Back-to-School Pediatric Vaccination: A Family Physician’s Perspective on Boosting Rates, Countering Misinformation

Vaccination remains one of the most effective tools in modern medicine for preventing serious childhood illnesses. Yet, in recent years, vaccine hesitancy and misinformation have threatened to undermine decades of public health progress. In a recent interview with Patient Care®, board-certified family physician Sarah Sams, MD, shared in-depth strategies for improving vaccine uptake, addressing parental concerns, and optimizing office procedures for efficient immunization.

Sarah Sams, MD, is a member of the board of directors of the American Academy of Family Physicians (AAFP). Dr Sams also an associate director and full-time faculty member at Grant Family Medicine Residency in Columbus, Ohio.

The following transcript has been lightly edited for style and clarity.

Patient Care: What is one action you believe every physician can take this month, during National Immunization Awareness Month, to strengthen vaccine confidence?

Sarah Sams, MD: I think doing interviews like this, writing letters to the editor, or speaking to local groups—like PTOs or Mothers of Preschoolers (MOPS) groups—can help educate the public about the importance of vaccines. Talk about what the recommendations are, why we make them, and what the safety data show. Make sure there is awareness in your own community not only about where to get vaccines, but also that you're available to discuss people's concerns. That way, there’s real education happening—not just fear-mongering social media posts that can frighten our patients.

Patient Care: Is there anything else we didn’t touch on that you’d like to add?

Dr Sams: Family physicians are a really good source of information for the entire family—not just for kids, not just for adults, but for everyone. So please encourage people to reach out to their family physicians for information. The AAFP offers patient-facing resources through familydoctor.org, where patients can access trusted information when they have concerns about what’s real and what’s not in the news.

Patient Care: Back-to-school season is here. How can clinicians ensure pediatric patients are up to date with their vaccines?

Dr Sams: Most of us now have electronic medical records, and those usually have health maintenance tabs where you can run reports to see who is due for particular vaccines. You can then reach out individually to those patients, either by phone or MyChart, and say, “Hey, looks like your child might be behind on vaccines.”

The other thing is to pay attention to vaccine needs when kids come in for non–well visits—when they’re here for an ear infection, strep throat, or something else in between well-child checks. If they can’t get the vaccine at that time, or don’t want it because of the illness, at least remind them they’re behind and immediately schedule a follow-up appointment so they can get caught up as quickly as possible.

Patient Care: What is your approach to catch-up vaccination for children who may be behind?

Dr Sams: I actually saw a child this week who needed catch-up vaccines. They had been going to a different physician early in their childhood and hadn’t received them. We’re now following the schedule, because certain intervals must occur between doses of a particular vaccine.

Often, we’ll schedule nurse visits for vaccines in between well-child checks. If the family is hesitant to do them all at once, we start with the vaccines for illnesses the child is most likely to come in contact with. For example, right now there’s been a measles epidemic in many places. If they’re old enough—post–1 year—and can get the measles vaccine, we might start with that. We focus on the diseases most concerning for that age group or location.

We don’t see much polio right now, so if a family wants to space out vaccines, we might delay that one since the risk of exposure is low. But if the family is willing to do multiple vaccines in a visit, we’ll do as many as possible, then schedule a shorter interval between well-child checks for nurse visits to complete the series.

Patient Care: What communication strategies have you found most effective in addressing vaccine hesitancy without damaging the patient–clinician relationship?

Dr Sams: It really depends on the individual patient and their personality. Some just need a lot of data. Others have a history or experience with a family member that has made them hesitant. I ask what their concerns are and try to address those directly.

Sometimes we use humor. I often share a video that takes a humorous approach to contrast outcomes in unvaccinated versus vaccinated populations. It still includes a lot of facts and data, which some patients find helpful.

One of the biggest problems right now is that many of the diseases we vaccinate against have not been seen by this generation, such as measles and whooping cough. They’ve been eradicated or reduced for so long that the parents of these children—or young adults themselves—have never seen these illnesses and don’t realize how serious they can be. They hear about potential side effects from a vaccine, and that becomes their only concern; they don’t understand the risks of the illness itself.

So we do some education about that. Fortunately—or unfortunately—I’ve been around long enough to have seen some of these illnesses before widespread vaccination, and I can speak directly to the severe manifestations they can cause, including death.

Patient Care: How do you handle coadministration in a respiratory virus season when time is tight and multiple shots may be due?

Dr Sams: Especially with pediatric patients, there are often multiple vaccines due at well-child visits—not just during respiratory season. My approach is to pre-chart before the visit, determine what that patient needs, and enter those orders. We do a pre-huddle with nursing and medical assistant staff, and I tell them what I think the patient needs.

As they room the patient, they ask if they’re okay with those vaccines. If the patient or parent says yes, they start preparing them before I even walk in. If they say no, the staff lets me know they have questions or have declined. That gives me the opportunity to go in, ask again, provide education, and, if they change their mind, I send a secure chat to my medical assistant, sign the order, and they administer it.

Patient Care: How can clinicians effectively counter misinformation about vaccine safety, particularly concerns around aluminum or preservatives, during brief office visits?

Dr Sams: Thimerosal, a mercury-containing preservative, has been removed from all childhood vaccines since about 2001, though some multidose influenza vaccines still contain preservatives. The easiest way to avoid this concern is to purchase single-dose, preservative-free vaccines.

If only multidose vaccines are available, I provide information on the very small amounts of preservative present and explain that, for a single vaccine like the flu shot, those levels are safe.