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Practice Matters

Vaccine hesitancy

By: Chad Rittle, DNP, MPH, RN, FAAOHN, and Holly Carpenter, BSN, RN

Breaking through public health barriers

Nurses play an essential role in promoting recommended immunizations across patients’ life­spans. That effort includes providing education about vaccine benefits, understanding why individuals may be hesitant, and addressing concerns. Vaccine hesitancy arises for various reasons.

Misinformation vs. disinformation

People who share misinformation (incorrect information provided without malicious intent) believe it’s true and may have altruistic reasons for repeating it. Conversely, disinformation is false information disseminated deliberately by a person or organization with an agenda: to make money, to sell a product, to promote an ideology, to gain politically, or to create chaos and confusion.

People frequently look for evidence to support what they want to believe or find easier to accept, neglecting to verify whether it comes from a reputable source, such as large academic medical institutions, U.S. government agencies such as the Centers for Disease Control and Prevention (CDC) and Food and Drug Administration, public health departments, and MedlinePlus (a service of the National Library of Medicine). Certain consumer sites, such as WebMD can be reliable as well.

Trusted messengers

Nurses can help clarify misinformation and dispel disinformation when they clearly understand the science behind vaccines and CDC data (bit.ly/3p3pgr3). Assess your ability to easily explain how vaccinations work by practicing with friends or family who don’t work in healthcare.

When meeting with patients, check their records to ensure they’re up-to-date on routine immunizations. If they aren’t, offer needed vaccinations or help them make an appointment to be vaccinated. Follow up consistently and ask if they have vaccine questions or concerns. Answer questions honestly; if you don’t have an answer, ask managers, the local health department, or a pharmacist. If you treat patients with dignity and respect, you’ll increase their trust in you.

Underserved communities

Individuals in underserved communities might not know where to find credible and true vaccine information. This need presents an opportunity for nurses to engage with patients, develop positive relationships, and become trusted messengers. There is also an opportunity for nurses to seek out existing trusted sources in underserved communities such as clergy and community leaders. Working together, nurses and these allies can positively impact vaccination beliefs and practices.

Share vaccine success stories with patients, and ask what they’ve heard, dispelling any myths, misinformation, or disinformation. Remain calm and communicate openly. Your recommendation to vaccinate will resonate with patients.

Opposition to vaccines

Facts don’t necessarily convince people and can be conveniently ignored if they conflict with an individual’s personal beliefs. In these circumstances, help patients find trustworthy sources and supply them with clear, consistent, and relevant reasons to get vaccinated. Keep in mind that mistrust in the news media, the pharmaceutical industry, and government is real. Emphasize that science advances over time and that vaccine recommendations may change based on the current best evidence. Avoid arguments, political or otherwise, and accept that some patients won’t get certain vaccinations, no matter how persuasive the evidence.

It takes work and time to achieve vaccination goals. Use your standing as a highly trusted professional to better educate patients about vaccines and motivate them to be vaccinated.

Chad Rittle is a retired associate professor at Chatham University in Pittsburgh, Pennsylvania, and a Pennsylvania State Nurses Association member. Holly Carpenter is a senior policy advisor for the American Nurses Association.


Berg S. How to have crucial conversations with vaccine-hesitant patients. American Medical Association. September 15, 2021. ama-assn.org/delivering-care/public-health/how-have-crucial-conversations-vaccine-hesitant-patients

Dubé E, Ward JK, Verger P, MacDonald NE. Vaccine hesitancy, acceptance, and anti-vaccination: Trends and future prospects for public health. Annual Review of Public Health. 2021;42:175-91. annualreviews.org/doi/10.1146/annurev-publhealth-090419-102240?url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org&rfr_dat=cr_pub++0pubmed

Kestenbaum LA, Feemster KA. Identifying and addressing vaccine hesitancy. Pediatr Ann. 2015;44(4):e71-5. doi:10.3928/00904481-20150410-07

Lin C, Mullen J, Smith D, Kotarba M, Kaplan SJ, Tu P. Healthcare providers’ vaccine perceptions, hesitancy, and recommendation to patients: A systematic review. Vaccines. 2021;9(7):713. doi:10.3390/vaccines9070713

Miller R, Suppok R. Library insider: Surviving an infodemic. University Times. University of Pittsburgh. November 4, 2021. utimes.pitt.edu/news/library-insider-surviving

Weintraub Austin E, Borah P. Explained: How to talk to anti-vaxxers. The National Interest. August 24, 2020. nationalinterest.org/blog/reboot/explained-how-talk-anti-vaxxers-167312

1 Comment. Leave new

  • Shaquana Jones
    December 30, 2022 4:17 pm

    I agree with this. Sometimes it will take a village to overcome this. I experience this a lot in Urgent care. This was a great neutral read.


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