Healthcare, early learning & childcare professionals play a key role in vaccine communication. They are a trusted source of vaccine information for parents and guardians.
This page provides advice on how to talk to parents and guardians about childhood vaccines.
Understanding vaccine hesitancy
What is vaccine hesitancy and refusal?
The World Health Organisation defines vaccine hesitancy and refusal as a delay in the acceptance of vaccines or refusal of vaccines despite the availability of vaccination services. Vaccine hesitant individuals may express concern, doubt, or be indecisive about the benefits or safety of vaccines or be reluctant or refuse to be vaccinated.
Why are some people vaccine-hesitant?
People express hesitancy towards vaccines for complex reasons. Studies find that parents worry about vaccine safety and adverse effects. However, simply providing information about vaccine safety about vaccines may not be sufficient in itself. The parents we spoke to described feeling confused and fearful as they encountered conflicting claims from different sources and worried about being judged for their choices. Therefore, communication that builds rapport and trust is needed.
Understanding the reasons for vaccine hesitancy
Vaccine hesitancy is the reluctance or refusal to have oneself or one's children vaccinated despite the availability of vaccination services.
The reason for vaccine hesitancy varies across individuals, regions, cultures, and time periods. In some cases, there may be emotional, cultural, social, or political elements to vaccine hesitancy. In addition, some vaccines are accepted more readily by individuals than others.
Research suggests that the three following factors may explain vaccine hesitancy:
- A lack of confidence in the safety or effectiveness of vaccines or vaccination programmes and services
- A sense of complacency regarding the risks of vaccine-preventable diseases
- A lack of convenience in the availability or accessibility of vaccines
We describe these as the 3Cs:
- Complacency: The person perceives the risk of vaccine-preventable illnesses as being low. Other health or life responsibilities may be more important at that time.
- Confidence: The person expresses not having faith or trust in vaccines and those responsible for delivering vaccination programmes and services.
- Convenience: The person's ability to access vaccination programmes can be affected by geographical accessibility, understanding (language and health literacy) and how appealing the immunisation services are.
What else can influence people’s vaccine decisions?
Research suggests that several factors can influence an individual's decision to accept a vaccine or be vaccine-hesitant. Conversations we had with parents revealed these factors and included:
- Healthcare experience: the individual, family or community members' positive or negative experience with healthcare or vaccination services
- Group and individual influences: the individual, family or community members' beliefs, attitudes, knowledge and awareness about health and vaccinations
- Media and social media platforms: media, websites and social media platforms that can highlight false, incorrect and misleading vaccine information or vaccine rumours and myths
- Health information and digital/health literacy: the individuals' ability to access, identify, weigh up and understand the correct vaccine information
Additional information on vaccine hesitancy is available in the European Centre for Disease Prevention and Control (ECDC) Report "Let's talk about protection: Vaccination guide".
Why are healthcare professionals important?
Parents consider their child's healthcare professionals to be trusted sources of vaccine information. This trust is evident even in vaccine-hesitant parents or parents who have considered delaying one or more vaccines.
In addition, healthcare professionals play a key role in establishing and maintaining a commitment to communicate about vaccines and maintaining high vaccination rates. You do this by taking time to answer parents’ questions, providing vaccine information and making sure they keep up to date with the HSE vaccine schedule and their vaccination visits. Therefore, you play a crucial role in informing and helping parents make vaccine decisions and choices.
How to approach vaccine hesitancy
For those who are vaccine-hesitant, building trust is essential through a respectful, non-judgmental approach that aims to draw out and address specific concerns.
Key points for you to remember:
- Ask permission to discuss concerns
- Acknowledge any concerns that are expressed
- Try to address each concern
- Don't overwhelm parents with scientific information and medical jargon
- Use or provide accessible resources
How to approach vaccine refusal
For those who refuse vaccines, you should aim is to keep the consultation brief, keep the door open for further discussion and provide appropriate resources if wanted.
Key points for you to remember:
- Ask permission to discuss concerns
- Acknowledge any concerns that are expressed
- Try to address each concern
When should vaccine conversations begin?
Discussions with healthcare professionals about childhood vaccination can and should occur with new parents. However, starting the vaccine conversation is never too early. Studies have shown that the vaccine decision-making process begins for most people in the lead-up to becoming a parent. In addition, the parents we spoke to describe becoming a parent as a busy time where they can feel overwhelmed by lots of information.
Talking to parents about vaccines
Many parents have questions about their children's vaccines. Answering their questions can help parents feel confident in following the HSE childhood immunisation schedule.
For a list of common questions posed by parents and to read the answers to those questions, see our page ‘Guide for Parents about Childhood Vaccines’.
Consider the following tips and approaches for a successful discussion about vaccines:
- Emphasise benefits: maintain the focus on the benefits of protection. Parents must be fully aware that when they get their children vaccinated, they protect them and their communities from dangerous diseases.
- Respond to parents’ concerns: research suggests that tailoring the discussion to parents' concerns can foster trust and positively affect the provider-parent relationship.
- Acknowledge risks: Avoiding references to risks and negative side effects might be tempting. However, it is important always to be honest in discussing the known side effects of vaccines. Communicate accurate information about risks. For example, statistically, the degree of serious reactions to vaccines is very rare.
- Balance scientific evidence with relatable stories: Too much scientific evidence may be overwhelming or confusing for some parents. For other parents, too many anecdotal stories may be unconvincing. Respond to the parent's needs and be prepared to use a mix of references to scientific evidence and relatable stories.
- Provide a strong recommendation: Clearly state your strong recommendation, such as "I strongly recommend you vaccinate your child".
- Remain open to the conversation: If parents refuse to vaccinate, continue the conversation about vaccines during the next visit.
Explaining the vaccination programme to parents in Ireland
Download and print our FREE 'Every Child Needs 5' Immunisation info poster which has been specially designed for healthcare, early learning & childcare professionals in Ireland. It explains the immunisation stage in an easy-to-explain manner. Use this with a hand gesture to explain the process to the parents
In addition to above, consider recommending that parents use the easy-to-use parent's chart on vaccination below:
Explaining Full Childhood Vaccination Schedule for Ireland
Download our FREE 'Full Childhood Immunisation Schedule for Ireland' for Parents and Professionals outlining the full childhood immunisation schedule for Ireland. It explains the number of visits and diseases vaccines protect against.
Vaccine conversation guide for healthcare workers
When we spoke to parents, they told us that healthcare professionals play an essential role in their vaccine decisions and choices. You do this by maintaining trusting relationships, listening to and discussing their questions and concerns, and providing them with vaccine information and resources. However, healthcare settings are busy, and long vaccine conversations can take time. Because of this, we designed this resource to guide you with conversational techniques and resources for discussing vaccines with parents.
Download our infographics below, on a vaccine conversation guide for healthcare workers. Alternatively, the ECDC has produced a Guide for professionals on talking with parents "Let's talk about protection"
Why are Early Learning Educators important?
The early learning educators and parents we spoke to describe developing strong and trusted relationships while children are in their care. In addition, childcare facilities are legally required to maintain immunisation records on all children attending.
Therefore, parents would discuss vaccine concerns and questions with you. You do this by listening to their concerns and directing parents toward the correct vaccine information to answer parents' questions. However, childcare settings can be busy, and conversations about vaccines can be difficult and take time. Therefore, we have provided you with a, 'Guide for Parents about Childhood Vaccines', that lists common questions posed by parents and the answers to those questions.
Download the ECDC's Guide for the professionals on talking with parents "Let's talk about protection"
The following tips and approaches should help you in discussing vaccines with parents:
- Remember, it is not your role to convince those who are vaccine-hesitant
- Avoid offering medical advice and your own opinions
- Guarantee confidentiality and the conversation to happen in a safe space
- Listen and maintain the dignity of the speaker
- Don't judge what the person is saying
- Support the person to speak their whole truth/experience
- Try to direct them to trusted vaccine information
Debunking false information
Parents are often exposed to false information about vaccines. In addition, they may have read or heard scary stories about vaccines from family members, friends, websites, or social media. Sometimes these involve dramatic and traumatic stories of harm to children.
According to ‘The Debunking Handbook’, you are more likely to be successful in debunking false information if you apply the following steps:
- Lead with accurate information: the discussion should put emphasis on accurate information. Make it simple, concrete, and plausible. For example, "the benefits of vaccines outweigh the risks".
- Avoid repeating the false information unnecessarily: if you need to acknowledge the false information, avoid repeating the scary story. Needless repetitions may reinforce belief in the false information.
- Explain why the false information is wrong: Rather than simply stating the information is false, provide an explanation to help the parent understand why it is false.
- Reinforce accurate information: Restate the accurate information again to ensure that the last thing parents process is factual.
Further information & practical advice
- How to talk to parents in the ECDC’s ‘Let’s talk about protection' and the US CDC on ‘Talking with Parents about Vaccines for Infants’
- How to counter false information in ‘The Debunking Handbook’
- The World Health Organisation’s Report of the SAGE Immunisation Working Group on Vaccine Hesitancy
- Read the Vaccine Hesitancy Toolkit
