Doctors grapple with how to talk to vaccine-hesitant parents
Anna Jakubek’s cozy apartment in Chicago’s Rogers Park neighborhood can be chaotic in the mornings as she readies her six-year-old daughter, Nina, for school.
On weekdays, Jakubek makes sure Nina eats her organic berries, bacon and eggs, dresses her and brushes her hair. Then they rush out the door, hoping not to miss the bus.
Nina, who attends Chicago Public Schools, only received her MMR shot, against measles, mumps and rubella, a few months ago. Worried that her daughter would not be allowed to participate fully in school activities, Jakubek had her inoculated just before she started kindergarten.
But Jakubek still has not had her younger daughter, three-year-old Mila, vaccinated. With the exception of the MMR vaccine, Mila has received all the shots she should have, including Hepatitis A, Dtap, and more.
“So what I really refuse right now is this MMR,” she said.
Doctors recommend that children get the MMR vaccine between 12 and 15 months of age. But Jakubek, like many other vaccine-hesitant parents, believes it could cause autism, behavioral disorders, or problems with her child’s nervous system. The original study that suggested a link between vaccines and autism has long been discredited, and further studies have conclusively shown no link between vaccines and those conditions. Still, Jakubek is unconvinced.
“I feel like getting the vaccination is a greater risk than getting (the) actual disease,” said Jakubek, who herself had the measles, mumps and rubella vaccine as a child growing up in Poland. “If I had a choice not to vaccinate her at all, yeah, I wouldn’t.”
So far, Jakubek said she hasn’t experienced much push-back on her beliefs. Other parents have not challenged her, and her children’s pediatrician has respected her wishes.
“She’s not pushing, which I really appreciate that, she’s not pushing,” Jakubek said of the pediatrician. “She wants (an) explanation why, and I deliver that explanation and she will tell me that this could be a deadly disease, and I have my opinion about this, too. So we exchange three or four sentences and this is it.”
“There are physicians who have just given up,” said Dr. Robert Jacobson, a pediatrician at the Mayo Clinic in Rochester, Minnesota. Jacobson says he looks at the recent resurgence of measles, as well as dismally low vaccination rates for other diseases, such as the flu, and he blames his fellow medical community.
“That’s our fault,” he said. “We’re being challenged and we should rise up to the challenge and make sure our patients hear our recommendations.”
For the last several years, Jacobson has been training other doctors on how to talk to parents like Jakubek. His methodology, which he calls the C.A.S.E. Approach, urges doctors to establish personal connections with vaccine-hesitant parents.
“They want to hear your expertise, they want to hear your recommendation,” Jacobson said of parents. “They want to hear what you’re doing with your own children, and what you would do if you were in their shoes.”
Jacobson said he is dismayed when he sometimes hears about doctors who ban unvaccinated children from their practices, or who stuff parents’ arms with brochures on vaccines, rather than discuss the issue with them. In his trainings, Jacobson said he urges doctors to have those conversations in their offices when they come up
“We’ve got real work to do, and we can’t just rely on being the high priests of medicine,” he said.
For Jakubek, those discussions might push her away from her doctor. But she may end up vaccinating her younger daughter soon, anyhow.
In the wake of Illinois’s measles resurgence, her younger daughter’s daycare informed parents that they should get their children vaccinated. Jakubek said she’d still rather wait, but she’ll do it if she has to.