Determinants of parental vaccine hesitancy

Question We engage parents on a daily basis in the office to discuss immunization for their children, and some of them are hesitant about vaccination. Discussing the importance of vaccines for the child and the public, and reviewing the safety of vaccines has not led to substantial increases in acceptance in our office. What factors influence a parent's views of vaccines, and how can we effectively address them in practice? Answer Despite medical acceptance of vaccines and widespread accessibility, many Canadian children do not receive all their vaccines, and parental hesitancy has increased in the past 30 years. Thus, family physicians play an important role in addressing concerns that parents might have about vaccines and in increasing vaccine uptake. Determinants of vaccine hesitancy are heterogeneous and multifactorial. Factors that affect vaccine decision making include the perceived risks of vaccines, the relationship between parents and health care providers, and the social norm of vaccination. Communication strategies such as motivational interviewing and using presumptive language are valuable tools to increase vaccine uptake in children with vaccine-hesitant parents.