Q: Which interventions are effective in managing parental vaccine refusal? A: it's unclear whether educational initiatives alone alter vaccine refusal. Although about a third of parents cite herd immunity as motivation for vaccination, its efficacy in addressing vaccine hesitancy isn't clear (strength of recommendation [SOR]: B, systematic reviews not limited to randomized controlled trials [RCTs]). ultifaceted interventions (encompassing improved access to vaccines, immunization mandates, and patient education) may produce a ≥25% increase in vaccine uptake in groups with vaccine hesitancy and low utilization (SOR: B, extrapolated from a meta-analysis across di-verse cultures).Correcting false information about influenza vaccination improves perceptions about the vaccine, but may decrease intention to vaccinate in parents who already have strong concerns about safety (SOR: C, low-quality RCT). Discussions about vaccines that are more paternalistic (presumptive rather than participatory) are associated with higher vaccination rates, but lower visit satisfaction (SOR: C, observational study). Providers should thoroughly address patient concerns about safety and encourage vaccine use (SOR: C, expert opinion).Authors: Dan Brelsford, MD; Elise Knutzen, PharmD; Jon O. Neher, MD University of Washington at Valley Family Medicine Residency, Renton; Sarah Safranek, MLIS University of Washington, Seattle
