COMMENTARY

Changing Minds About Vaccination

Gregory A. Poland, MD; Caroline M. Poland, LMHC, LCAC, NCC

Disclosures

February 23, 2015

In This Article

Measles Outbreak and Failure to Vaccinate

As of February 2015, the United States is experiencing a large measles outbreak, with more than 120 cases scattered across 17 states. The primary cause of this outbreak is the failure to vaccinate, although smaller numbers of cases have occurred in persons previously vaccinated.[1] The outbreak highlights the need to increase rates of vaccine acceptance among those who are either vaccine hesitant or refuse vaccines.

Addressing vaccine hesitant/resistant patients and parents remains a difficult but important task to tackle. Critical to this task is the need for physicians and other healthcare workers (HCWs) to use effective communication and education strategies (informed by psychology, counseling, and behavioral psychology[2]) in ways that allow parents and patients to make data-informed choices that benefit individual and community health.

Consider this common case study example:

Jane is a 36-year-old mother of three, her youngest having just celebrated her first birthday. Although she chose to have her oldest two children vaccinated, she has since started reading blogs and Internet sites, many of which tout the importance of "natural" living and condemn the use of "vaccine toxins." Some of these blogs have also shared winsomely written, highly emotional stories of the negative effects of vaccines like measles-mumps-rubella (MMR) vaccine. Jane, who cares deeply about the health of her children, has made the decision to not vaccinate her 1-year-old, reinforced by a support group of mothers who all believe similarly. She is in your office and has informed you of her decision. Consistent with national recommendations, you are about to recommend that she give her daughter the MMR vaccine. How do you most effectively proceed?

This scenario, in many familiar variations, occurs in medical offices across America every day. It is critical to be able to communicate effectively with the patient, using the patient's preferred cognitive style, if we are to influence decision-making.

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