Vaccine Communication Skills: How to Speak with Vaccine-

Hesitant Parents & the Media

Kris Calvin

CEO, AAP-CA

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).

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

2008

Lee et al NVIC 2010

Kindergarten PBEs by County2000

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 firstAsk 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.”

•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.

Assess depth of concern

•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.

Be ready for your own negative emotions.

•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.

Pre-empt resistance

•Focus on those diseases that are still seen and they can understand, and tell stories about children who did not get vaccines.

Use “stories” rather than theories

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 pointsReview 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 positiveDon’t pretend to know something you don’t knowCorrect inaccurate informationIf you make an error, correct yourself as soon as possibleThere’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!

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!