Making the Case for Vaccines: Top Fifteen Questions of Vaccine Hesitancy Paul A. Offit, MD Director of the Vaccine Education Center at the Children’s Hospital of Philadelphia Maurice R. Hilleman Professor of Vaccinology Professor of Pediatrics at the Perelman School of Medicine at the University of Pennsylvania

Vaccine hesitancy is a behavior, influenced by a number of factors including issues of confidence (do not trust vaccine or provider), complacency (do not perceive a need for a vaccine, do not value the vaccine), and convenience (access). The SAGE Vaccine Hesitancy Working Group, WHO

Top Fifteen Questions of Vaccine Hesitancy Learning Objectives: 1.To understand the main issues presented by parents, medical providers, and others involved with providing vaccines to children of vaccine hesitant parents 2.To address concerns that are presented and provide data that enhances administration of vaccines along recommended guidelines 3.To encourage dialogue in settings that support parents’ medical education on averting vaccine preventable diseases

Top Fifteen Questions of Vaccine Hesitancy Confidence Why aren’t all vaccines 100% effective? Isn’t natural immunity better than vaccine- acquired immunity?

Top Fifteen Questions of Vaccine Hesitancy Confidence Vaccine information sheets list lots of potential side effects. Why is vaccination recommended if it can cause all of these side effects? The media and websites have reported that vaccines are linked to long-term health problems such as multiple sclerosis, diabetes, and autism. Is that true?

Top Fifteen Questions of Vaccine Hesitancy Confidence Why do vaccines contain ingredients such as mercury, thimerosal, formaldehyde, and gelatin? How are safety studies conducted on vaccines and is the data available for parents and providers to review? “My chiropractor has advised me and my family not to be immunized”…How do other medical professionals respond to this?

Top Fifteen Questions of Vaccine Hesitancy Complacency Pediatricians have asked: How do we deal with parents that choose the Dr. Robert Sears schedule (delaying polio and Hep B, etc.) or other alternative schedules as they feel their children are not at risk of exposure to these diseases early in life? (What convincing evidence can we get across to them?) Any ideas/examples of what public health officials can say or do with parents who are vaccine hesitant and with providers who accept a lot of patients who don’t wish to follow the recommended schedule? Any specific studies or materials we can offer to physicians to strengthen their ability to endorse vaccines to parents?

Top Fifteen Questions of Vaccine Hesitancy Complacency Parents (and some providers) have never seen a case of some of these diseases. Why do we need to vaccinate for something that isn’t in our community? Certain vaccines (like HPV) are not required for school entry. Does that mean that they are not as important?

Top Fifteen Questions of Vaccine Hesitancy Convenience How do we address religious exemptions in our practice? (Safety of other patients; parents opting children out for convenience) Why so many vaccines? (Won’t that overwhelm my child’s immune system?)

Top Fifteen Questions of Vaccine Hesitancy Convenience Why can’t I (as a parent) just wait until my children are older? “As a daycare provider/school nurse, it is frustrating to have to keep up with so many shot requirements, especially since I’m not sure that I agree with the need.” How can I work with parents to be compliant and avoid exclusion from our program/school?

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