Objective To provide primary care physicians with clinical guidance for addressing parental vaccine hesitancy. Sources of information The PubMed database was searched for English-language articles published in the 10 years before January 1, 2018. Search terms included vaccine hesitancy or confidence or acceptance, parents or children, and communication, counseling, or clinical practice. References of identified articles were assessed for additional relevant articles. A separate gray literature search was conducted using Google to find best-practice guidelines from public health and health care organizations, knowledge translation materials for health care providers, and resources that could be used in discussions with parents about vaccines. Main message Practical tips for addressing parental vaccine hesitancy in primary care include starting early, presenting vaccination as the default approach, building trust, being honest about side effects, providing reassurance on a robust vaccine safety system, focusing on protection of the child and community, telling stories, and addressing pain. Also provided are statements that providers could use in vaccination-related conversations; answers to commonly asked questions on benefits, safety, and immunologic aspects of vaccines; and links to a number of online resources for physicians and parents. Conclusion Vaccine-hesitant parents who are on the fence far outnumber vaccine refusers; therefore, counseling this group might be more effective. Reasons behind vaccine hesitancy are complex and encompass more than just a knowledge deficit. As a trusted source of information on vaccines, family physicians play a key role in driving vaccine acceptance.

https://www.cfp.ca/content/cfp/65/3/175.full.pdf

Addressing vaccine hesitancy: Clinical guidance for primary care physicians working with parents.

Strengthening vaccination programmes and health systems in the European Union: A framework for action

Objectives To explain vaccination refusal in a sample of Australian parents. Design Qualitative design, purposive sampling in a defined population. Setting A geographically bounded community of approximately 30 000 people in regional Australia with high prevalence of vaccination refusal. Participants Semi structured interviews with 32 non-vaccinating parents: 9 fathers, 22 mothers and 1 pregnant woman. Purposive sampling of parents who had decided to discontinue or decline all vaccinations for their children. Recruitment via local advertising then snowballing. Results Thematic analysis focused on explaining decision-making pathways of parents who refuse vaccination. Common patterns in parents’ accounts included: perceived deterioration in health in Western societies; a personal experience introducing doubt about vaccine safety; concerns regarding consent; varied encounters with health professionals (dismissive, hindering and helpful); a quest for ‘the real truth’; reactance to system inflexibilities and ongoing risk assessment. Conclusions We suggest responses tailored to the perspectives of non-vaccinating parents to assist professionals in understanding and maintaining empathic clinical relationships with this important patient group.

https://bmjopen.bmj.com/content/bmjopen/9/5/e026299.full.pdf

Understanding non-vaccinating parents' views to inform and improve clinical encounters: A qualitative study in an Australian community

Communicating With Vaccine-Hesitant Parents: A Narrative Review.

"We treat humans, not herds!": A qualitative study of complementary and alternative medicine (CAM) providers' individualized approaches to vaccination in Switzerland.

Kate L. Slotwinski

Papers

Provider-parent Communication When Discussing Vaccines: A Systematic Review