Parents' Decisions about Vaccination and the Art of Gentle Persuasion

"Too much urging can backfire and entrench some parents' opposition to vaccination."

This blog posting uses Dr. Seuss's book Green Eggs and Ham to provide a light-hearted analogy to the plight of anyone who has tried to persuade another person to abandon an entrenched position - especially a parent's decision to not vaccinate their child. As the author of this blog notes, "psychologists have found that too much urging can result in a backfire effect, with the person becoming more committed to their beliefs."

The importance of talking with parents who actively decline vaccines is described here as key: "One of the most important times to address this problem is when parents are forming or solidifying their views on vaccination - usually during pregnancy or in the child's first year. At this time, their family doctor or child health nurse has a crucial role in discussing concerns." An international group of clinicians and communication scientists worked to develop a framework for health professionals in communicating about vaccination (For a summary of "Communicating with Parents about Vaccination: A Framework for Health Professionals", please see below.) The framework involves a tailored approach and is informed by evidence in the areas of communication science and motivational interviewing. It begins with a spectrum of parental positions: unquestioning acceptance, cautious acceptance, hesitance, delay/selective vaccination, and refusal. The common theme is listening and acknowledgement. Across all scenarios, "it is more effective if professionals build rapport, accept questions and concerns, and facilitate valid consent by discussing both benefits and risks of vaccination."

Citing Dr. Seuss's Green Eggs and Ham, this blog's author notes that it is not until Sam I Am finally acknowledges, "'You do not like them, so you say. Try them try them and you may' that the winds of refusal change. The narrator tries the strange dish and, by book's end, happily declares his love for it, and his gratitude to Sam. Seuss showed us that a simple acknowledgement and a more respectful plea is part of the art of gentle persuasion."

December 2013 update: A multidisciplinary group with expertise in cognitive science, immunisation, general practice, paediatrics, complex interventions, and communication is doing further development on the framework and looking at if and how it can be implemented in primary care practice. Click here to learn more.