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Patient-Provider Communication About Vaccines Lacking in Pediatrics

A small margin of parents reported skipping pediatrician visits to avoid patient-provider communication about vaccines, a growing problem for overall preventive and well-child care.

Patient-provider communication about vaccines, particularly in the pediatric setting, is falling short, with at least one in seven parents reporting in a recent C.S. Mott Children’s Hospital poll that they haven’t discussed vaccines with their child’s regular provider.

This comes even as data pours in suggesting that provider testimony about vaccines helps improve vaccine enthusiasm among parents and ensure kids get all of their vaccines, the researchers said.

Most parents are having some talks with their child’s pediatrician about vaccines, the survey indicated, but there’s some variation in which shots they discuss. For example, 82 percent of parents said they’ve discussed the vaccines that are required for school with their child’s doctor, while only 68 percent discussed the flu shot and 57 percent discussed the COVID-19 vaccine.

That variation is surprising, Sarah Clark, MPH, the poll’s director, considering how new the COVID-19 vaccine is.

“Historically, parents have relied on their child’s pediatrician or other primary care provider to guide them in decisions about their child’s health, including recommendations about vaccines,” Clark said in a statement.

“With a new vaccine like COVID, we would expect parents to have a lot of questions and concerns, and we would expect parents to turn to that trusted primary care provider who has guided them through other vaccine decisions for their child. The lower rates of discussions for the COVID vaccine may suggest a downturn in the role of the primary care provider as the go-to source on this topic.”

Other healthcare professionals, like nurses or pharmacists, are starting to emerge as resources for vaccine information, the survey continued, although doctors are still number one. Four percent of parents said they discussed school vaccines with another healthcare professional, 8 percent discussed the flu vaccine, and 14 percent discussed the COVID-19 vaccine with another healthcare professional.

Meanwhile, some parents don’t want to engage with healthcare providers at all when it comes to discussing vaccines. A slim proportion (3 percent) of parents said they delayed or skipped a medical appointment for their child because they wanted to avoid a discussion about vaccines.

Clark said this level of disengagement, especially for the COVID vaccine, could be due to the extreme polarization the nation experienced during the pandemic.

“During the pandemic we saw a lot of misinformation and division over vaccines, as well as disruptions in care because of COVID precautions,” Clark explained. “This may have affected how often parents were talking with their child’s regular provider. Without that trusted source of vaccine information and guidance, families may turn to other sources that may be less accurate.”

Nevertheless, Clark emphasized the importance of open communication about vaccines as well as healthcare access.

“Avoiding conversations about vaccines with a child’s health provider prevents caretakers from learning about and considering new information that might influence their decision,” Clark said.

“When parents delay or skip visits altogether, they are not prioritizing their child’s well-being,” she added. “Children won’t receive screening for medical or mental health problems, and parents will not receive information or guidance about how to keep their child healthy and safe.”

Despite some hesitance, the poll showed that patient-provider communication about vaccines is generally fruitful. Around eight in 10 parents said providers were open about their questions or concerns about the flu or COVID shots, while seven in 10 said the provider offered information that was helpful for making a decision to get the jabs.

Sixty-five percent of parents said their pediatrician explained all of the knowns and unknowns about the COVID vaccine, while 55 percent said the same about the flu vaccine.

All said, parents who discussed vaccines with their child’s doctor were more likely to opt into vaccination.

Conversely, of the 6 percent of parents who said their child has not received any vaccines 43 percent said they’ve had no discussions about shots with their pediatrician in the past two years.

“Lack of discussion prevents these parents from learning about and considering new information that might prompt them to reevaluate the reasons for their decision to not vaccinate their child,” the researchers wrote in the report.

Forgoing patient-provider communication about vaccines could also open the door for patient navigation pitfalls. About a quarter of parents said they had a hard time getting their child scheduled for a vaccine in the past two years, with barriers including appointment challenges and having to go to another location for the jabs.

Parents who reported those barriers were also more likely to report that they did not discuss vaccines with their child’s pediatrician. Having a discussion about vaccines may have answered parent questions, but the researchers acknowledged that the backlog in well-child visits opening during the pandemic may have left clinicians pressed for time.

Meanwhile, providers may be reticent to discuss vaccines they do not carry or for which they have low supply.

“This situation disrupts the parent-provider discussion around those vaccines,” Clark said. “Even when parents bring the child in for a visit, they may be told that they need to go elsewhere to get flu and COVID vaccines, requiring extra time and hassle for families.”

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