In response to: Addressing pediatric vaccine hesitancy

Dear Dr. Gelinas:

In the article titled “Addressing pediatric vaccine hesitancy” published in the July 2026 Vol. 21 No. 7 of American Nurse Journal, you address the rise in parental uncertainty about the childhood vaccination series and vaccines for pediatric patients overall. This piece does an excellent job at describing the recent inconsistencies in vaccine recommendations and how that weakens the trust that parents put into institutions like the CDC, American Academy of Pediatrics (AAP), and the Department of Health and Human Services (HHS).

The article instills that nurses have a duty to their patients and overall public health to promote effective vaccination schedules for children and it includes methods that nurses can employ to build and maintain vaccine confidence in parents. While I agree with utilizing presumptive communication, participatory language, and motivational interviewing, I think that refuting myths should not be written off due to risk of backfiring.

Promoting dialogue with vaccine-hesitant parents is the first step in identifying and correcting harmful misinformation that can influence public and pediatric health. Beginning these conversations at all appointments to identify if and false information is the root of fear is paramount to correcting it. A study focused on pediatric vaccinations in New York State found “[healthcare providers] were more likely to routinely recommend standard vaccines to all patients if they also report initiating vaccine discussion (476/485 (98%) vs 148/344 (43%), p < .05) and reviewing and recommending vaccinations at each encounter (315/320 (98%) vs 308/508 (61%), p < .05)” (Fernandes et al., 2023).You state that correcting vaccine misinformation or myths, such as the long-held belief that vaccines cause autism, may trigger defensiveness or even reinforce these falsities. However, allowing these myths to exist without adamant correction can be dangerous and allow them to spread and cause more damage to pediatric and public health. I recommend empathetic refutational interviewing as an intersection of the article’s nurse-parent communication methods and correcting harmful vaccine misinformation.Empathetic refutational interviewing addresses the roots of vaccine concerns and replaces misinformation with not only a correct but also a compelling alternative while also providing a concise explanation. This style of refutation has been proven effective in combating vaccine myths while also promoting trust between the provider and patient/parent. An example would be asking a parent where their belief comes from, whether it is religious, political, from social media, or family and friends; and then explaining where that idea may have come from while addressing why it is incorrect.Different methods for healthcare providers to correct vaccine misinformation can be utilized by nurses and include directly discrediting myths. Specifically, statements delivered in a reassuring tone that simply refute specific myths and then provide accurate information are likely to decrease the beliefs that vaccines cause serious illness.Sincerely, Olivia Tymon SUNY Downstate College of Nursing ABSN Program

References

Fernandes, A., Wang, D., Domachowske, J. B., & Suryadevara, M. (2023). Vaccine knowledge, attitudes, and recommendation practices among health care providers in New York State. Human vaccines & immunotherapeutics, 19(1), 2173914. https://doi.org/10.1080/21645515.2023.2173914

Holford, D., Mäki, K. O., Karlsson, L. C., Lewandowsky, S., Gould, V. C., & Soveri, A. (2025). A randomized controlled trial of empathetic refutational learning with health care professionals. BMC public health, 25(1), 583. https://doi.org/10.1186/s12889-025-21787-4

Wood, R. M., Juanchich, M., Ramirez, M., & Zhang, S. (2023). Promoting COVID-19 vaccine confidence through public responses to misinformation: The joint influence of message source and message content. Social science & medicine (1982), 324, 115863. https://doi.org/10.1016/j.socscimed.2023.115863

Author Reply:

Dear Olivia Tymon,

Thank you for taking the time to read the article and share your thoughtful feedback. Fostering continued dialogue about the importance of immunization and strategies to address vaccine hesitancy is essential to protecting public health. I welcome the perspectives of fellow nursing professionals as we work together to better understand and address this growing concern.

I appreciate your perspective on communication strategies and your concern about the potential consequences of refuting myths. Addressing misinformation can be a difficult and delicate part of the vaccination discussion and must be approached with mutual respect, validation of concerns, and without judgment to be effective. You raise an important point that allowing these myths to go unaddressed can be dangerous and contribute to their spread. However, correcting misinformation must be done carefully to avoid inadvertently amplifying the very myths we seek to dispel.

A recent article published in the New England Journal of Medicine reinforces that educational materials alone and fear-based approaches can sometimes backfire and instead recommends fact-checking and correcting misinformation using a “truth sandwich” strategy. This approach begins by stating the facts, followed by identifying and refuting misinformation with clear, evidence-based information, and concludes by reinforcing the facts.

Thank you again for this thoughtful feedback. I agree that myths and misinformation should be addressed, but they must be approached cautiously, as attempts to correct misinformation may have unintended consequences and backfire. It is important to first validate an individual’s feelings and concerns and ask permission to share evidence and factual information. Approaching these conversations with empathy, respect, and a willingness to listen can help foster trust and create a more productive dialogue about vaccination.

Sincerely,

Emily Baughman & Dr. Sunny G. Hallowell

References:
O’Leary ST, Danchin M. Childhood Vaccine Hesitancy. N Engl J Med. 2026;394(21):2134-2145. doi:10.1056/NEJMcp2516616