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Table 5 Example of dialogue with the unquestioning or cautious acceptor parent

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

Health professional:

Hello Mrs Cheung. I understand you have brought Lily for her vaccinations today.

Mother:

Yeah, that’s right.

Health professional:

Hello, Lily. OK, have you read the leaflet about the injections? I’d be happy to share with you more information about vaccination. (build rapport, seek questions and concerns)

Mother:

Well only one thing. She had a slight cold last week, she seems to be over it now but I just wondered if it was safe.

Health professional:

She’s back to her normal self now?

Mother:

Yes she is

Health professional:

Then it is safe for Lily to have them today. (pausing to allow mother to interject if she has questions and observing body language) We are vaccinating her against measles, mumps and rubella, Hib, meningococcal C disease and pneumococcal disease* – all serious diseases which have been made much rarer through vaccination programs. It will be three injections and I will give her two in one arm and one in the other arm. They may upset her for a few moments but most children settle straight away after some comforting and 90% don’t have any other side effects at all (positive framing of risk using percentages). If there is a problem, the commonest thing is a slightly sore arm that will last for a few days and then settles (pause to allow questions or clarification – chunking and checking).

Mother:

OK – anything else?

Health professional:

One of the vaccines contains a small amount of weakened measles, mumps and rubella viruses which stimulate Lily’s immune system to respond and develop protection to these infections. That means she may have some mild symptoms of measles, such as a rash and a fever, and she may feel a bit off-colour 7 to 11 days after the vaccine.(pause) About 3 weeks after the vaccine, she may get a mild form of mumps, with swelling under her jaw. But this is less common and happens in only about 1% of children (qualitative and quantitative risk estimates). These symptoms are not infectious so she can’t pass them onto to anyone else and they usually go away after 1 to 2 days. The side-effects of the vaccine are usually mild and they are milder than the risks of having measles, mumps or rubella diseases. If you have worries afterwards, bring her back to the clinic and we can check her over. How does that sound? (structured information using chunks and checks and unbiased expectation of consent)

Mother:

Fine, yeah, that’s OK.

  1. * Based on UK vaccination schedule in 2011 [55].