Tips for talking to reluctant patients about vaccines

You can’t convince every patient of the value of vaccines, so focus your efforts and follow these tips.

1. Distinguish “chronic no” patients (those who have unequivocally refused the vaccine for years) from “undifferentiated no” patients (those who have declined for reasons you have yet to explore). For “chronic no” patients, don't challenge them beyond a brief check-in; use your time to discuss other clinical concerns. Focus your efforts primarily on the “undifferentiated no” patients, which you can potentially influence.

2. Have your nurse lay the groundwork by asking patients if they would like to receive the needed vaccination. If a patient declines, the nurse can document the patient's fears and concerns, which makes the doctor aware of the patient's intentions, and then provide a vaccine information sheet, which the patient can review while waiting for the doctor.

3. Use the “Ask-Tell-Ask” framework to pinpoint and address patients' reluctance about receiving a vaccine.

• Ask: “Would you tell me more about why you do not want a flu shot?” Then listen carefully to them.

• Tell: Respond with brief but clear information centered on the patient's belief or question. Watch for nonverbal reactions, and address further questions or confusion.

• Ask: “What are your thoughts now about getting a flu shot?” If the patient agrees, have your nurse administer the vaccine. If the patient is firmly opposed to getting the vaccine, respect the patient's autonomy but leave the door open for more conversation in the future.

Read the full article in FPM: "How to Talk to Reluctant Patients About the Flu Shot."