What’s Up Docs? Article
Niyi Omotoso, MD, FAAP
Posted June 5, 2024
We all have become too familiar in recent times with vaccine hesitancy. Last Spring 2023 at a regional immunization coalition conference, I witnessed the stories. Two parents, who are now vaccine advocates, described their journey from being vaccine confident to vaccine hesitant. The key factor they both elaborated on was their loss of trust in their child’s primary care provider. They noted how their fears/concerns were not validated and sowed doubts.
How does that happen? Takes me back memory lane to why I fell in love with pediatrics while in medical school, through residency training, and during I.D. fellowship. I chose pediatrics because I wanted to build relationships with my patient-families to facilitate wellness over their lifespan. And pediatrics provides such an opportunity for storytelling. I get to exchange stories about my own experiences and those of my patient-family, while forming our own story together over the years as their child grows up. Active listening allows us to fully be present as they share their story. An opportunity I grab every time.
Consistent messaging is equally important. The Indian Health Services webpage has a great line: “every patient at every encounter will be offered every recommended vaccine when appropriate.” Starting at the newborn checkup or new patient appointment, we sit down with the family and review the schedule from newborn vaccination at birth hospital thru 16-year old’s 2nd meningococcal vaccine. The conversation continues at every visit even if the child is fully immunized and/or is in for a routine/sick visit. In addition, our clinic exam rooms have posters illustrating the CDC routine childhood immunization schedule from newborn through 16 year-old well child checkup. Our waiting room also has bilingual educational posters on the health benefits which families read as they wait.
During shelter-in-place, we experienced remarkably low covid immunization rates among our youngest patients. Fast forward to this past winter, our rates went up. One key difference was the initial covid vaccine series were administered in stand-alone covid vaccine clinics. With inclusion in VFC inventory, we are now the ones administering them during routine visits simultaneously with other routine vaccines. Similar success story upon receipt of RSV vaccines, we rolled it out at the first newborn visit in the same manner we do all our other vaccines – explain to the family that their child is due for these vaccines, name each one and ask if they have questions.
Looking back at the just concluded 2023-2024 RSV season, none of my patient-families declined RSV immunization of their newborn/infant. Our patient-families have a relationship with us and trust has been fostered over time. As we promote health equity through a holistic preventive medicine approach, routine childhood immunizations must continue to be a foundational piece. We must continue to clearly communicate unequivocally belief in routine immunizations at every visit. Story-sharing, active listening and consistent messaging builds that trusting relationship between you and your patient-families, and makes your medical home feel secure. Let us lean on our strengths – relationship building!
Omoniyi Omotoso, MD, MPH, FAAP
Area Director for Contra Costa & Solano counties, and AAPCA1 Chapter Immunization Representative (CIR)
Resources:
https://www.cdc.gov/vaccines/schedules/downloads/teen/parent-version-schedule-7-18yrs.pdf
file:///C:/Users/niyi1/Downloads/Vaccine%20language%20toolkit%20-%20DeBeaumont%20Foundation.pdf