Vaccine Communication Skills:
How to Speak with VaccineHesitant Parents & the Media
Kris Calvin
CEO, AAP-CA
Objectives
 Understand changing concerns of vaccinehesitant families
 Gain skills & best practices for effective
communication with vaccine hesitant families
 Become more comfortable skills engaging
the media on vaccine issues.
 Understand how these skills translate in the
advocacy arena (example of AB 2109).
Vaccination is
the top Public
Health
achievement of
the 20th
Century
MMWR 1999; 48:241
2010: Practicing Pediatricians: Top Vaccine Safety
Concerns of Patients/Families
•Autism
•Thimerosal
•Aluminum
•Pain of so many shots
• Why so many shots at once/so early? Concern about overwhelming
the immune system.
•Have not seen these diseases so do not see the value that outweighs
any risk
2012 Vaccine-”educated”
parents
 May be “pro-vaccine” for themselves, but object to it
for infants/children
 May no longer believe in a vaccine-autism
connection (or at least will not say so)
 Want “green” vaccines—pure, natural (no additives)
 Overwhelming the young immune system = #1
concern, many want alternative schedule
More 2012 Parent Concerns
 General mistrust of scientific
research/systems of care—funding, motives
(per shot payment)
 My unvaccinated baby is “healthier” than
vaccinated children (rosy cheeks)
 I am fine not caring about “public health”—my
responsibility is MY child only
 Highly influenced by non-MD providers—
chiropractors, nurses, midwives/doulas
Kindergarten PBEs by County
2000
2008
Lee et al NVIC 2010
Do you matter?
Do practicing MDs consider it important to have
effective vaccine communication skills?
•Many spoke to what a huge part of practice vaccines have
become.
•Numerous spoke about the importance of these skills for both
general pediatricians and subspecialists.
•Importance of subspecialist supporting need for vaccines,
even in cases where they do not give the vaccines
themselves.
•Also for many children with special health care needs, the
subspecialist is the medical home.
Why Parents Who Planned To Delay/Refuse
Vaccine Changed Their Minds
Gust et al Pediatr 2009;122:718
From
FFrom
Practicing Pediatricians:
Best Practices
Practicing Pediatricians:
What I didn’t think I would
do or see!
•Nearly all have learned to “negotiate” vaccines for some
families, using slightly modified “alternate schedules” as part
of routine practice. (This requires diligence, documentation
and clear communication about what is acceptable and what
is not. This is NOT about substituting a Sears-type schedule
for science.)
•Many parents feel it is now “due diligence” to at least
question one or more vaccines, even if they will readily accept
them.
•MD must deal with own anger/rejection at not being trusted
over vaccines.
Listen first
Ask each family/parent what, if any, are their
concerns about vaccines.
“Having a prepared spiel and spouting lots of
science without knowing what someone’s specific
concerns are wastes time and does not build trust.”
Assess depth of concern
•First tier: Parents who want to “exercise due diligence”.
•Second tier: One or more specific fears based on myths in
the media or from friends, that if listened to and carefully
responded, will set aside.
•Third tier: those who are fearful of vaccines either due to a
close personal experience (a sibling whose child had autism
after a vaccine, or had what they perceived as a bad adverse
reaction) or who refuse vaccines as part of a larger life
philosophy.
Be ready for your own negative emotions.
•Doctors need to recognize that they need to come to
terms with emotions of anger or disappointment in
parents who listen to celebrities or media rather than
trained MDs, who feel that they know what is best for
the child. Those emotions; move beyond judgment to
help the patients.
Pre-empt resistance
•Begin at the first visit letting the family know
proactively their position as a doctor in strong
support of vaccines for their child. Give websites
you trust about vaccines.
•Share if you vaccinate your own child/ your niece,
your nephew.
Use “stories” rather than theories
•Focus on those diseases that are still seen and they
can understand, and tell stories about children who
did not get vaccines.
Other Lessons Learned

Maximize benefits to their child
– not a public health discussion
– vaccines provide protection
– risk of disease for omitted vaccines
BOTTOM LINE:

This is not a debate, it is a
conversation. It doesn’t matter if you
are “right” ; it matters what they
want and decide to do.
Working With the Media
Improving the Value of Medical Journalism
<Media slides courtesy of Val Ulene, LA Times health
columnist>
Why Engage the Media
As a major source of medical information,
the media can be particularly important in
educating the general public, the medical
community and policy makers.
Most news articles on medically related topics
fail to discuss important issues such as
evidence quality, costs, and risks versus
benefits
Barriers to Good Medical
Reporting
 Lack of time
 Lack of space
 Lack of knowledge
Overcoming Barriers:
What Can Doctors Do to Help
 Make yourself available
 Provide accurate, up-to-date information
about health-related topics
 Be professional
 Tell a good story
Should I Do the Interview?
 Find out what the reporter wants to know and what
their attitude toward the subject might be
 Get to know the media outlet
 Determine if you’re the right person to do the
interview
 Decide whether it’s worth your time and energy
DON’T BE AFRAID TO TURN DOWN AN
INTERVIEW!
Where Do People Get Their
News?
Use Social Media
About a quarter (27%) of adults say they regularly or
sometimes get news or news headlines through
Facebook, Twitter or other social networking sites.
This rises to 38% of people younger than 30, but now
spans a notable share of older Americans (12% of
those 65 and older) as well.
Preparing for interviews
 Bring the journalist up to speed
 Get yourself up to speed
 Prepare and practice key message points
 Review facts and figures
 Identify questions (easy, hard and terrible) and
formulate responses
The Interview
 Answer their questions in clear, concise,
simple language
 Stick to what you know
 Take charge
 Take a stance
 Be enthusiastic!
Avoid Getting Trapped
Stay calm and positive
Don’t pretend to know something you don’t
know
Correct inaccurate information
If you make an error, correct yourself as soon
as possible
There’s no such thing as “off the record”
Follow-up After an Interview
 Ask if you’ll have the opportunity to review
and correct the piece
 Make yourself available for follow-up
questions
Don’t Wait for Them to Call
You!

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Send press releases
Invite to press conferences
Provide them with information kits
Reach out to personal contacts
Submit letters to the editors
Write spec articles
Not for today--AB 2109 (PAN)
PBES
 REQUIRES HEALTH CARE PROVIDER
SIGNATURE FOR PBE
 INTENDED TO DECREASE CONVENIENCE
PBES WHILE STILL PERMITTING
PARENTAL CHOICE
 BASED ON WASHINGTON STATE LAW
SHOWING RESULTS
 LOW BURDEN TO MD PRACTICES—
FAX/EMAIL OK; FEW PATIENTS PER
PRACTICE
THANK YOU!