How to help registrars talk to vaccine-hesitant parents

Dr Alan Leeb (pictured) offers his registrars sound advice for communicating with parents about childhood vaccination.

With about 30 years of GP supervision under his belt, and as developer of the vaccine safety surveillance program SmartVax, Perth doctor Alan Leeb offers sage advice to registrars dealing with vaccine-hesitant parents.

“Our approach to vaccine-hesitant parents has changed during recent years.

“It’s important to accept that most vaccine-hesitant parents are just that – hesitant – not necessarily anti-vaxers. They just need additional support to help get them over the line,” Dr Leeb told GPSA.

“If a parent is hesitant, registrars need to understand the importance of showing empathy and providing parents with support as well as easy access.”

Dr Leeb explains to his registrars that vaccines are one of the most successful and cost-effective public health interventions of all time, but there is under-vaccination.

“Despite high vaccination rates of over 95 per cent of children fully vaccinated, there are pockets of low coverage in all states,” he said.

“It is estimated that only 3.3 per cent of non-vaccinated Australian children are vaccine refusers, leaving the bulk of under-vaccinated kids due to logistical factors, missed opportunities and delays in vaccine delivery.”

Dr Leeb said GP supervisors should teach their registrars the most important determinant of vaccination uptake was recommendation by a health care provider.

“Registrars need to understand the impact that simple interventions may have,” he said.

“Parents don’t want motherhood statements that ‘All vaccines are safe and work,’ they want the facts about vaccine safety, effectiveness and disease severity to be able to interpret the risks and benefits within their own frame of reference and moral belief system.

“Parents who have questions about vaccines and are sitting on the fence care deeply for their children and want to do the right thing but often remain conflicted and scared.

“It is our role as the trusted health care provider to build their trust and confidence in our immunisation program.

“The timing of our vaccination program is important and has been carefully devised, therefore timely delivery of vaccination is important.

“Many parents may seem to be vaccine-hesitant parents, but for various reasons they are actually late vaccinators and logistical issues including family size, and missed opportunities are common factors.”

Dr Leeb advised supervisors to teach their registrars to always have vaccination in the back of their mind when parents bring children to them for other reasons and opportunistically offer catch-up vaccination.

“Whenever a registrar sees a child, they should have a quick glance at the child’s immunisation records and if required, speak to the parents about vaccinating the child opportunistically while they are in the clinic,” he said.

“Teach your registrar how to be supportive of parents by finding out where they stand and what the individual barriers are.”

Dr Leeb referred GP supervisors to work by Julie Leask who provides some useful tips for health professionals when discussing vaccination with parents who are acceptors, hesitant, late or selective vaccinators, and vaccine refusers. Read the article at https://bmcpediatr.biomedcentral.com/articles/10.1186/1471-2431-12-154

He said the SKAI website http://www.ncirs.org.au/health-professionals/skai-supporting-health-professionals was also a great resource for immunisation providers and parents.

See the GPSA Immunisation and Vaccination Teaching Plan here.