It matters how you phrase a child’s flu vaccine recommendation

June 8, 2017|Family Practice News

FROM VACCINE

Vaccine hesitant parents were more likely to change their minds about flu vaccine for their children when pediatricians or pediatric nurse practitioners used a presumptive recommendation that their children get the vaccine, pursued the recommendation if the parent was resistant, and combined their recommendation for the flu vaccine with other childhood vaccines, said Annika M. Hofstetter, MD, PhD, of the University of Washington, Seattle, and her associates.

The researchers recruited 17 pediatricians and pediatric nurse practitioners from eight primary care pediatric practices in the Seattle area to take part in 50 videotaped visits with parents during the 2011-2012 and 2013-2014 flu seasons.

Parents were primarily mothers who were married, white, 30 years of age, had an annual household income above $75,000, and vaccine hesitant. Most (85%) had discussed vaccines previously with their child’s clinician. Only 44% of the parents immediately accepted the clinician’s first recommendation that their child receive a flu vaccine. Immediate acceptance was higher when a presumptive format (“Today we’ll do the flu vaccine”) was used (72%), compared with a participatory format (“Are we gonna do the flu vaccine today?”) (17%; P less than .01). If the parents verbally resisted, only 25% of clinicians pursued their original recommendation. In response, 60% of parents immediately accepted the recommendation. Overall, 48% of parents accepted flu vaccination by the end of the visit.

More parents accepted flu vaccine for their child if the clinician recommended it concurrently, rather than separately, from other vaccines (83% vs. 33%; P less than .01), Dr. Hofstetter and her colleagues said. The various communication patterns did not appear to negatively affect the way parents rated their visit experiences.