Measles Outbreak – Talking to Parents about Immunization
According to the Centers for Disease Control and Prevention (CDC) from January 1 to March 28, 2019, 387 individual cases of measles have been confirmed in 15 states. This is the second-greatest number of cases reported in the U.S. since measles was eliminated in 2000. The states that have reported cases to CDC are Arizona, California, Colorado, Connecticut, Georgia, Illinois, Kentucky, Michigan, Missouri, New Hampshire, New Jersey, New York, Oregon, Texas, and Washington.
This outbreak of measles underscores the importance of vaccination and the importance of communication between providers and their patients regarding immunization. According to the CDC, parents consider their child’s healthcare professionals to be their most trusted source of information when it comes to vaccines. This is true even for parents who are vaccine-hesitant or who have considered delaying one or more vaccines. Therefore, providers have a critical role in helping parents choose vaccines for their child.
The CDC has several resources available to assist providers with these very important conversations. Resources include proven communication strategies and tips for effectively addressing questions that providers may hear from parents, as well as information for parents who choose not to vaccinate. There is also a video featuring a CDC pediatrician answering tough vaccine questions which may be helpful for some parents.
A big challenge for providers is when parents decline immunizations, despite strong recommendation and conversation. Strategies providers can use in these instances include:
- Continuing the conversation about vaccines during the next visit and restate your strong recommendation.
- Informing parents about clinical presentations of vaccine-preventable diseases, including early symptoms.
- Reminding parents to call before bringing their child into the office, clinic, or emergency department when the child is ill so health care professionals can take precautions to protect others. Explain that when scheduling an office visit for an ill child who has not received vaccines, you will need take all possible precautions to prevent contact with other patients, especially those too young to be fully vaccinated and those who have weakened immune systems.
- Sharing If You Choose Not to Vaccinate Your Child, Understand the Risks and Responsibilities with parents. This fact sheet explains the risks involved with their decision, including risks to other members of their community, and additional precautionary responsibilities for parents.
Providers may wish to have parents sign AAP’s Refusal to Vaccinate form each time a vaccine is refused so that you have a record of their refusal in their child’s medical file.
Most importantly, remember that vaccine success comes in many forms. It may mean that parents accept all vaccines when a provider recommends them, or that they schedule some vaccines for another day. For very vaccine-hesitant parents, success may simply mean agreeing to leave the door open for future conversations. At a minimum, work with parents to agree on at least one action, such as:
- Scheduling another appointment or
- Encouraging the parent to read additional information you provide them.
If a parent declines vaccines once, it does not guarantee they always will. Continue to remind parents about the importance of keeping their child up to date on vaccines during future visits and work with them to get their child caught up if they fall behind. Lastly, providers should document in the medical record conversations and recommendations about vaccination including the parent’s decisions regarding vaccination.
Note: Providers will also want to consult State and local laws to understand legal implications of vaccination choices.
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