Primary care physicians all too frequently come face-to-face with the powerful effects of antivaccination "pseudoscience" during the course of patient visits -- especially when the patient is an infant or a young child. Even a trusted family physician can expect to hear questions that often are preceded by "I was reading about vaccines online …" or "I was watching this show about vaccines …"
To prepare physicians-in-training to deal with immunization pushback from parents and others, the California AFP (CAFP) and other partners have lent their support to the American Academy of Pediatrics, California, to help develop and distribute a vaccine safety communication curriculum(vaccinecommunicationresource.wikispaces.com) designed for primary care residency programs nationwide.
According to family physician Jeffery Luther, M.D., of Long Beach, Calif., the project began just more than two years ago in response to the growing number of parents who reject vaccinations for their children, as well as adults who choose to forgo their own vaccinations. By identifying gaps in vaccine safety communication training for medical residents, the groups hoped to combat negative vaccine messages and increase the number of people getting vaccinated.
Luther, who is director of the Long Beach Memorial Medical Center Family Medicine Residency Program, said the project(www.immunizeca.org) used data drawn from an online survey(www.surveymonkey.com) of residents, as well as from six focus groups conducted at primary care residency programs and three focus groups that involved practicing pediatricians.
Those data showed that the top reasons residents and practicing physicians were given by parents reluctant to immunize their children were
- vaccines may cause autism or other developmental disabilities (72.9 percent),
- a vaccine is "too new" or has not been tested enough to ensure its safety (61.5 percent), and
- too many vaccines are given during a single doctor's visit or during the child's first 2 years (59.7 percent).
"Residents are not really trained to deal with that kind of pseudoscience," Luther told AAFP News Now. "So we developed a program that will teach residents to counsel these parents and patients in order to improve vaccination rates.
"Although the AAP got the grant, they wanted to widen the scope of the project, targeting pediatric, family physician and internal medicine residents. Because all of the connections they had were to pediatric programs, they reached out to the CAFP to make sure FP practices were studied, as well."
The curriculum that the groups developed based on the survey and other data uses an online case-based format designed to put residents in real-life vaccination communication scenarios. It also guides trainees through websites that offer evidence-based information about vaccine safety -- as well as those that propagate misinformation about vaccines -- and helps them recognize the difference.
Luther said the program also offers a lecture/slide deck(www.scribd.com) that features nearly 100 slides that include vaccine data, information about vaccine myths and more, as well as a small-group discussion guide vaccine safety communication curriculum(www.scribd.com) that offers its own case-based discussion approach to teaching residents vaccine safety communication skills.
All program materials are intended as a template to be used by residency program directors as they see fit, Luther explained.
"We have put out curriculums for pediatrics, family medicine and internal medicine," he said. "Any program that wants it can get it for free. So far, we are getting a great response from program directors."
The biggest goal going forward, according to Luther, will be disseminating the data widely.
"You've got parents out there arguing with their physicians because they are scared and they want to protect their child," he said. "That is healthy, but we have got to arm our physicians with good counseling tools and good statistics that will dispel the rumors."