A guide to addressing vaccine hesitancy
How to help steer the conversation towards a better understanding of the risks and benefits of vaccines
Given the recent measles outbreaks and declining vaccination rates, I wanted to share with you some tips that may help when you talk with family and friends about vaccination. Of course, it is most important for people to discuss these choices with their doctors, but given the state of the world, I think it is very important for people to initiate grassroot efforts. If you live in a community that does not have a high vaccination coverage, then you may be having these conversations already. I know discussions surrounding vaccines can be heated and emotionally charged. However, in the spirit of collaboration and community-mindedness, we need to leave the emotions out of it and try to help each other. This post will discuss some of the methods that may be effective for communication strategies when talking about vaccines with people who are hesitant.
A few reminders:
Do not allow conversations to become argumentative. Once that happens, it becomes difficult to move the conversation in a productive direction
It’s okay to be frustrated, but do not let that come out in a conversation.
Come from a place of empathy, not judgement
Be patient. It can take time to make health decisions
What is Motivational Interviewing?
When I was in medical school, I learned about motivational interviewing as a collaborative, communication style that helps people explore motivations to make a behavioral change. This style helps build trust so that the person feels heard and not judged. It helps reduce resistance and encourage autonomy. Here are some of the core principles:
Express Empathy: listen actively and show understanding
DON’T: say “why won’t you just get the vaccine?” That is too confrontational
DO: say “what are your main concerns about the vaccine?” Helps start the conversation
Develop Discrepancy: highlight the gap between current behavior and personal goals or values
Roll with Resistance: avoid arguing. Instead, acknowledge concerns and guide reflection
Support Self-Efficacy: empower the person to make the best choice for themselves
Affirmations to reinforce strengths and positive intentions
“I can tell you really care about making the best decision for your child.”
“That’s a great question. You’re thinking carefully about this, which is really important.”
Reflective listening (rephrasing what you hear to show understanding)
“It sounds like you’re worried about the safety of vaccines, and I want to make sure you have all of the right information”
“You’re feeling torn because you want to protect your child but also want to avoid unnecessary risks.”
Summarizing (helps organize important issues and guide next steps)
“So, you’re worried about side effects but also don’t want your child to get measles. You want to be sure you’re making the safest choice. How can I help with that?”
Elicit-Provide-Elicit - try this out before overwhelming someone with facts. It also helps to stay non-confrontational
Elicit: “What concerns do you have about the MMR vaccine?”
Provide: “Most side effects are mild, like a sore arm or fever, and serious reactions are extremely rare - less than one in a million.”
Elicit: “What do you think about that?”
Example of how this conversation may look between parents
This is a theoretical scenario that can play out that uses the principles mentioned earlier.
Scene: A playground bench while watching their kids play.
Alex is a parent who is friendly and understanding who supports vaccines. Jamie is a concerned parent who is unsure about the MMR vaccine.
Alex: Hey Jamie, I overheard you talking about your son’s upcoming check-up. How are you feeling about it?
Jamie: Oh, I’m a little nervous. The doctor mentioned the MMR shot, and I just don’t know. There’s so much conflicting information out there.
Alex: That makes sense. It sounds like you really want to make the best decision for your child.
Jamie: Yeah, exactly. I just keep hearing stories—like that MMR might be linked to autism, or that it can cause serious side effects. I don’t want to take any risks.
Alex: I hear you. You’re being really thoughtful and cautious, which is totally understandable as a parent. What are your biggest concerns?
Jamie: Well, I just don’t know if it’s necessary. I mean, I don’t really see measles around, so is it worth the possible risks?
Alex: That’s a great question. It sounds like you’re weighing the risks and benefits really carefully.
(Elicit-Provide-Elicit technique)
Alex: Can I share something that helped me when I was deciding?
Jamie: Yeah, sure.
Alex: I used to think measles wasn’t a big deal either because I hadn’t seen it. But I learned that measles cases have been rising in some areas where vaccine rates dropped. It’s actually way more contagious than the flu—like, if one kid gets it, nine out of ten unvaccinated people around them can catch it. And it can lead to serious complications, even in healthy kids.
(Pauses to let Jamie process the information.)
Alex: What do you think about that?
Jamie: I didn’t realize it was that contagious. But I still worry about the side effects. What if something happens to my son?
Alex: That’s a really valid concern. It’s scary to think about something bad happening. I actually asked my doctor the same thing, and I found out that the most common side effects are mild, like a sore arm or a low fever. The serious ones, like allergic reactions, are incredibly rare—like one in a million rare. But measles complications, like pneumonia or brain swelling, are much more common.
Jamie: I guess I never really thought about the risk of measles itself. I was more focused on the shot itself being the danger.
Alex: Yeah, that’s totally understandable. There’s so much noise out there that it’s easy to focus on the vaccine instead of the disease it prevents. If you’re open to it, your doctor might be able to answer some of your questions too. What would make you feel more comfortable about the decision?
Jamie: I think I need to read more from sources I can trust. I don’t want to just Google things and get scared by misinformation.
Alex: That makes sense. I found the CDC and the American Academy of Pediatrics really helpful—they break things down in a way that’s easy to understand. Want me to send you a link?
Jamie: Yeah, that’d be great. Thanks for talking about this with me. I was worried you’d just try to push me into it.
Alex: Not at all! We’re all just trying to do what’s best for our kids. I know you’re coming from a place of love, and I respect that.
I hope you found this information helpful!
Subscribe to stay informed about your health. While not required, any support is greatly appreciated.
I've said it before. People need to walk older cemeteries and look at the graves with lambs on their tombstones. This area typically the children. Sometimes cause of death is there. Look for the ones with multiple children dying within days or weeks of one another. We've lost the memory of how horrible these diseases are. Those cemeteries sold me on vaccines long ago.
This is great and I hope it’s helpful for some people! I think it’s important to establish that there are minority groups that are hesitant due to medical racism in this country too. I would encourage everyone to learn about Tuskegee syphilis study if you don’t know about medical racism. I did a study as an undergraduate when the first Covid vaccines were available in the spring 2020 about why people were against vaccines vs. hesitant to receive them. The distrust in the medical and science community was the top response why people were hesitant to receive them. It is important to find why they don’t trust the medical/scientific community then address their concerns about vaccines. Some people have personal experiences with medical racism or knowing someone that responded poorly to a vaccine (e.g. Guillain-Barré syndrome) so that is where some of their emotions come in when they are anti-vaccination. Also, I would recommend that compassion and sympathy are needed when you have these conversations otherwise people react with anger and hatred towards medical providers/scientists. As a virologist in grad school with parents that are anti-vax now (they weren’t prior to 2021) this is how I approach these conversations with the public, but also with my parents.