Communicating with Parents about Childhood Vaccines: The Experience of Primary Care Physicians

Background:Little is known about the prevalence of parental requests to deviate from recommended vaccine schedules and physicians' practices and attitudes regarding communicating with parents about vaccines.

Objectives:To assess among Pediatricians (Peds) and Family Medicine (FM) physicians: 1) prevalence of parental requests to deviate from recommended schedules; 2) responses to such requests; and 3) attitudes about the burden and success of communicating with parents about vaccines.

Methods:Nationally representative surveys of Peds and FM physicians conducted 2/2009-5/2009.

Results:Response rates were 88% for Peds and 78% for FM (N=696). Nine percent reported that ≥10% of parents refused a vaccine and 20% reported that ≥10% of parents requested to spread out vaccines in the past month. More Peds than FM reported always/often requiring parents to sign a form if they refused vaccination (53% vs 31%, p<0.0001); 70% of Peds and 55% of FM (p=0.0001) agreed to spread out vaccines in the primary series at least sometimes. When talking with concerned parents, 59% of Peds and 45% of FM reported spending 10-19 minutes (p<0.001) and 9% vs 5% spending ≥20 minutes (p=NS). Peds were more likely than FM to report their job less satisfying because of parental vaccine concerns (46% vs 21%, p<0.0001) and perceived that parental disagreement with their recommendations showed a lack of respect for their medical judgement/experience (41% vs 22%, p<0.0001). Messages most commonly reported as "very effective" were personal statements about what physicians would do for their own children or their personal experiences with vaccine safety among their patients.

Conclusions:  Communicating about vaccines is time-consuming and results in decreased job satisfaction, especially for Peds. Peds and FM report handling parental requests to deviate from the recommended schedule differently, but all report the greatest success for convincing skeptical parents is using personal messages such as what they would do with their own children.