Childhood Vaccine Hesitancy

Vaccine development is considered one of the greatest achievements of public health and medical science with millions of lives saved worldwide from many once-deadly infectious diseases.  Fortunately, most parents readily accept all vaccines recommended by the American Academy of Pediatrics (AAP).  However, vaccine hesitancy is becoming increasingly prevalent. Pediatric Resident, Dr. Caroline Fu, joins Associate Professor of Pediatrics at MCG, Dr. Donna Moore, to discuss childhood vaccine hesitancy. 

After listening to this podcast, learners should be able to:

1. Recognize the public health concerns of childhood vaccination refusal and delays.
2. Understand common objections and concerns about vaccines and know how to dispel misconceptions.
3. Utilize communication strategies for counseling vaccine hesitant parents.
4. Know how to access reputable resources to provide parents who would like additional resources.
5. Explain the few true medical contraindications to vaccines vs. religious or philosophical objections.
6. Review tips on how to approach parents who continue to refuse vaccines despite extensive counseling.

FREE CME Credit (requires free sign-up):  https://mcg.cloud-cme.com/course/courseoverview?P=0&EID=11406 

References: 

• Wolfe, RM and Sharp, LK.  Anti-Vaccinationists Past and Present.  BMJ.  2002; 325:430. 
• AAP COMMITTEE ON PRACTICE AND AMBULATORY MEDICINE, AAP COMMITTEE ON INFECTIOUS DISEASE, AAP COMMITTEE ON STATE GOVERNMENT AFFAIRS, AAP COUNCIL ON SCHOOL HEALTH, AAP SECTION ON ADMINISTRATION AND PRACTICE MANAGEMENT.  Medical versus Nonmedical Immunization Exemptions for Child Care and School Attendance.  2016; 138 (3): e20162145 
• Edwards KM, Hackell JM, AAP THE COMMITTEE ON INFECTIOUS DISEASES, THE COMMITTEE ON PRACTICE AND AMBULATORY MEDICINE.  Countering Vaccine Hesitancy.  Pediatrics.  2016; 138(3): e20162146 
• Natbony, J and Genies, M. Vaccine Hesitancy and Refusal in Brief.   Pediatrics in Review.  2016; 40.1(22-3) 
• Smith, M.  Vaccine Safety: Medical Contraindications, Myths, and Risk Communication.  Pediatrics in Review.  2015; 36:6 (227-236). 
• Healy, MC and Pickering, LK.  How to Communicate with Vaccine-Hesitant Parents.  2011; 127:S127-S133. 
• McKee, C and Bohannon, K.  Exploring the Reasons Behind Parental Refusal of Vaccines.  Journal of Pediatric Pharmacology and Therapeutics.  2016; 1:2 (104-9). 
• Wombwell E, Fangman MT, Yoder AK, and Spero DL.  Religious Barriers to Measles Vaccination.  Journal of Community Health.  2015; 40:597-604. 
• Singh, K and Mehta, S.  The clinical development process for a novel preventative vaccine: An overview.  Journal of Postgraduate Medicine. 2016; 62(1): 4-11.   
• Girotto, J.  What does full FDA Approval Mean for a Vaccine already authorized for emergency use?  UConn Today.  August 19, 2021. https://today.uconn.edu/2021/08/what-does-full-fda-approval-mean-for-a-vaccine-already-authorized-for-emergency-use/ 
• Quinn SC, Jamison AM, Freimuth V.  Communicating effectively about emergency use authorization and vaccines in the COVID-19 pandemic.  Am J Public Health.  2021; 111(3):355-358. 
• JD Grabstein. What the World Teaches, Applied to Vaccines and Immunoglobulins. Vaccine.  2013 April 12;31(16):2011-23.doi: 10.1016/j.vaccine.2013.02.026. Epub 2013 Feb 26. 
• World Health Organization. Ten health issues who will tackle this year. 2019.  https://www.who.int/news-room/spotlight/ten-threats-to-global-health-in-2019

Resources for parents and providers 

• CDC provider resources for conversation with vaccine hesitant parents: https://www.cdc.gov/vaccines/hcp/conversations/index.html
• https://www.cdc.gov/vaccines/parents/index.html (CDC vaccines for parents resource) 
• https://www.cdc.gov/vaccines/pubs/pinkbook/index.html (PinkBook CDC) 
• https://www.cdc.gov/vaccines/hcp/acip-recs/vacc-specific/hepb.html (Advisory Committee on Immunization Practices; contraindications and precautions for vaccines) 
• https://www.fda.gov/vaccines-blood-biologics/safety-availability-biologics/thimerosal-and-vaccines#cstat
• https://www.chop.edu/centers-programs/vaccine-education-center/vaccine-ingredients CHOP vaccine ingredients  
• https://www.chop.edu/centers-programs/vaccine-education-center/resources/vaccine-and-vaccine-safety-related-qa-sheets CHOP Vaccine safety q and a 
• https://www.vaccinesafety.edu/Religion.htm
• https://downloads.aap.org/DOPCSP/SOID_RTV_form_01-2019_English.pdf AAP Refusal to Vaccinate Form - English 
• https://downloads.aap.org/DOPCSP/SOID_RTV_form_01-2019_Spanish.pdf AAP Refusal to Vaccinate Form - Spanish 
• https://www.nytimes.com/interactive/2020/science/coronavirus-vaccine-tracker.html COVID vaccine tracker (details the vaccine trials and approval process).