Three steps to encourage flu vaccinations

Patients have numerous reasons for not wanting an influenza vaccination. To help them overcome their reluctance, Colleen Fogarty, MD, uses the “ask-tell-ask” technique:

1. Ask. Greet the patient, confirm the patient’s decision not to get a flu shot based on the nurse’s rooming notes, and then ask the patient for more information on why he or she does not want one, listening carefully to the patient’s response.

2. Tell. With the patient’s permission, briefly provide information specific to the patient’s belief or fear. For example, if the patient is worried about getting sick from the flu shot because a family member once developed a cough shortly after getting a flu shot, explain that the flu vaccine is made of killed virus, not live, and cannot make the patient sick. Carefully watch for nonverbal cues of understanding, doubt, or other reactions.

3. Ask. After discussing the information, ask what the patient now thinks about getting a flu shot. Some patients may change their mind and want one, while others will continue to say “no.” Provide a clear medical recommendation for the vaccine, but respect the patient’s autonomy to choose. Invite patients who remain reluctant to let you know if they ever change their mind or want additional information, leaving the door open for conversation in the future.

Adapted from "How to Talk to Reluctant Patients About the Flu Shot."