masked patients in waiting room

Dealing with Vaccine Hesitancy in Your Practice


Be proactive and build on trust

As COVID-19 cases rise across the United States and the highly contagious Delta variant continues to spread, “the fight against the pandemic is focused on an estimated 93 million people who are eligible for shots but have chosen not to get them,” stated a recent article in the New York Times. Who are these people who are not getting the vaccine and why? Should doctors work harder to educate them in the hopes of changing their minds and protecting their communities?  

Vaccine hesitant or vaccine refusers? The answer informs your approach

Part of what makes the vaccination issue so complicated is that there is no single answer to who is still not getting the vaccine or why. While there are some trends related to political affiliation, geographic location, and race, unvaccinated Americans are not one monolithic group. It’s important to approach each patient as an individual, and to try to understand their particular concerns or situation. 

That said, public health experts generally distinguish between two groups: vaccine refusers and the vaccine hesitant – those who have taken a “wait and see” approach. The latter group is the one doctors should focus on. According to the New York Times, “health officials are making progress in inoculating this second group.”

Can you dismiss vaccine refusers from your practice? The short answer is yes. But you may want to consider other strategies first. 

The short answer to the question “Can I dismiss vaccine refusers from my practice?” is yes. For pediatricians, who may often encounter parents who are hesitant to vaccinate their children, the guidance from the American Academy of Pediatrics (AAP) has been to dismiss these patients as a last resort. 

A 2016 journal article, “Countering Vaccine Hesitancy,” stated: “The AAP recommends that pediatricians continue to engage with vaccine-hesitant parents, provide other health care services to their children, and attempt to modify their opposition to vaccines. Fortunately, most vaccine-hesitant parents are responsive to vaccine information, consider vaccinating their children, and are not opposed to all vaccines.”

The AAP also stated, “If after counseling efforts are exhausted, parents decline immunizations … pediatricians may request they sign a vaccine refusal form and/or seek care from a different health care provider,” adding that it is an “acceptable option for pediatric care clinicians to dismiss families who refuse vaccines.”

Trusted voices matter now more than ever

You may be tempted to avoid addressing vaccination directly and rely on mask requirements, but hesitancy is a growing threat that doctors need to address. Historically, pediatricians have had to navigate this issue given that they are the group of doctors who commonly encounter vaccine hesitancy. A 2020 article in the Journal of Pediatrics titled “Caring for the Vaccine-Hesitant Family: Evidence-Based Alternatives to Dismissal,” stated “Vaccine hesitancy is a growing public health threat.”

Vaccine hesitancy is a growing public health threat. Doctors have a responsibility to address it with their patients. 

All doctors have a responsibility to step up, now more than ever. According to a recent webinar presented by the World Health Organization (WHO), “Trusted voices – who, why and how to communicate about COVID-19 vaccines,” trust is hard to establish during a crisis, and people turn to sources they’ve trusted in the past. Research tells us that doctors are consistently trusted sources of information. 

“Doctors, not just the ones on the front lines, have a really important role in communicating true information to their patients and other members of the public because time after time, the research tells us the person patients trust the most is their doctor,” said Tara Kirk Sell, Ph.D., M.A., a senior scholar at the Johns Hopkins Center for Health Security.

There are numerous examples of people who would not have gotten the COVID-19 vaccine had their own doctor not recommended it. 

How to approach vaccine-hesitant patients 

The WHO webinar explains how managing misinformation helps gain trust. When it comes to dealing with vaccine-hesitant patients, doctors are advised to:

  • Be proactive in telling patients about misinformation they may encounter (on social media, etc.).
  • Debunk myths and rumors with facts. It’s hard to argue with the data: as of July 30, about 97 percent of people hospitalized with COVID-19 in the U.S. were unvaccinated.
  • Point to trusted people and sources that support vaccination.
  • Accept and communicate uncertainty – explain what is known and unknown.
  • Be transparent about possible risks – e.g., prepare people for possible side effects.
  • Use clear, simple language and avoid jargon.

For more tips, see our previous post, How Can Doctors Retain Patients’ Trust?, which covers three common patient scenarios doctors have encountered during the pandemic and how to handle them.

Who is mandating the vaccine 

It may also be helpful for both you and your patients to know how other sectors and organizations are handling the vaccination issue. As of the time this post was written:

If you’re wondering how such policies might work for your practice, check out our post Are You Requiring Your Staff to Get Vaccinated?


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