BMC Pediatrics

, 12:154

First online:

Open Access This content is freely available online to anyone, anywhere at any time.

Communicating with parents about vaccination: a framework for health professionals

  • Julie LeaskAffiliated withSchool of Public Health, and Discipline of Paediatrics and Child Health University of Sydney and National Centre for Immunisation Research and Surveillance, The Children’s Hospital at Westmead Email author 
  • , Paul KinnersleyAffiliated withInstitute of Primary Care and Public Health, Cardiff University
  • , Cath JacksonAffiliated withYork Trials Unit, Department of Health Sciences, University of York
  • , Francine CheaterAffiliated withInstitute for Applied Health Research, Associate Dean (Research) School of Health and Life Sciences, Glasgow Caledonian University
  • , Helen BedfordAffiliated withCentre for Paediatric Epidemiology and Biostatistics, UCL Institute of Child Health
  • , Greg RowlesAffiliated withGreg Rowles, General practitioner



A critical factor shaping parental attitudes to vaccination is the parent’s interactions with health professionals. An effective interaction can address the concerns of vaccine supportive parents and motivate a hesitant parent towards vaccine acceptance. Poor communication can contribute to rejection of vaccinations or dissatisfaction with care. We sought to provide a framework for health professionals when communicating with parents about vaccination.


Literature review to identify a spectrum of parent attitudes or ‘positions’ on childhood vaccination with estimates of the proportion of each group based on population studies. Development of a framework related to each parental position with determination of key indicators, goals and strategies based on communication science, motivational interviewing and valid consent principles.


Five distinct parental groups were identified: the ‘unquestioning acceptor’ (30–40%), the ‘cautious acceptor’ (25–35%); the ‘hesitant’ (20–30%); the ‘late or selective vaccinator’ (2–27%); and the ‘refuser’ of all vaccines (<2%). The goals of the encounter with each group will vary, depending on the parents’ readiness to vaccinate. In all encounters, health professionals should build rapport, accept questions and concerns, and facilitate valid consent. For the hesitant, late or selective vaccinators, or refusers, strategies should include use of a guiding style and eliciting the parent’s own motivations to vaccinate while, avoiding excessive persuasion and adversarial debates. It may be necessary to book another appointment or offer attendance at a specialised adverse events clinic. Good information resources should also be used.


Health professionals have a central role in maintaining public trust in vaccination, including addressing parents’ concerns. These recommendations are tailored to specific parental positions on vaccination and provide a structured approach to assist professionals. They advocate respectful interactions that aim to guide parents towards quality decisions.