Risk Management Tools & Resources


Communicating Effectively With Vaccine-Hesitant Parents of Pediatric Patients


Laura M. Cascella, MA, CPHRM

Distrust of vaccines has an enduring and pronounced place in U.S. history. Long before the arrival of the COVID-19 vaccines, skepticism and doubt about vaccines for other diseases thwarted inoculation efforts and led to public health concerns. The United States is not alone in this struggle; even before the pandemic, the World Health Organization listed vaccine hesitancy as one of the 10 leading threats to global health.1

In pediatrics, it is not uncommon for healthcare providers to encounter parents who are hesitant to allow their children to have some or all recommended vaccinations, or who would prefer to delay one or more vaccinations. An American Academy of Pediatrics survey found that 87 percent of pediatricians have encountered parents who refused a vaccine for their child — a statistic that has increased over the years.2

One highly publicized reason for vaccine hesitancy is fear that vaccines cause or contribute to autism, but this is not the only reason that some parents hesitate to immunize their children. Research shows that vaccine-hesitant parents are diverse, and numerous concerns and beliefs contribute to their hesitancy, such as:

  • Concerns about adverse reactions
  • Fears about causing a child pain
  • Unease about the number of vaccinations required
  • Concerns about vaccine additives
  • Lack of awareness about the severity of some diseases
  • Apprehension related to the thoroughness of vaccine research
  • Concerns about freedom of choice and freedom of religion
  • Distrust of the government, pharmaceutical companies, and healthcare officials
  • Concerns about vaccine effectiveness3

Vaccine-hesitant parents also may have "varying degrees of indecision about specific vaccines or about vaccinations in general."4 Because of the complexity involved in these issues, pediatricians and other pediatric providers might have to spend time educating, raising awareness, providing guidance, and possibly navigating difficult and even contentious conversations with their patients' parents.

Unfortunately, these issues may cause stress and frustration for providers because of the propagation of misinformation and the time commitment required to discuss vaccination concerns during already-busy schedules. However, the COVID-19 pandemic and recent disease outbreaks of measles, whooping cough, mumps, and other contagious illnesses highlight the importance of these conversations. Further, the value of effective communication with vaccine-hesitant parents is emphasized by the trust that parents have in their children's providers. This trust plays a major role in parents' understanding and decision-making about vaccines.5

Numerous strategies can help pediatricians, nurse practitioners, physician assistants, nurses, and other clinical staff communicate with vaccine-hesitant parents and nurture a collaborative and patient-centered relationship. Examples of these strategies include:

Despite best efforts and various communication strategies, some parents may continue to refuse or delay vaccinations for their children. Although these situations can be discouraging, pediatric providers can take steps to support ongoing communication and mitigate any potential liability risks. To learn more, see MedPro's article Risk Strategies for Managing Parents of Pediatric Patients Who Refuse or Delay Vaccines.

In Summary

Pediatricians and other pediatric providers will likely encounter vaccine-hesitant parents during the course of their practice. Although these parents might have questions about the safety, efficacy, and necessity of vaccinations, their hesitancy does not necessarily indicate a refusal to vaccinate.

Pediatric providers should consider various approaches and strategies for communicating with vaccine-hesitant parents in a clear, respectful way. Doing so will help strengthen the provider–parent partnership and support the development of collaborative treatment goals for pediatric patients.


1 World Health Organization. (2019). Ten threats to global health in 2019. Retrieved from www.who.int/news-room/spotlight/ten-threats-to-global-health-in-2019

2 Edwards, K. M., & Hackell, J. M. (2016). Countering vaccine hesitancy. Pediatrics, 138(3), e20162146. doi: 10.1542/peds.2016-2146

3 Ibid

4 Ibid

5 Centers for Disease Control and Prevention. (2018, April 11 [last reviewed]). Talking with parents about vaccines for infants. Retrieved from www.cdc.gov/vaccines/hcp/conversations/talking-with-parents.html

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