Primary care physicians must listen, educate, vaccinate

Ada D. Stewart, MD, FAAFP
_{Photo courtesy of AAFP}

Fall is the best time of year to be a family physician. It’s the time I get to catch up with many of my young patients, see how they’ve grown, what they’ve learned, and how they’re feeling. I’ve known some of my young patients since they were babies and enjoy being part of their early health journey. Family physicians also have strong relationships with their young patients’ parents, which is why we must keep them engaged in their children’s preventive health – especially when it comes to immunizations.

Despite national efforts, recent data from the United Nations and UNICEF revealed nearly 25 million children missed vaccinations in 2021. Adding to that concern, four in 10 parents don’t plan to vaccinate their children under age 5 against COVID-19, and only 30% of children ages 5 to 11 have received at least one dose of the vaccine. These statistics are especially alarming as we head into a new school year.

As a family physician, I seize every opportunity to help patients understand the vital role of vaccines in protecting their own and their children’s health. Vaccines are safe, effective and they save lives. The COVID-19 vaccine has been proven to reduce the risk of severe illness, hospitalization, and even death, across all age groups. That’s why it’s important for all of us in primary care to continue having conversations about vaccine hesitancy in a curious and nonjudgmental way.

A frustrating challenge we face today is misinformation about vaccines on the Internet, as well as in the news and on social media. When a patient expresses concern about a particular vaccine, I want to know why. Where are they getting their information? Many patients are influenced by cultural factors and stories from the past that have made them fearful of vaccines and mistrustful of doctors. Unfortunately, Black and Hispanic people have been among our patients most affected by COVID-19, making it more important than ever to have these conversations to prevent further health disparities.

Be direct

My advice is simple: Be direct. Data show that a physician recommendation is the most important reason a patient agrees to get vaccinated. Some of my key recommendations for patients and parents are:

• Vaccines are safe, effective and they save lives. Childhood diseases like whooping cough, measles, mumps, and polio were often fatal or disabling in the past, but they very rarely cause deaths in the developed world today because of vaccines and public health advances. If we stopped vaccinating, these diseases could come back, and cause new epidemics.
• Vaccines prevent severe infection and reduce your child’s risk of severe illness or hospitalization by helping them build up protections against diseases for if or when they are exposed to them.
• Being vaccinated helps build a community of immunity that is key to heading back to school and remaining healthy. As the CDC notes, devastating outbreaks can be caused by a small drop in the level needed for herd immunity against diseases. Therefore, it’s critical for everyone to do their part and stay up to date on vaccinations.
• Side effects are possible and occur because the vaccine is doing its job by activating the immune system. Common side effects include redness or swelling at the injection site or a low-grade fever. These symptoms are usually mild and go away in a day or two.
• I want you to make informed decisions about your own and your family’s health. What are your plans for vaccination today? Are there any other questions I can answer?

I also encourage my fellow primary care colleagues to be persistent. According to a 2013 study published in JAMA Pediatrics, nearly half of parents who declined vaccinations for their children ultimately changed their mind and proceeded to follow the recommendations at a subsequent visit.

Bottom line: Unless the patient believes we’ve heard and understand their concerns, it’s hard to make the case for vaccine safety. Go forth. Listen. Educate. Vaccinate!

Ada D. Stewart, MD, FAAFP, is board chair of the American Academy of Family Physicians. An AAFP member since 1995, she has served in leadership positions at the state and national levels. In 2021, she was recognized with a resolution by the South Carolina House of Representatives and Senate for her leadership and service to the people of South Carolina.