Strategies for talking to parents

American Medical Association’s 10 tips

1. Understand your patients’ concerns Concerns can vary from patient to patient across demographics. It’s important to build trust as a foundation to move forward.

2. Ask “why” to get to the root cause If a patient declines the vaccine, say, “May I ask why? What have you heard in your community?” This reduces the tone of judgement.

3. Counter misinformation Understand where the patient is receiving their information and counter any misinformation or conspiracies in the community.

4. You are their most trusted source 85% of respondents of a Kaiser Family Foundation survey believe their health care provider is the most trusted source for COVID-19 vaccine information.

5. Initiate vaccine discussions Adult patients say the second biggest reason they don’t get an immunization is that a “doctor hasn’t told me I need it.”

6. Tailor your message Focus the discussion on how getting a vaccine can help protect a loved one in their own life.

7. Be transparent about side effects First ask patients how they felt after receiving a recent vaccine (e.g., flu) and use this as a reference point to address side effects.

8. Create a unified message Prepare your staff to answer questions and ensure messaging is clear and consistent.

9. Display visual encouragement Reinforce feelings of trust and safety by wearing pins and stickers that show you’ve been vaccinated.

10. Share stories Tell illustrative stories on vaccine importance.

Drivers of hesitancy for parents of unvaccinated children

• Misinformation about the safety and ingredients of the vaccine
• Misbelief that the vaccine increases risk of autism
• Misbelief around allergic reactions and DNA alteration
• Concerns that the vaccine will cause greater harm than the disease itself
• Mistrust in health authorities and health system
• Political polarization: Republicans have shown to be more accepting of misinformation and less likely to consider COVID-19 a threat to their family

Motivational interviewing

Motivational interviewing is an evidence-based and culturally sensitive way to speak with unvaccinated patients. The goal is to help people manage mixed feelings and move toward healthy behavior change aligned with their values and needs. (CDC)

• Embrace an attitude of empathy and collaboration. Be sensitive to culture, family dynamics, and circumstances that may influence how patients view vaccines.
• Ask permission to discuss vaccines. If the patient says no, respect that.
• Move on and say, “I respect that, and because I care about your overall health, maybe we could talk about the vaccines at a future time.”
• OR you could spend several minutes curiously exploring why the patient doesn’t want to talk about it. The goal is to understand, not to change their mind.
• Ask the patient scaled questions. The goal is to understand what would motivate them to move higher on the scale.
• “On a scale of 1 to 10, how likely are you to get a COVID-19 vaccine?”

Vaccination motivators

• Worry and perceived risk that the family or the child could be seriously affected by COVID
• 13% increase in vaccination status for every increasing level of worry (2022)
• Parents of the children are fully vaccinated
• Clear, transparent information about efficacy

Quotes from patients/parents

“I’m afraid because the words “emergency approval” kind of scares me, especially when it comes to my children. Emergency makes it seemed like it wasn’t tested as long as it needs to show proper results.”

“I want to ensure that I have done what I can to protect my children. The pros outweigh the cons. The risk of COVID is horrible, the symptoms that COVID long haulers are dealing with are horrible.”

“I’m unsure because we hear new stuff all the time about all of the COVID vaccines and you don’t know what to believe any more.”

Talking points with parents of unvaccinated children

• “Why should my child be vaccinated?”
• Young children can become very sick from COVID-19, resulting in hospitalization, long-term health complications, and death.
• “I know people who were infected even after the vaccine.”
• Similar to adults, vaccinated children can still get COVID, but the vaccine helps prevent from developing serious illness and severe cases.
• “My child already had COVID.”
• Children should still get vaccinated, even if they already had COVID. This will provide extra protection from future infections.
• “I received the vaccine when I was pregnant with my child.”
• You should still get your child vaccinated, even if you were vaccinated during pregnancy or while breastfeeding, as transferred antibodies lessen over time.
• “Is the vaccine safe for children?”
• Safety was studied in over 10,000 children ages 6 months to 5 years and across 4,600 children ages 5 to 11 years.
• Some experienced mild, short-term side effects such as tiredness or fever.
• The COVID-19 vaccine was based on science that has been tested for years without any long-term effects.
• “What are the long-term effects of the vaccine?”
• Vaccines rarely cause long-term effects, and any effects are usually less severe than effects of long COVID.
• COVID-19 illness is far more likely to cause myocarditis than is the vaccine.
• Adverse effects are required to be reported in a national database that is publicly available.