Some vaccines, like the shingles vaccine, hurt worse than others. Providers could let patients know, “This is going to hurt.” Communication is always key.

It is additionally important for us to ask our patients about their fears. In the hurry-up world that we live in, sometimes taking that extra minute is really worth it in terms of adjusting to what people are afraid of. It is also persistence on our part. If people are questioning vaccines, it is important that we try to understand the issues from their point of view.

If more action is not taken to address vaccine hesitancy, we will see more outbreaks. We are experiencing a measles outbreak here in Columbus, Ohio, which is primarily occurring in unvaccinated children. The initial cases were probably internationally acquired. Children who are not vaccinated and get diseases also put their siblings who may be too young to be vaccinated at risk. So, when talking to patients about vaccines, start small. “How does this affect you and your household?” That is No. 1.

Then, “How does your household affect your neighbors? Are your kids playing together? What are they going to get?” Lean into the altruistic humanitarian side of what I hope exists in us all.