Family doc advances immunization by educating physicians and patients
Gretchen LaSalle, MD, MPH, FAAFP, literally wrote the book on talking to patients about vaccines. The family physician began working in that space not because she was an expert but because she needed to learn more.
From patient questions to vaccine expertise
“I was coming up against increasing vaccine questions from my patients and didn’t feel fully prepared to deal with the questions they were bringing me, mostly from social media,” said LaSalle, who practices in Spokane, Washington. “I got into a self-learning journey, trying to teach myself these things so I could help my patients avoid falling victim to misinformation. There was a lot of great information for physicians out there, but there was nothing in one place that answered all the questions we needed to answer to help our patients. That’s how I ended up writing my book.”
Gretchen LaSalle, MD, MPH, FAAFP
Why family medicine?
“I loved all my rotations. I don’t think I would do as well in a specialty where I only knew about one thing. I like being the person who can answer all sorts of questions that patients bring me. I also loved the fact that family medicine is unpredictable. You never know what’s going to be behind that door, and I love that variety. Family medicine gets to do a little bit of everything: procedures, mental health, women’s care, pediatrics. It provides a strong foundation for pursuing a variety of things folks may feel passionate about; for me it’s vaccines and public health and for others it may be sports medicine, adolescent medicine or OB care.”
LaSalle had published journal articles and editorials before her book, “Let’s Talk Vaccines: A Clinician’s Guide to Addressing Vaccine Hesitancy and Saving Lives,” was published in 2019, but her work was just getting started.
She served on multiple state and regional immunization committees and during that service met John Merrill-Steskal, MD, a fellow family physician in Washington who was an AAFP Vaccine Science Fellow in 2016. Merrill-Steskal told LaSalle about the fellowship, which since 2009 has developed a group of family physicians interested in, and knowledgeable about, vaccine issues. The fellows work to address interactions between public health and the family medicine community.
Advancing vaccine education and public health
LaSalle applied and was accepted just in time for the COVID-19 pandemic.
“It was a really interesting time to be doing this work,” said LaSalle, who completed the fellowship in 2021 and earned a master of public health degree in 2025. “It was an excellent experience for me and has spurred me to want to learn even more and continue my education. I love learning and helping my patients.”
What inspired you?
I don’t know why, but I remember when I was about 8 thinking, ‘I want to be a doctor.’ I started learning the systems of the body, thinking, ‘If I’m going to get a jump on medical school, I’m going to start now.’ Maybe it’s because I love learning, and I value relationships—being part of people’s lives in joyous and difficult times and seeing them grow and change over the lifespan, being with them on that journey, advocating for them, and teaching them.
LaSalle said her fellowship included surveying patients about their confidence in vaccines and vaccine messengers before and after the pandemic. She said her research during the fellowship, as well as her own experience in two decades of practice, led her to change the way she talks to patients
“Try to meet people where they are and not make assumptions,” said LaSalle, an adjunct professor of public health at Gonzaga University. “That’s a huge piece of what I talk about with folks when I’m teaching. We don’t want to assume why people are not vaccinating. We don’t want to lump people into categories. We want to dig into people’s concerns and be a trusted source to help them make decisions. It’s not a quick process. It’s a slow drip to get people to vaccinate sometimes, but it’s certainly well worth it.”
LaSalle represents the AAFP at the Vaccine Integrity Project, specifically for issues related to the respiratory syncytial virus vaccine. She also serves on the Washington State Department of Health Vaccine Advisory Committee and the Washington Vaccine Association, a non-profit organization that enables the state to purchase childhood vaccines by collecting funds from insurers.
Why are you passionate about immunizations?
I am passionate about prevention, and I’ve learned that I am motivated by injustice and inefficiency. Building confidence in vaccines, arguably our greatest preventive innovation in medicine, felt like an opportunity to address it all. It felt like an injustice that my patients and parents, especially those making choices for children who weren’t old enough to make their own medical decisions, were falling victim to misinformation on social media. And, although one-on-one conversations are the most effective way to get the message across to individual patients, it felt inefficient. I wanted to have a broader voice, and that is how I ended up pursuing writing, public speaking, committee work and now teaching.
LaSalle has been involved in creating AAFP education content for family physicians related to vaccines and has represented the Academy in interviews with national news outlets in vaccine-related stories.
“The fellowship helped me to make connections within the organization and also with vaccinating partners,” she said. “It opened doors to participation in committees and work groups and other organizations that are focused on vaccinating our population. That’s been a great outcome of this fellowship. I got to meet people that I would not have probably met otherwise.”