You are a nurse practitioner working in a family practice. A first-time parent brings their child in for a 2-month checkup. The parent seems nervous when vaccines are mentioned as a routine part of the appointment. You ask the parent specifically about vaccination, and the parent is hesitant. They say that they “can’t get idea of something bad happening to the baby because of the vaccination out of [their] head”. You have a strong commitment to vaccination as a part of good health care practice and to adhering to the standard public health vaccination schedule. How do you proceed with this conversation?
You are a first-time parent taking your 2-month-old baby into your doctor’s office for a checkup. You are told when you arrive that the nurse practitioner, whom you’ve met before and liked, will be seeing you today. You don’t have any concerns about your baby’s growth and development and are excited to see how much weight they’ve gained since their last appointment. You are surprised when the nurse mentions vaccination; you had thought that you didn’t have to worry about that until the next appointment. Since your baby was born you’ve been very aware of all the ways that they could be harmed, and you’ve been intent on avoiding all the risks you can; you have even stopped driving with your baby in the car unless absolutely necessary. You know that the risks associated with vaccination are low but wonder if they could nonetheless be reduced or avoided somehow. You experience the nurse’s questions about vaccination as a type of threat and feel defensive, although you also recognize that’s not the nurse’s intent. How will you respond to the nurse practitioner?
- How did your response to the case shift when you read about it from a different perspective?
- What do you see as the most important values for each person involved in the conversation?
- What are some of the other values and principles that are relevant when considering how to proceed in cases like this?
- Which factors contribute to making this a difficult conversation?
- What would the best possible outcome in this case look or sound like?
Halperin, S.A. 2000. How to Manage Parents Unsure About Immunization. CME. January 2000; 62-75. https://www.ucalgary.ca/paed/files/paed/4-halperin-article3.pdf
Zimlich, R. 2018. 4 Tools to Frame Conversations about Vacccines. Contemporary Pediatrics, November 13, 2018. https://www.contemporarypediatrics.com/pediatric-immunization/4-tools-frame-conversations-about-vaccination
Centers for Disease Control and Prevention. Talking with Parents about Vaccines for Infants. Provider Resources for Vaccine Conversations with Parents. [Accessed March 12, 2019] https://www.cdc.gov/vaccines/hcp/conversations/talking-with-parents.html
Paterson, P., Meurice, F., Stanberry, L.R., Glismann, S., Rosenthal, S.L., Larson, H.J. 2016. Vaccine hesitancy and healthcare providers. Vaccine, Vol 34 (52), 20 December 2016, p. 6700-6706
TEDx Talks. Tara Haelle. Why Parents Fear Vaccines. Published on May 2nd 2016. TEDxOslo. https://www.youtube.com/watch?v=ggtkzkoI3eM