Vaccine Communication Skills: How to Speak with Vaccine-Hesitant Parents

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Vaccine Communication Skills How to Speak with
Vaccine-Hesitant Parents the Media

• Kris Calvin
• CEO, AAP-CA

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Objectives

• Understand changing concerns of
  vaccine-hesitant 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).

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Vaccination is the top Public Health achievement
of the 20th Century
MMWR 1999 48241
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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

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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 vaccinespure, natural (no
  additives)
• Overwhelming the young immune system 1
  concern, many want alternative schedule

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More 2012 Parent Concerns

• General mistrust of scientific research/systems
  of carefunding, motives (per shot payment)
• My unvaccinated baby is healthier than
  vaccinated children (rosy cheeks)
• I am fine not caring about public healthmy
  responsibility is MY child only
• Highly influenced by non-MD providerschiropractor
  s, nurses, midwives/doulas

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Kindergarten PBEs by County
2000
Lee et al NVIC 2010
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Do you matter?
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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.

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Why Parents Who Planned To Delay/Refuse Vaccine
Changed Their Minds
Gust et al Pediatr 2009122718
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How can you respond?
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From FFrom Practicing Pediatricians Best
Practices
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Practicing Pediatricians What I didnt 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.

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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 someones specific concerns are
wastes time and does not build trust.
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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.

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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.

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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.

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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.

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Other Lessons Learned

• Maximize benefits to their child
• not a public health discussion
• vaccines provide protection
• risk of disease for omitted vaccines

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BOTTOM LINE

• This is not a debate, it is a conversation. It
  doesnt matter if you are right it matters
  what they want and decide to do.

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Working With the Media

• Improving the Value of Medical Journalism
• ltMedia slides courtesy of Val Ulene, LA Times
  health columnistgt

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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.

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• Most news articles on medically related topics
  fail to discuss important issues such as evidence
  quality, costs, and risks versus benefits

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Barriers to Good Medical Reporting

• Lack of time
• Lack of space
• Lack of knowledge

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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

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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 youre the right person to do the
  interview
• Decide whether its worth your time and energy

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• DONT BE AFRAID TO TURN DOWN AN INTERVIEW!

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Where Do People Get Their News?
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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.

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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

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The Interview

• Answer their questions in clear, concise, simple
  language
• Stick to what you know
• Take charge
• Take a stance
• Be enthusiastic!

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Avoid Getting Trapped

• Stay calm and positive
• Dont pretend to know something you dont know
• Correct inaccurate information
• If you make an error, correct yourself as soon as
  possible
• Theres no such thing as off the record

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Follow-up After an Interview

• Ask if youll have the opportunity to review and
  correct the piece
• Make yourself available for follow-up questions

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Dont Wait for Them to Call You!

• 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

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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 PRACTICESFAX/EMAIL OK FEW
  PATIENTS PER PRACTICE

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THANK YOU!