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When parents won’t vaccinate their children: a qualitative investigation of australian primary care providers’ experiences

9 Sep, 2017
Berry et al. , Source: BMC Pediatrics

Background: Increasingly, the experiences and perceptions of parents who decline vaccination are the subject of
investigation. However, the experiences of clinicians who encounter these parents in the course of their work has
received little academic attention to date. This study aimed to understand the challenges faced and strategies used
when general practitioners and immunising nurses encounter parents who choose not to vaccinate their children.
Methods: Primary care providers were recruited from regions identified through the Australian Childhood Immunisation
Register (ACIR) as having higher than national average rates of registered objection to childhood vaccination. Interviews
began with an exploration of provider experiences with parents who accept, are hesitant towards, and who decline
vaccination. Participants were asked specifically about how they addressed any difficulties they encountered in their
interactions. Thematic analysis focused on encounters with parents – challenges and strategies.
Results: Twenty-six general practitioners (GPs), community and practice nurses (PNs) were interviewed across
two regions in NSW, Australia. Providers’ sense of professional identity as health advocates and experts became
conflicted in their encounters with vaccine objecting parents. Providers were dissatisfied when such consultations
resulted in a ‘therapeutic roadblock’ whereby provider-parent communication came to a standstill. There were
mixed views about being asked to sign forms exempting parents from vaccinating their children. These ranged
from a belief that completing the forms rewarded parents for non-conformity to seeing it as a positive opportunity
for engagement. Three common strategies were employed by providers to navigate through these challenges; 1)
to explore and inform, 2) to mobilise clinical rapport and 3) to adopt a general principle to first do no harm to the
therapeutic relationship.
Conclusions: Many healthcare providers find consultations with vaccine objecting parents challenging and some,
particularly more experienced providers, employ successful strategies to address this. Primary care providers, especially
those more junior, could benefit from additional communication guidance to better the outcome and increase the
efficiency of their interactions with such parents.
Keywords: Vaccination, Iimmunisation, Communication, Vaccine-hesitance, Consultation, Primary healthcare provider

This entry was posted on Saturday, September 9th, 2017 at 11:17 pm and is filed under Literature.

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