Risk Management Tools & Resources


Strategies for Communicating With Vaccine-Hesitant Parents of Pediatric Patients: Use Communication Techniques


Laura M. Cascella, MA, CPHRM

Conducting appointments for pediatric patients who have vaccine-hesitant parents can cause stress and frustration for pediatricians and other pediatric providers. However, having a structured and practiced approach for communicating with these parents can help alleviate some of the anxiety associated with these encounters.

Communication techniques, such as the presumptive approach or the CASE approach, can facilitate vaccine discussions and provide a roadmap for guiding conversations.

The Presumptive Approach

Taking a presumptive approach rather than a participatory approach with vaccine communication has proven effective with vaccine-hesitant parents. A presumptive approach assumes that parents are planning to accept vaccine recommendations, which most do.1

Inform the parents about what shots are scheduled for that visit rather than initiating a broad discussion regarding their thoughts on vaccines. The Centers for Disease Control and Prevention (CDC) offers the following examples:

  • Say: “Your child needs three shots today.”
  • Don’t say: “What do you want to do about shots?”
  • Say: “Your child needs DTaP, Hib, and Hepatitis B shots today.”
  • Don’t say: “Have you thought about the shots your child needs today?”2

Although the presumptive communication method has been successful, a clinical report from the American Academy of Pediatrics cautions that this approach might not work well with all parents; thus, pediatric providers should use the presumptive approach based on their own judgment and experience with patients and their parents.3

The CASE Approach

Another communication model that pediatric providers can use to communicate with parents who have vaccine concerns is CASE. Likened to an “elevator speech,” CASE has been noted as a rapid and useful technique for addressing parental vaccine concerns.4 The acronym CASE stands for:

  • Corroborate: Acknowledge the parents' concern and find some point on which you can agree. Set the tone for a respectful and successful talk.
    • For example: “I understand why you are so concerned about this vaccine. The media is reporting a lot of conflicting information. Let’s talk about it more because we both want what is best for your child.”
  • About me: Describe what you have done to build your knowledge base and expertise.
    • For example: “Because of the concerns my patients’ parents have, I’ve kept up with the latest research on these issues. As a pediatrician, I’m dedicated to understanding vaccine benefits and risks and have followed these issues for many years.”
  • Science: Describe what the science says.
    • For example: “Like any treatment, vaccines are not without risks, but no evidence shows that they contribute to autism. Also, vaccinations are the best way to prevent your child from getting some serious diseases.”
  • Explain/advise: Give your advice based on the science.
    • For example: “Based on the research and benefits versus risks, I recommend your child receive these vaccinations on schedule.”5

An article about implementing the CASE approach notes that this technique helps pediatric providers connect emotionally with parents. Rather than immediately opposing parents' viewpoints — which they may interpret as dismissive, challenging, or arrogant — the provider acknowledges the validity of the parents' concerns and finds common ground on which to build an effective partnership.6

More information about these communication techniques and other approaches is available on CDC’s Talking to Parents about Vaccines webpage. For more strategies on addressing vaccine hesitancy, see MedPro’s Communicating Effectively With Vaccine-Hesitant Parents of Pediatric Patients.


1 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

2 Ibid.

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

4 Jacobson, R., Van Etta, L., & Bahta, L. (2013). The C.A.S.E. approach: guidance for talking to vaccine-hesitant parents. Minnesota Medicine, 96, 49–50. Retrieved from www.researchgate.net/publication/255713366_The_CASE_approach_guidance_for_talking_to_vaccine-hesitant_parents

5 Ibid; American Academy of Pediatrics. (2024, February 26 [last updated]). Talking with vaccine-hesitant parents. Retrieved from www.aap.org/en/patient-care/immunizations/communicating-with-families-and-promoting-vaccine-confidence/talking-with-vaccine-hesitant-parents/

6 Jacobson, R., et al. The C.A.S.E. approach: Guidance for talking to vaccine-hesitant parents.

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