Improving Communication About Vaccines

Doug Opel story

As a pediatrician, Dr. Doug Opel keeps running into the same difficult question: What do you say to parents who are reluctant to vaccinate their kids? It confronts him in his clinic and he hears it from colleagues nationwide. Now, with no easy answers in sight, Opel is spearheading innovative research to investigate the best way to communicate with the growing number of parents who are skeptical of vaccines.

“Ultimately, our goal is to persuade more of these parents to immunize their kids,” says Opel, principal investigator in the Treuman Katz Center for Pediatric Bioethics.

When Opel started this research in 2008, one of his first projects was developing the Parent Attitudes about Childhood Vaccines survey, or PACV, which asks vaccine-related questions and rates how much parents agree with statements like “Children get more shots than are good for them.” The survey is scored on a scale of zero to 100. Opel’s team has found that, if a parent scores 50 or higher, they are more likely to under-vaccinate their children.

“That’s a key connection,” he says, “because if we can identify who is most likely to under-immunize their child because they’re hesitant towards vaccines, we can try to influence them to do otherwise.”

Now Opel and his colleagues are finishing a study in which they videotaped pediatricians and parents discussing immunizations during well-child visits. This is helping them understand how physicians actually communicate about vaccines. For example, Opel’s team has noticed that many physicians simply tell parents which vaccines their child is going to get, presuming that they have no issue with what is recommended. Opel doesn’t know whether this is more effective than other approaches, such as inviting parents to participate in vaccine decisions. He plans to investigate this in his next study.

“Studies have shown that, if parents feel like they’re being listened to, they’re more likely to comply with their physician’s recommendations,” Opel says. “We’ll look at whether it’s helpful to step back, invite parents to talk about their vaccine concerns, and then address those in a more tailored way.”

As his research progresses, Opel envisions a future where pediatricians give parents the PACV survey soon after their child is born. This would tell a physician which parents are skeptical of vaccines, giving the doctor a chance to use the communication approach proven to be most persuasive.

For now, Opel’s research is impacting how he handles these issues in his own practice. Until he identifies a specific practice that improves parental acceptance of vaccines, he is more willing to try to a variety of approaches to see what resonates with a particular family.

“For a lot of parents, vaccinating their kids is not a rational decision, it’s an emotional one,” Opel says. “I try to partner with the family in that emotion and in how they think about vaccines, and then guide them to the best medical choice.”