Perspectives: 10 Pediatricians Share How They Discuss Vaccines With Patients

Pediatricians on discussing vaccines with patients

Verywell / Photo Illustration by Christian Alzate

By the age of 24 months, more than 90% of children in the United States have been vaccinated against Polio, Measles, Hepatitis B, and Chicken Pox. These immunizations are administered as preventative measures to decrease the spread of disease. Pediatricians carry the immense responsibility of educating their young patients' parents about vaccines and setting up a vaccination schedule that best serves a child's overall health.

With the CDC's recommendation of the pediatric COVID-19 vaccine for children ages 5 to 11, immunizations are top of mind once again for caregivers. Find out how doctors from across the country approach the topic with parents, and what they want families to know about vaccines.

For our Perspectives series, we are interviewing pediatricians from around the country on how they talk to parents about vaccines.

Monica Asnani, MD

Monica Asnani, MD

Verywell / Photo Composite by Christian Alzate / Monica Asnani, MD

Monica Asnani, MD

  • Occupation: Pediatrician
  • Location: Los Angeles, CA

What Do You Want Your Patients' Parents to Know About Vaccines?

Being a parent means making important choices about your child's health on a daily basis. What type of car seat should you use? Breast milk or formula? Is organic food really that important? Choosing to give vaccines is another one of those important choices that parents need to make. 

Childhood vaccines have been used successfully for decades; so successfully that most people (and young doctors!) have not seen most vaccine-preventable diseases in real life. If we take our foot off the pedal and slow down the use of these vaccines now, we will most certainly see a resurgence of serious diseases. 

Everyone knows the famous story of smallpox. Smallpox used to kill thousands of people each year, but now there are no cases of smallpox. That is the result of the smallpox vaccine. Getting your child routine childhood vaccines is a safe, easy way to protect them against a handful of serious and potentially life-threatening diseases. 

Monica Asnani, MD

Getting your child routine childhood vaccines is a safe, easy way to protect them against a handful of serious and potentially life-threatening diseases.

— Monica Asnani, MD

How Do You Approach Parents Who Are Hesitant About Vaccinations?

First and foremost, I try not to dismiss parents' hesitancy about vaccines. I don't know what they have heard and what their past experiences have been. I listen to their concerns and ask questions about where they heard their information and if they know anyone who has had a bad experience with a vaccine. 

Often there is a personal anecdote that is fueling the parents' fears. Then I ask them if they know why we give these vaccines, and I show them the immunization schedule and discuss each vaccine in detail—including what symptoms the diseases cause, how many cases there were before the vaccines, how many cases there are now, and the likelihood that their child will be exposed. Most of the time, parents comment to me, "That makes sense. Nobody has explained it like that before," and they proceed with the vaccines.  

How Do You Explain the COVID-19 Vaccine to Concerned Parents?

There are a lot of misconceptions about the COVID-19 vaccine. I think calling it "Operation Warp Speed" was a mistake because it implies that the process was done too fast and cut corners. The COVID-19 vaccine trials have been conducted with the same safety features as many other vaccine trials have been done in the past. The reason why this vaccine was created so quickly is that multiple countries shared their data and worked towards a common goal. Also, the United States government, along with the National Institutes of Health (NIH) and the Centers for Disease Control and Prevention (CDC) funded the normally very expensive process of developing a vaccine, which also accelerated the timeline.

At this point in the pandemic, with the Delta and Omicron variants, our choices are either to be vaccinated or to eventually contract COVID-19 disease. People who think they are going to remain unvaccinated, "be careful," and not contract COVID-19 are in denial. They may have already had asymptomatic COVID-19 and be unaware of that. 

I see this every day, even in my own family. I have an aunt who is unvaccinated because she says, "I don't need the vaccine; I'm healthy and have no risk factors. I take care of myself and I don't go anywhere." Except that she is 72 years old and has high blood pressure, is obese, and flew on an airplane across the country recently.  

It's true that the COVID-19 vaccine has some small risks. We have all heard stories about side effects. But the risks of significant health problems from the actual disease are much higher. Do you want to take a vaccine with a small risk, or wait until you get COVID-19 and have a higher risk of a problem? Also, the COVID-19 virus attacks at random. We never know which "healthy" person is going to have a bad outcome, so the safest thing to do is to protect everyone with the vaccine.

Gregg Sylvester, MD, MPH

Gregg Sylvester, MD, MPH

Verywell / Photo Composite by Christian Alzate / Gregg Sylvester, MD, MPH

Gregg Sylvester, MD, MPH

  • Occupation: Chief Medical Officer, Seqirus
  • Location: Delaware

What Do You Want Your Patients' Parents to Know About Vaccines?

In the case of influenza, this virus can be mild and in severe cases, it can be deadly. According to the CDC, nearly 50,000 hospitalizations occurred in children younger than 18 years of age during the 2019-2020 influenza season. That said, we have a saying at Seqirus: If you’ve seen one flu season, you’ve seen one flu season—as each is unique.

Health experts like the American Academy of Pediatrics (AAP) and CDC agree that vaccination is the best way to protect yourself and your children against infectious diseases such as influenza.

How Do You Approach Parents Who Are Hesitant About Vaccinations?

Children younger than 5 years old, particularly those younger than 2, are at increased risk of developing serious influenza-related complications. I would remind parents that influenza vaccination is the best way to reduce the incidence of seasonal influenza and is also an important tool to help minimize the burden of influenza on our healthcare systems amidst the COVID-19 pandemic.

How Do You Explain the COVID-19 Vaccine to Concerned Parents?

I can’t speak to COVID-19 vaccines specifically, but when parents express hesitation about vaccines in general, I always inform them of guidance by AAP and the CDC about the science behind the vaccines and recommendations for each age group.

With so many unknowns around COVID-19, it’s important to control what we can. We know the value of flu vaccination, so we must continue to prioritize it. The CDC recommends everyone six months of age and older without contraindications get a flu vaccination because we know that influenza vaccinations can lessen the severity of the disease. 

Wendy Lane, MD, MPH

Wendy Lane, MD, MPH

Verywell / Photo Composite by Christian Alzate / Wendy Lane, MD, MPH

Wendy Lane, MD, MPH

Occupation: Fellow with the American College of Preventive Medicine

Location: Maryland

What Do You Want Your Patients' Parents to Know About Vaccines?

Prevention is key to curbing the spread of viruses. Getting vaccinated is one of the most important tools at our disposal to protect ourselves and others. Vaccines prevent serious illness and death from many infections.

Keeping up with routine vaccinations is crucial to help prevent the spread of infectious disease, especially as we enter a particularly dangerous period with COVID-19 colliding with the cold and flu season.

How Do You Approach Parents Who Are Hesitant About Vaccinations?

As a preventive medicine specialist, I believe in the sound science behind vaccines, and I encourage all my patients to receive vaccines when eligible. With the amount of misinformation seen daily, it is easy to become skeptical. However, I always rely on science to encourage parents to trust in the power of vaccines.

The COVID-19 vaccine has been through several rigorous tests and continues to be tested to keep up with the constant evolution of the disease. Coronaviruses are not anything new, and scientists have been developing tests and vaccines on these types of diseases for years.

Vaccines have had a history of helping to mitigate the spread and even eradicate certain diseases. The COVID-19 vaccine is no different.

Wendy Lane, MD, MPH

The COVID-19 vaccine has been through several rigorous tests and continues to be tested even after being on the market to keep up with the constant evolution of the disease.

— Wendy Lane, MD, MPH

How Do You Explain the COVID-19 Vaccine to Concerned Parents?

A huge challenge that we face with vaccine-hesitant families is that vaccines are a true victim of their own success. Typically when people don’t have first-hand experience with an infectious disease, they are unlikely to understand how life-threatening it can be. Getting children vaccinated against COVID-19, as any other virus, helps their immune systems build up antibodies and protect them against contracting the virus in the future.

Vaccines are one of the safest and most effective preventive medicine tools we have today. Historically speaking, vaccines have controlled and even eradicated many dangerous diseases.

With a little bit of trust, we will be able to diminish the threat that COVID-19 poses to our children. We encourage everyone who has questions about the science behind vaccines to visit vaccineconfident.org, where they will be able to have their questions answered by a team of preventive medicine specialists.

Pamela Ponce, MD

Pamela Ponce, MD

Verywell / Photo Composite by Christian Alzate / Pamela Ponce, MD

Pamela Ponce, MD

  • Title: Pediatrician with Orlando Health Physician Associates
  • Location: Orlando, FL

What Do You Want Your Patients' Parents to Know About Vaccines?

Unfortunately, there is a lot of misinformation out there regarding vaccines, including safety and disease prevention. Vaccines go through numerous studies and trials prior to being available for everyday use. A vaccine's main role is to have the immune system recognize the disease as something that should not be there and then protect you against it. It does not always prevent disease but it does prevent severe disease and hospitalizations.

I like to use the idea that the vaccine sends a picture via email to your body and tells you to store this in a file and remember it if you see it again. That picture is something similar to the illness it is trying to protect against. Aside from a few vaccines, it is not a live component of the illness itself. Then what happens is, when you are exposed to the illness, your body very quickly recognizes the illness as something that shouldn’t be there and attacks. Your body does not allow it to take over and make you very sick. The vaccine is in and out of your system, it does not build up over time. It does not alter any of your DNA.

How Do You Approach Parents Who Are Hesitant About Vaccinations?

It is important to discuss with your doctor the concerns that you have regarding vaccines. Far too often these days people are getting incorrect information that can be very overwhelming and scary for parents. I typically will ask what a patient's concerns are and provide appropriate evidence-based guidance and resources for them. Having the conversation is important, but also doing so in a non-judgmental way is crucial. We hear their individual concerns and address them.

How Do You Explain the COVID-19 Vaccine to Concerned Parents?

I stress that both of my boys were in the Pfizer trial and, fortunately, were vaccinated in the trial. They did very well. I review with them the study data showing the safety and the expected side effects that may occur. I review with them any questions that they have and provide reassurance that when they get the vaccine, I will be available for any further concerns or questions. COVID-19 is now a preventable disease at this point. We do not know the long-term effects of getting even mild COVID-19, but we do know that these vaccines have been studied well and are safe.

Christina Johns, MD, MEd, FAAP

Christina Johns, MD, MEd, FAAP

Verywell / Photo Composite by Christian Alzate / Christina Johns, MD

Christina Johns, MD, MEd, FAAP

Title: Pediatrician and Senior Medical Advisor at PM Pediatrics

Location: Washington, DC

What Do You Want Your Patients' Parents to Know About Vaccines?

Vaccines for children are safe and effective. If parents have questions, the best resource is their child’s pediatrician. We have experience with vaccines and reading and understanding the medical literature. Combine that with our knowledge of their child’s individual medical history and family situation, and you can rest assured that this expert is positioned to give the best, tailored guidance.

How Do You Approach Parents Who Are Hesitant About Vaccinations?

The vaccine discussions I have with parents start with compassionate listening. I try to understand specifically what their concerns are and where they are rooted. From there, I try to lean into the science and share facts.

Without being immediately dismissive of any false data they may have, I try to share facts and peer-reviewed evidence and data. I then help them understand the quality of the data and how that varies by source. Hopefully, by de-personalizing the conversation and taking the emotion, fear, and anxiety out of the equation, we can lean into the science and make an evidence-based decision in the best interest of the child.

How Do You Explain the COVID-19 Vaccine to Concerned Parents?

Children are not at zero risk for COVID-19, and they need to be protected. We are starting to see that 7 to 8% of children who have had COVID-19 get long-COVID symptoms. We know that getting the vaccine decreases that risk. The COVID-19 vaccine has gone through the proper approval process and evaluation; no corners were cut in the phase 2/3 trial.

There is a higher risk of getting myocarditis from COVID-19 infection than from the vaccine. Nearly 10 million children ages 5 to 11 have been vaccinated so far, and they are doing very well with minimal side effects. Ultimately, in a risk/benefit analysis, the benefit of getting the vaccine outweighs the risk. Parents want to keep their children safe, and this is one important way to do it.

Ilan Shapiro, MD, MBA, FAAP, FACHE

Ilan Shapiro, MD

Verywell / Photo Composite by Christian Alzate / Ilan Shapiro, MD

Ilan Shapiro, MD, MBA, FAAP, FACHE

  • Title: Medical Director, Health Education and Wellness, AltaMed Health Services
  • Location: California

What Do You Want Your Patients' Parents to Know About Vaccines?

As a pediatrician and most importantly as a father, I understand that as parents, we will do everything possible to protect our children. This can mean having questions and doubts. As part of the process, we have to gather the best information we can access on the vaccines. We have to follow the science and data to give us the last push to make the decision. 

Ilan Shapiro, MD, MBA, FAAP, FACHE

We have to follow the science and data to give us the last push to make the decision.

— Ilan Shapiro, MD, MBA, FAAP, FACHE

How Do You Approach Parents Who Are Hesitant About Vaccinations?

When speaking with parents, it's important for me to validate their feelings. All parents want to do whatever it takes to protect their kids. When it comes to vaccinations, it's not about hesitancy, misinformation, or disinformation. Each parent asking questions is doing their due diligence to protect their kids. Part of the conversation is to learn about their concerns. I know that as a father, we have to think critically when it comes to protecting our children and this is part of the decision-making process. 

How Do You Explain the COVID-19 Vaccine to Concerned Parents?

At this time, kids are getting COVID-19 more often than before. Pediatricians are starting to see more long COVID among children. It's estimated that 10-15% of kids who were infected with COVID-19 experience headaches, trouble concentrating, problems with memory.

I've seen children experience temporary side effects as a result of vaccination, most commonly it has been fever, fatigue, and pain in the arm. These are well-known side effects and can last for a couple of hours. Many children who have received their first dose didn't experience any side effects. The data shows the vaccine protection rate for kids is more than 90%. It's important to protect our kids and the way to do it is through vaccination.

Cara Natterson, MD, FAAP

Cara Natterson, MD, FAAP

Verywell / Photo Composite by Christian Alzate / Cara Natterson, MD

Cara Natterson, MD, FAAP

Title: Pediatrician, author, founder of puberty brand OOMLA

Location: Santa Monica, CA

What Do You Want Your Patients' Parents to Know About Vaccines?

Whenever anyone makes a decision about anything, and particularly a parent making a decision impacting the health of their child, we have to compare apples with apples. In the case of the COVID-19 vaccine, that means comparing the risks of the vaccine with the risks of infection from the virus itself. This virus has wreaked havoc, killing more than 6 million people worldwide, according to the WHO. The list of short-term and long-term consequences of being infected is massive. The Pfizer vaccine (the brand and formulation authorized for younger children), has been administered to tens of millions of Americans with a short list of even shorter-term side effects.

How Do You Approach Parents Who Are Hesitant About Vaccinations?

I completely understand when parents feel nervous about putting a relatively new vaccine in their kids’ bodies. But in this case, not putting it in their bodies puts their kids, and the people around their kids, in far more jeopardy. It can be hard to remember that, especially amidst heated debate about something new.

Yes, children have been relatively spared from severe, life-threatening COVID-19 infection, but they are still struggling with many of the same devastating outcomes as adults, just at lower numbers. And they are still being infected and then passing the virus along to older individuals.

How Do You Explain the COVID-19 Vaccine to Concerned Parents?

I share my own experience as a parent. When my teenagers qualified for doses of COVID-19 vaccine, I stood in the same shoes. It helps them to hear how I made my decision to vaccinate, a decision based upon reading basically every study, article, and case report I could get my hands on over the past year and a half.

Given my background, lots of parents ask about the potential impact of vaccine on puberty. It’s important for parents to understand that there is simply no biologically plausible mechanism for the COVID-19 vaccine to interfere with pubertal development. So many of the things that parents put into and onto their kids’ bodies every day do have the ability to impact this, but not the COVID-19 vaccine.

There are many case reports about women having irregular, heavy, or missed periods following vaccination, a phenomenon now being studied aggressively. But the medical explanation for this does not have anything to do with the cascade of hormones that control puberty (or fertility or pregnancy for that matter). And as we learn more and more, we are beginning to hear that many women report menstrual irregularities after other vaccinations and medical interventions; they also report after illness. The menstrual cycle has been woefully ignored in scientific research on these topics and that is coming to an abrupt end (long overdue!), but even before that data is available, parents can let go of the rumor (and fear) that this vaccine impacts the hormonal shifts of puberty.  

Yamileth Cazorla-Lancaster, DO, MPH, MS, FAAP, CHWC

Yamileth Cazorla-Lancaster, DO

Verywell / Photo Composite by Christian Alzate / Yamileth Cazorla-Lancaster, DO

Yamileth Cazorla-Lancaster, DO, MPH, MS, FAAP, CHWC

Title: Pediatrician, author, and podcast host

Location: Yakima, WA

What Do You Want Your Patients' Parents to Know About Vaccines?

I spend a lot of time discussing vaccines with parents in my private pediatric practice.
For the most part, all parents share one thing in common: They love their children and they want to do the best for them. But what I often find is that parents are scared and are often making decisions from a place of fear. Fear can cloud our judgment when we are making important decisions such as whether or not to vaccinate our children against preventable infectious diseases.

How Do You Approach Parents Who Are Hesitant About Vaccinations?

The first thing that I want parents to do is to attempt to suspend their fear as they objectively contemplate the risks and benefits of their options. I remind parents that life is not risk-free and all of the decisions we make in life are associated with some degree of risk. This includes the air we breathe, the water we drink, and the food we eat. It includes any medications or alternative treatments we undergo. 

Yamileth Cazorla-Lancaster, DO, MPH, MS, FAAP, CHWC

The first thing that I want parents to do is to attempt to suspend their fear as they objectively contemplate the risks and benefits of their options.

— Yamileth Cazorla-Lancaster, DO, MPH, MS, FAAP, CHWC

I also want parents to understand the purpose of vaccines. Vaccines were created to decrease the risk of death from a potentially preventable infectious disease. Anything that we put into our body carries risk: risk of side effects, risk of complications. However, vaccines are clinically tested and the risk of serious adverse effects is extremely rare. In addition, vaccines are tested to ensure that they will actually be effective at decreasing the risk of acquiring and/or dying from a particular infectious disease. 

On the other hand, we have to consider the risk caused by the potentially preventable infectious disease. There are some infections that have a very high mortality and morbidity rate. That means that when a person acquires the infection, they have a very high risk of getting very sick, potentially being hospitalized, or potentially dying from the infection. We also have to consider our own individual risk of acquiring that infection. Sometimes our risk increases depending on where we live, our level of exposure, our occupation, or our lifestyle habits (such as travel).

As parents carefully and more objectively consider these risks and benefits, they are able to make a decision. I tell parents that at the end of the day they have to decide whether they are more willing to accept the very rare risks associated with receiving a vaccine or they are more willing to accept the risk of their child potentially dying from a preventable infectious disease. 

How Do You Explain the COVID-19 Vaccine to Concerned Parents?

In the case of COVID-19, there is another important consideration. We are in a global pandemic. This is new for all of us and it presents different scenarios and potential considerations.

The COVID-19 vaccine is now approved for children ages 5 to 11. In the clinical trial, the vaccine was found to be very safe and effective. Although children have a lower risk of hospitalization or death from COVID-19, we must be mindful that the pandemic has claimed the lives of many and, thus far, has no end in sight. When we think about the risks and benefits of vaccines, often we are thinking just about ourselves and our families or our own individual situation. However, vaccinating our children against COVID-19 may also provide another way to slow and potentially stop this pandemic to protect more people, save more lives, and eventually move on.

Ultimately, each parent has to decide what choice they are most comfortable with and I am always happy to have these conversations with my individual families in the office. I find it is more effective to sit down and talk face-to-face rather than trying to fight it out in an emotional and passionate argument online. We are all adults and can sit down and have civil and thoughtful conversations. 

I wish every parent luck as they navigate parenthood and this pandemic. I know that you are doing the best that you can and that you are a wonderful parent. Thank you for loving and keeping your child’s best interests in mind!

Samantha Ball, DO

Samantha Ball, DO

Verywell / Photo Composite by Christian Alzate / Samantha Ball, DO

Samantha Ball, DO

Title: Pediatrician

Location: Dacula, GA

What Do You Want Your Patients' Parents to Know About Vaccines?

As a pediatrician, I spend many hours daily counseling parents on routine vaccines for children that have been clinically proven to prevent death and severe disease. In my opinion, it is important to have a space where parents can ask questions and have their concerns validated and heard.

However, honest and accurate information gets clouded when vaccine misinformation is so easily spread. I always encourage parents to talk with their pediatrician to get the best, most trusted information about the care for their child. You trust us when your child is sick; trust us to help prevent disease. We do the research so you don't have to.

Samantha Ball, DO

Trust us to help prevent disease. We do the research so you don't have to.

— Samantha Ball, DO

How Do You Approach Parents Who Are Hesitant About Vaccinations?

My first step is to listen and identify concerns. I acknowledge that we both have a shared goal (doing what is best for the child) and offer parents the help to sort out and interpret the best information to make an informed decision. Then I teach. I target the education to their specific concerns. Some of the things we talk about are vaccine benefits and limitations, vaccine safety and adverse events, risks of natural infection, and long-term effects of natural infection versus a vaccine.

How Do You Explain the COVID-19 Vaccine to Concerned Parents?

Getting yourself and your child vaccinated is an important step to protect against infections and serious illness or death. This will also help you decrease the spread and keep kids in school and extracurricular activities. While death from COVID-19 infection in kids is rare, the long-term impacts are not negligible. 

The Pfizer vaccine is currently the only one with Emergency Use Authorization for children down to age 5 years. The dose is one-third the dose of the vaccine for those 12 and older. This was determined to be the smallest effective dose while having the least side effects, including zero events of myocarditis and anaphylaxis.

We currently know that more than 2,000 children ages 5 to 11 volunteered for the clinical trial and it was found to be over 90% effective. The most common side effects were similar to older age groups (pain at the injection site, fatigue, headache, and muscle aches). This is short-lived; 1-3 days.

The longer you wait to vaccinate, the longer your children will be at risk of getting sick from COVID-19, spreading COVID-19, schools closing due to outbreaks from COVID-19, and deaths from COVID-19. You can't wait until millions are vaccinated before you decide, because even though cases are trending down, you cannot predict who will be "fine" and who won't be.

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