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Table 7 Example of dialogue with the vaccine-refusing parent

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

  There is a discussion about Oliver’s upper respiratory tract infection then:
Health professional: Do you mind if we take a moment to talk about Oliver’s vaccinations?
Mother: Ah, yes, we did some research into it and decided not to vaccinate him.
Health professional: OK, can I just talk it through so I understand your decision? (asking permission to discuss and use of a guiding style)
Mother: Yeah, OK.
Health professional: To start with can I just ask you how important you think it is to get Oliver protected from the diseases vaccines are designed to prevent? (assessing importance)
Mother: Well, mostly the diseases aren’t that much of a problem in healthy children and we keep Oliver very healthy with a good diet, organic food, and plenty of fresh air.
Health professional: You’re right, most children will overcome illnesses without too much of a problem (acknowledging). Unfortunately, there are still children that get pretty sick with these diseases, and sadly a significant number of children end up in hospital with complications from the disease. With measles, for example, 9 in every 100 children get pneumonia and some need to go to hospital (pause).
Mother: I didn’t know that.
Health professional: Yes, it can still be a serious problem. Could I ask now how confident you are that the vaccinations are safe? (assessing confidence)
Mother: I’m not all confident in them being safe.
Health professional: What have you heard? (exploring)
Mother: Well on one internet site it said that children can get brain damage and all kinds of problems after vaccination. And the drug companies try to cover it up.
Health professional: That sounds frightening (empathic response). Which vaccines are you most concerned about? (eliciting specific concerns)
Mother: The MMR one because it can cause autism.
Health professional: I understand you are concerned about vaccinations (building rapport by accepting rather than rebutting concerns) but I’d just like to give you my view if that’s OK? (Mother nods.) Although there has been some research that raises concerns about vaccine safety, each time a concern comes up, new research is done to check whether the results are consistent or not. The vaccines that we use are very safe and serious side effects are very rare. Would you like to look at the MMR vaccine decision aid which can help you weigh up the risks of the vaccine and the diseases? (respecting autonomy, offering information)
Mother: Well, I guess I could have a look but I’m still pretty cautious about Oliver getting these jabs.
Health professional: Well, take a look at the decision aid and then if you like, come back to the clinic for another talk. We have a clinic each Tuesday and I’ll be here most weeks. Would you like to come back in two weeks? (leaving door open to further discussion)
Mother: OK thanks.