Pediatricians Try New Tactics To Win Over Vaccine Skeptical Parents

In pediatricians’ offices across the country, doctors are increasingly confronting concerns from parents about vaccines that for decades have protected children from serious and sometimes deadly diseases.

Vaccine hesitancy is nothing new. But physicians say this skepticism has gained new momentum in recent years as vaccine misinformation has become widespread on social media, and as more Americans have become distrustful of the medical establishment.

The New York Times spoke to pediatricians across the country who said they were looking for better ways to address these concerns and, ultimately, get more children vaccinated. Some have focused on explaining the immediate risks of foregoing specific vaccines, or have started sharing nongovernment resources that parents may be more likely to trust. Others are now scheduling additional appointments in their already-crammed days in order to continue these difficult conversations.

“There are times where I’ll say, ‘I’d like to bring you back to talk more about this,’ and schedule a visit specifically to talk about what they’re worried about,” said Dr. Marina Jeffery, a family medicine physician in Monroe, La.

Dr. Jeffery and others said that despite the increase in vaccine hesitancy, they have found some success in easing fears, and that many skeptical parents do go on to vaccinate their children.

Getting parents to this point “requires a lot of listening,” said Dr. Percy Huggins, a pediatrician at TriBeCa Pediatrics in Brooklyn. “But it’s so rewarding when you can see the switch taking place, and they trust you to come up with a plan for their child.”

Declining Trust, Fewer Shots

Over the past several years, the share of U.S. kindergartners who have received school-required vaccines has decreased. “I’m seeing now a surge of people refusing vaccines — even parents that gave their kids all their infant vaccines,” said Dr. Susan McWhirter, a pediatrician in Columbus, Ga., noting that the change had seemed especially stark since the Covid-19 pandemic ended.

A national survey of 1,559 American adults found that 16 percent of people thought that approved vaccines were unsafe in October 2023, up from 9 percent in April 2021. Approved vaccines include the measles, mumps and rubella vaccine (M.M.R.), the diphtheria, tetanus and acellular pertussis vaccine (DTaP), the polio vaccine and the varicella vaccine.

“It’s scary to think that we might start to see some of these vaccine-preventable, eradicated illnesses come back,” said Dr. Krupa Playforth, a pediatrician in Vienna, Va. Rates of childhood illnesses such as measles are, in fact, on the rise, and several physicians said they were worried that the issue would only grow worse if Robert F. Kennedy Jr., President Trump’s nominee for secretary of health and human services, were confirmed. He is a longtime vaccine skeptic, and would be in a position to influence national messaging on vaccines.

“Right now we have a lot of parents asking about the necessity of certain vaccines,” Dr. Huggins said. If Mr. Kennedy is appointed, she predicted, “we’re definitely going to see more questions.”

Dr. Playforth and other pediatricians said the hesitation they were seeing wasn’t just about vaccines. Once the most trusted source for medical information, doctors themselves have encountered greater disdain and skepticism about their expertise since the pandemic. A July 2024 study based on surveys of nearly half a million American adults found that the share of people who said they had “a lot” of trust in physicians had dropped to 40 percent in January 2024, down from about 72 percent in April 2020.

There’s now “this general suspicion of the establishment,” Dr. Playforth said. Because of this, she sometimes shares vaccine information from nongovernment sources, such as the Children’s Hospital of Philadelphia or the economist Emily Oster, who writes about parenting. “Because she’s not associated with the government, I think people are more willing to read her,” Dr. Playforth said.

She also talks openly with her patients about the vaccine decisions she made with her own children. And she shares medical information and personal stories on Instagram as @thepediatricianmom. She does this knowing that social media is also driving some of the distrust she sees in her clinic.

Recently, the parents of an 8-week-old girl challenged her on whether their daughter’s upcoming vaccines were necessary, citing a common false claim on social media that breastfed babies receive enough protective antibodies through their mothers’ milk. Dr. Playforth spent 40 minutes with the parents discussing the risks and benefits of specific vaccines — as well as the risks of forgoing them. The parents decided to vaccinate.

“They really needed the assurance of knowing that my recommendations came from a place of wanting their baby to be as safe as possible,” she said.

Over time, she has had to rethink her approach with concerned parents. Among other adjustments, Dr. Playforth has recently changed the structure of her practice so that she can spend more time with patients. In the past, she would often try to quickly address misconceptions and share literature and links to online resources. But such resources aren’t always helpful if they don’t address a parent’s specific questions, she said. It’s much more powerful to “sit and chat through exactly why a parent is concerned — and what the misinformation they’ve read or heard is,” she said.

Not every doctor handles this skepticism well. Some might simply debunk common vaccine myths or outright dismiss parents’ concerns without first listening to them. Yet research suggests that this kind of general myth-busting alone does not reduce vaccine hesitancy.

Some doctors may also gloss over the potential for side effects, but they shouldn’t, Dr. Playforth said. Dr. Phil Boucher, a pediatrician in Lincoln, Neb., agreed, explaining that he always walked parents through potential adverse reactions. “It builds trust and shows we are weighing the pros and cons” rather than providing blanket positive statements, he said. Dr. Boucher also administers all the vaccines himself.

Dr. McWhirter said that she had become adept at deciphering which patient families were open-minded and which ones weren’t — and that she spent more time talking to the former. “You learn as a physician which people just need reassurance, and which ones you know you’re not going to really convince no matter what you do,” she said.

“When they say, ‘I need to do my own research,’ that’s usually a phrase that tells me I’m not going to get anywhere,” she said.

If she senses families are willing to listen, Dr. McWhirter said, she takes the time to talk with them. “If I think it’s going to help, I’m going to do it,” she said. “So what if I get behind?”

Finding a Middle Ground

Some pediatrics practices simply refuse to accept families that won’t vaccinate, often to minimize the chance that their high-risk patients could be exposed to serious diseases. Although the American Academy of Pediatrics used to advise against this practice, they changed their policy in 2016, calling the refusal to treat vaccine-hesitant patients “an acceptable option.”

But others worry that this approach can backfire. “I find that that leads to children lacking a good health resource,” Dr. Boucher said.

To find a middle ground, many pediatricians said they were willing to accommodate alternative vaccine schedules that spread shots out over a longer period of time, even though they support the C.D.C.-recommended schedule.

“I am not one to say, ‘If you don’t do it the way that I say, you’re out of here,’” Dr. Boucher said. When parents of a 2-month-old baby recently told him they didn’t want to vaccinate, he told them he heard their concerns, and wasn’t going to pressure them. But he went on to explain that he was concerned the baby could be exposed to R.S.V. and pertussis over the coming winter months, which could be dangerous. He asked them to think about vaccinating for just those infections.

“They literally booked an appointment the next day,” he said.