Four steps to talking about the flu vaccine

By Kate Land, MD

As fall rolls around and flu season looms, many primary care physicians ready themselves for having numerous conversations aimed at convincing patients to get the flu vaccine.

It can be frustrating – patient after patient says: “The flu vaccine gives me the flu!” or “I never get the flu.” Some ask if it is safe. It would be great to have an effective approach to conversations with hesitant patients.

I write a yearly flu post for our parenting blog KP Thriving Families. For this year’s post I wanted to be sure my communication would be effective; how we talk with our patients about vaccines affects their likelihood to choose to vaccinate. To be certain I was on target with using the most persuasive and effective language, I reached out to my colleague, Ken Hempstead, MD, a Kaiser Permanente regional vaccine communication lead in Northern California.

He asked that physicians and clinicians first reflect on how we currently talk with patients about vaccination:

“Do we lecture, or debate, or even argue?”

“Is it easy to fall into judgment, and shame or blame our patients when they do not agree?”

We feel strongly about the life-saving value of the flu vaccine and want to convince our patients to get it. When they resist, it is easy to fall into “docsplaining” – citing statistics, studies, and facts. This doesn’t work; it creates more resistance.

Four ways to persuade

Here are some tips to improve your vaccine communication:

• Start strong. Your clear, confident recommendation to vaccinate is important. Rather than asking if they want the flu vaccine, assume that they will be getting vaccinated. Use a statement rather than a question: “You are due for your flu shot today, we should take care of that before you leave.” You may be surprised how often this works. When patients clearly understand your recommendation and expectation, they are more likely to agree!
• Don’t “argue.” Answer questions with confident, short answers. Be careful to not fall into the trap of lecturing, debating, or arguing. Many people already have fairly long-standing opinions about the flu vaccine. You will not change their minds by citing evidence. Surprisingly, we have learned that when patients are confronted with research and data, they can become more resistant to vaccination. Dr. Hempstead suggests we try to “break the habit of correcting people’s mistaken beliefs about the flu shot.”
• Focus on common ground. Instead of correcting mistaken beliefs or lecturing, focus on the reason you want them protected. Emphasize your common goals with the patient/family: “What we both want is to see you have a smooth winter with your asthma.” “We both want your kids protected in as many ways as possible.”
• Use positive terms. “Protection,” “safe,” “healthy,” are far more convincing than negative terms like “side effect,” “illness,” or “danger.” Frame your conversation with positive terms, rather than spending time discussing or debating the perceived negatives of the vaccine. “Getting the flu shot today is the most important thing you can do to have a safe and healthy winter.”

This fall, we can turn that long stream of conversations about the flu shot around by focusing on the positive and avoiding debate. If we do, our visits with patients this fall will be more effective and satisfying for doctors and patients alike!

Kate Land, MD, is a pediatrician with The Permanente Medical Group, which provides care to Kaiser Permanente members in Northern California. She serves as chief of Health Education and Promotion for Kaiser Permanente’s Napa-Solano area and writes for the Thriving Families blog. Follow her on Twitter at @KPkiddoc.