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Table 4 Parental position, with the recommendations for each group

From: Communicating with parents about vaccination: a framework for health professionals

Parental position Key indicators Goal Strategies*
    See also Table3
Unquestioning acceptor Present for vaccination when it is due Child vaccinated and parent positive about decision Build rapport
Cautious acceptor Child is fully vaccinated to date   Accept questions and concerns
    Use verbal and numerical descriptions of vaccine and disease risks
    Explain common side effects and rare, important risks
    Aim to keep discussion brief but flexibly addressing parent’s needs
The hesitant Present on time or slightly late Child vaccinated and parent accepts decision Use guiding style
Late or selective vaccinator Child is fully or partially vaccinated This group may need most time but are most likely to change behaviour Provide risk and benefit information (as above)
  Present late   Use decision aids and other quality information tools
  Child is partially vaccinated   Book another appointment to re-visit discussion
Refuser Present for another reason. Subject of vaccination may have to be raised by health professional. Parent prepared to think about vaccination and attend clinic for further discussion Avoid scientific ‘ping pong’ – debating back and forth about vaccination.
  Child is partially or completely unvaccinated Feels concerns heard and not critical of providers Ask about importance of protecting child against infectious disease and confidence in the vaccine and respond accordingly
   Parent is aware of the risks of not immunising the child Explore receptivity to an individualised schedule
    Aim to keep discussion brief but leaving door open to further discussion if parent is moving towards considering vaccination
    Offer attendance at special clinic
  1. * Based on UK vaccination schedule in 2011 [55].