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Talking with Parents & Immunization Resources. Agenda. Parental Concerns Communication Strategies Immunization Resources. Objectives. Describe concerns parents have regarding childhood vaccinations Identify science-based communication approaches to help address parental concerns.
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Agenda • Parental Concerns • Communication Strategies • Immunization Resources
Objectives • Describe concerns parents have regarding childhood vaccinations • Identify science-based communication approaches to help address parental concerns
Common Parental Concerns • Too Many Vaccines • Is Natural Immunity Better • Do We Still Need to Vaccinate? • Are Vaccines Safe?
How do you respond? Have you heard… “Five vaccines seems like a lot for such a young baby...” or “Won’t this overwhelm his/her immune system?”
Too Many Vaccines? In a national survey of parents: 23% questioned the number of shots given to children 25% were convinced vaccines weaken the immune system
Key Points Children are exposed to thousands of different antigens (bacteria, dust, etc.) daily Vaccines are just a small part of what a child’s immune system faces Children able to generate protective immune responses to multiple vaccines at once Vaccinated children get fewer infections (both vaccine-preventable and unrelated)
What Can You Say? • Concerns about immune system being overwhelmed: • Immune system not weakened/overwhelmed by multiple shots • Explain what happens when immune system is weakened • Immune system deals with hundreds of viruses and bacteria during everyday activities • Babies immune systems can handle multiple shots better than fighting off serious diseases
Alternative and Delayed Schedules • Regular childhood schedule is well tested • Schedules designed to delay vaccine administration incur risks: • Susceptible to disease for a longer time period • No evidence for benefit; unknown effect on efficacy • Increased opportunities for known side effects • Some single-ingredient vaccines not available • Extra visits = extra time and cost
What Can You Say? • Wanting to use an alternative schedule: • No benefit • Vaccines are given as early as possible because babies are most susceptible to harm from disease. • A choice not to get a vaccine is not a risk-free choice. It's just a choice to take a different risk.
How do you respond? Have you heard… “I’d rather my child develop natural immunity. Isn’t it better?”
Isn’t Natural Immunity Better? YES... Immunity after disease follows a single infection; vaccine immunity may require several doses, and/or boosters
Isn’t Natural Immunity Better? …and NO The cost is pain, discomfort and the potential for complications, disability, death Vaccines are one of the safest most effective disease prevention tools known
What Can You Say? • Why take the risk? • Vaccines can safely and easily offer you the same level of immunity that you would get from natural infection but without the risk • When children are exposed to the disease, they are at risk for serious complications • Vaccine immunity is natural immunity
How do you respond? Have you heard… “I don’t see the point. I had chickenpox when I was little... and polio doesn’t even exist any more.”
No Benefit…? Vaccines are a victim of their own success! Never seen, rarely hear about If we give a bunch of children vaccines, and no one catches anything, where’s the news in that? Perception that: Risk of disease is low Risk from disease is low
Unprotected People in NC • Cases of vaccine-preventable diseases are seen across the U.S., but also here in North Carolina • Measles in 2006 • Mumps in 2010 • Pertussis (every year)
What Can You Say? • Vaccination keeps disease away • When we stop vaccinating, disease returns • While some diseases are not common in the U.S., they are only a plane ride away • Share experiences you’ve had with these diseases
How do you respond? Have you heard… “I’m just not sure vaccines are safe.” Or “Don’t vaccines cause autism?” Or “Are the additives in vaccines safe?”
Are Vaccines Safe? No vaccine (and no medication) is completely risk free common mild side effects: pain, tenderness, redness rare, serious side effects: anaphylaxis Because vaccines are given to healthy children, they must be as safe as possible Benefit clearly outweighs risk
What Can You Say? • Are vaccines safe? • Vaccines are safer than the diseases they prevent (risk/benefit) • Share most common reaction/side effects you’ve seen following vaccine • Teach them what a normal reaction looks like/what to expect
Vaccines and Autism Why is this a concern? Autism rates increasing around the world Children start showing autistic symptoms around same time they get immunizations. BUT: Evidence of autism actually present before vaccines given Multiple independent studies have shown no link between autism and vaccines The one study that suggested a connection was retracted and discredited Thimerosal (common preservative) was removed from all routine child vaccines in 2001
What Can You Say? • Do vaccines cause autism? • No. No one knows causes of autism • Genetics may play a role. • Taking parental concerns seriously – scientists thoroughly studied vaccines & autism and found vaccines did not increase risk of autism • Autism rates same in vaccinated and unvaccinated children • If don’t vaccinate – not reducing risk of autism, but are increasing the risk of contracting disease
Adjuvants: Aluminum Adjuvants enhance the immune response Aluminum salts only adjuvant in US Aluminum is everywhere in the environment: a major component of the earth’s crust, and found in air, food, and water. Breastmilk and formula contain aluminum Safety well established
What Can You Say? • What about other ingredients in vaccines? • Vaccines manufactured under the strictest of standards, including all ingredients • Aluminum is naturally occurring element found in many foods including fruits and vegetables • Helps trigger body’s immune response • Tiny amounts used in vaccines are very safe
Resources http://www.chop.edu/
Communicating with Parents • Take time to listen • Validate their concerns • Use a “heart and head” approach • Balance risks and benefits • Be flexible • Direct them to reliable resources
Responding to Parent Refusals Give some vaccines if you can Revisit the immunization discussion at subsequent visits Good documentation of discussion of benefits of vaccine and risks of being unimmunized Sign a refusal waiver Diekema, Committee on Bioethics et al, Pediatrics 2005
Be a Role Model and Ask More of People May want to mention that you are up-to-date on your vaccines… May want to mention that your children, grandchildren, nieces, nephews, etc. are vaccinated Ask people to help you provide a community where children are safer from diseases
Healthcare Providers Can Make a Difference Can have a positive influence on parents decision to vaccinate their children Including parents who believe that vaccinations are unsafe. Work to increase your efforts to build honest and respectful relationships with parents Their child’s health is your priority, too! Smith PJ et al, Pediatrics 2006
Summary Many parents have questions or concerns about childhood vaccines When parents are concerned about vaccines, we must find out why and address their concerns Most parents weigh risk and benefit, and determine that vaccines are right for their child and for society Most parents have great faith in their child’s provider Most parents readily accept recommendations about vaccination
Provider Section Highlights • Branch Memos • Coverage Criteria • Consultant List • Continuing Education • E-newsletter- Vax Facts
Vax Facts • An e-newsletter from the Immunization Branch sent monthly • How to subscribe: • Send an email to this address: ncip.enewsletter-subscribe@lists.ncmail.net. • No need to include any special instructions in the subject line or in the body of the email message you send.
Centers for Disease Control & Prevention (CDC) website - www.cdc.gov/vaccines
