Emphasize the Essentials
Some vaccines are more important than others for very young children to receive. For example, haemophilus influenza and pneumococcal disease together cause meningitis and pneumonias—serious illnesses in many cases that actually cause childhood deaths. Likewise, pertussis (whooping cough) is still in circulation. This disease is a serious illness that can potentially kill young children. It needs to be prevented by vaccine.
If vaccination is limited by the parents, be sure you educate parents to elect the pertussis, h. influenza and pneumococcal vaccines in the first year. Include the facts about the truly serious risks these disease hold for very young children.
Consider Altering the Schedule
Most of the people in my practice eventually come around to having the vaccines done. If we agree to complete the vaccines but the parents want to follow a different schedule than the standard one, it can usually be worked out without reducing needed vaccination coverage.
Educate parents in alternatives to adjust the vaccination schedule so that the children are vaccinated and the parents feel their concerns have been addressed. This will also protect your practice provided you stay on top of the case and follow-up with parents about agreed-on vaccines.
Get some backup! Utilize the Internet to educate parents. Since most people have access to online sources of medical information – both good and poor – be sure to steer parents to good sources of vaccination information. The following are highly recommended:
- American Academy of Pediatrics (AAP)’s childhood immunization website contains lots of great information for both parents and clinicians. In particular, it contains a page of information just on vaccine safety related to questions of autism, thimerosol, multiple vaccines, and the dosing schedule.
- Centers for Disease Control and Prevention (CDC). CDC produces the Vaccine Information Statements required by Federal law to be distributed prior to each vaccination. Its vaccines website addresses a variety of vaccine and immunization topics, including information segmented by patient age.
- Immunization Action Coalition (IAC). IAC is a nonprofit organization that promotes immunization. It offers vaccine-related information for healthcare professionals. IAC sponsors a second site, VaccineInformation.org, to provide educational materials more focused to parents and the general public.
- National Network for Immunization Information (NNii) . NNii provides current, science-based, extensively reviewed information to healthcare professionals, the media, policy makers, and the public.
- Vaccine Education Center (VEC). The goal of the VEC at Children’s Hospital of Philadelphia is to accurately communicate the facts about each childhood vaccine. VEC publishes a monthly vaccine e-newsletter for parents as part of its “Parents PACK program.” The Parents PACK website – for Possessing, Accessing and Communicating Knowledge about vaccines—is designed to supplement vaccine educational materials to regular office visits. Materials are available in English and Spanish.
- The Institute for Vaccine Safety (IVS). The IVS is part of the Johns Hopkins Bloomberg School of Public Health. It provides an independent assessment of vaccines and vaccine safety to help educate physicians, the public and the media about key issues surrounding the safety of vaccines.
- Every Child by Two (ECBT) was founded by former First Lady Rosalynn Carter and former First Lady of Arkansas Betty Bumpers in 1991 to advocate essential vaccination for children two and younger. The website features news and information for parents related to childhood immunization, including many videos by leading experts in vaccine science and safety. Many of these videos specifically address common vaccine questions and concerns related to multi-dosing, autism fears, vaccine safety testing, and the dosing schedule.
The CDC also provides a 68-page booklet, Parents’ Guide to Childhood Immunizations, introducing parents to childhood diseases and the vaccines that can protect children from them. A new, updated version will be available in Spring 2010.
Consider investing in a supply of DVDs or VHS tapes from the Vaccine Education Center to lend to parents. They make two videos: “Vaccines and Your Baby” and “Vaccines: Separating Fact from Fear”. In the first video, parents learn about vaccines and how they work, the science behind vaccines, immunity, and 11 of the diseases that vaccines prevent. The second video answers questions many parents have about vaccines.
To order them in English and Spanish, visit www.chop.edu/service/vaccine-education-center/familyOrder.cfm. Alternatively, parents can view the videos online at the VEC website.
I often travel to underdeveloped countries to treat medically needy children. Just last month, I visited three disabled children in an orphanage in Honduras who suffered from meningitis. These were meningitis cases that would have been avoided with the right vaccines. Elsewhere in my travels I have seen similar illnesses that could have been avoided by vaccines if they had been applied. However, most parents did not. Many think of chicken pox, for example, as a benign disease. But I have witnessed children die of chicken pox. We do not see the negative side of these illnesses any more in this country because of our successful vaccine program. It is easy to become an advocate for vaccines when you see first-hand what these illnesses still do. This is why I believe it is important to engage parents to convince them to have their children vaccinated because we are the ones who see or have seen the suffering caused by non-vaccination.