The decision to vaccinate is much like a math equation. Someone needs to be confident in the vaccine, want the vaccine, and get a strong provider recommendation. These three things added together almost always mean someone will choose to vaccinate.

Vaccine Confidence is about understanding the science, the vaccine development process Integrity and vaccine safety. Vaccine Demand is about disease risk perception, vaccine risks and benefits, and removing barriers. A Strong Provider Recommendation is about being a vaccine advocate at every patient encounter.

Vaccine confidence is largely about believing in that vaccines were developed with honesty and care and that they are safe. How can your practice increase vaccine confidence?

Be able to speak to the vaccine development process:

• Make sure your staff understands the rigor of the vaccine development process.
• Hang the vaccine development infographic in your waiting area and exam rooms.

Be knowledgeable about vaccine safety:

• The biggest safety issues tend to be around side effects and ingredients. Be sure you and your staff know the issues.
• Have handouts available to point patients and families to credible information.

Be able to explain vaccine science:

Some healthcare providers don’t think families need to understand vaccine science but research shows this is what families are looking for and what contributes to vaccine confidences so…

• Be sure to be able to easily and understandably explain the science.
• Don’t have the time? Send families to credible websites (shameless plug here – we have an entire science section on our website that was vetted by some of the top vaccine experts in the country.

Make sure your staff are well informed, strong vaccine advocates.

It is self-defeating if a doctor advocates for vaccines, but a med tech or nurse gives conflicting opinions, particularly given they have more time to spend with patients.

Vaccine demand is generally about having accurate knowledge of the dangers posed by the disease, understanding the benefits of vaccination, and removing barriers to getting vaccinated.

People do not have good risk perception.

Most vaccines have a one in 1 million risk of a serious adverse event. To put this in context, one-in-one-million is equivalent to:

• ONE single step in a journey of 568 miles
• ONE minute over the course of two years

So one-in-a-million is a very small probability. Families and patients need to better understand the true risks of a disease compared with the small probability of a vaccine adverse event. Having a factual understanding of risks helps caregivers make a truly informed decision about keeping themselves and their families safe.

Here are some pre-vaccine facts:

What did the world look like before vaccines? It wasn’t pretty. All kidding aside, a LOT of kids died.

Before the measles vaccine, nearly everyone got measles and hundreds died from it every. Today, most providers have not even seen a case of measles because of vaccines!

• Before there was a vaccine for diphtheria, an average of 15,000 Americans would die from it each year. But thanks to
•  vaccines, only 2 cases of diphtheria were reported to the CDC between 2004 – 2014.
• In 1964, before the rubella vaccine, an epidemic infected 12.5 million Americans, killing 2,000 babies and causing 11,000 miscarriages. Since 2012, though, there have only been 15 cases of rubella reported to the CDC. Thanks, vaccines!

We’ve all seen the pins and t-shirts thanking vaccines. Yes, they are pithy and sort of fabulously snarky. But they are also very, very true. We need to help people understand that the only human disease that has been eradicated (wiped from the face of the earth) is smallpox. Every other disease is held at bay by vaccinations. So if we stop vaccinating, the diseases will come back.

What did the world look like before vaccines? It wasn’t pretty. All kidding aside, a LOT of kids died.

Use your EHR systems not only to remind caregivers to schedule appointments, but also to prepare them for the vaccines their children will receive and to point them to good information about those vaccines. Ensure all your staff ask about vaccines at every visit.

Giving a strong provider recommendation Most healthcare providers believe they give strong vaccine recommendations. But studies show that may not always be the case. For instance, during H1N1, only 38% of patients felt they received a strong vaccine recommendation for their children. Thirty-fife percent of patients reported that healthcare providers did not provide any recommendation, and 5% of providers actually discouraged vaccination. We can do better. There are two great models to focus on when providing a strong recommendation. Together, they can instill confidence and drive demand for vaccines. The first model, SHARE, was developed by the Centers for Disease Control and Prevention (CDC). It is a highly effective, evidence-based recommendation model that provides tangible talking points:

Research shows that presumptive positive conversations are more effective in positive behaviors than neutral or questioning conversations.

What does presumptive positive look like? It’s stating “it’s time to get your vaccine now” rather than asking “are you planning to get this vaccine.” This works because the majority of us support vaccination and we relate to the way presumptive positive questions make vaccination seem like the normal course of action. Neutral or questioning approaches make us wonder if our choice needs to be examined.

Only delve into the “questioning mode” if someone answers a presumptive positive with “no” or “I don’t know” type answers. Then, find out what their single biggest issue is that is stopping them from getting vaccinated.

• If it’s access: help make it easy to get vaccinated
• If it’s a lack of urgency: help them understand the risks of going unvaccinated
• If it’s information: offer to share understandable and credible information around their biggest concern (shameless plug here, we’ve got TONS of this on our website so send them to us!)