Vaccines are one of the biggest wins in public health interventions in modern medicine, preventing millions of deaths worldwide each year.¹ Vaccine hesitancy is still a common and sometimes challenging part of family medicine practice. For osteopathic family physicians, residents, and medical students, these conversations require not only clinical knowledge, but also empathy, communication skills, and a commitment to whole-person care.
Addressing vaccine hesitancy is not about winning an argument. It is about building trust, understanding concerns, and supporting informed decision-making over time, an approach that aligns closely with osteopathic principles and the longitudinal relationships central to family medicine.
Vaccine Hesitancy Is a Spectrum
The World Health Organization defines vaccine hesitancy as a delay in acceptance or refusal of vaccines despite availability of vaccination services.² Importantly, hesitancy is not a single belief or a diagnosis. Patients may be underinformed, uncertain, concerned about safety, distrustful due to prior experiences, or firmly opposed because of deeply held beliefs.
Recognizing where a patient falls on this spectrum allows clinicians to individualize counseling. Assuming all hesitant patients have the same beliefs risks alienating those who are simply seeking reassurance.
Clinical takeaway: Curiosity is often the most effective first step.
Lead With Trust before Data
As clinicians, we rely on evidence. However, the research consistently shows that facts alone rarely change minds, this is especially true when fear or mistrust is involved.³ Patients are more receptive when they feel heard and respected.
Effective conversations often begin with:
- Acknowledging concerns without judgment.
- Validating emotions without reinforcing misinformation.
- Emphasizing shared goals, such as keeping families healthy.
This patient-centered approach is consistent with the osteopathic philosophy emphasizing the unity of mind, body, and spirit.⁴
The Importance of a Clear Recommendation
A strong recommendation from a trusted clinician is one of the most influential factors in vaccine acceptance.⁵ Both the CDC and AAFP recommend confidently presenting vaccines as routine and expected care.
Best practices include:
- Normalizing vaccination.
- Using confident, non-hesitant language.
- Avoiding unnecessary framing of vaccines as optional.
- Encourage questions and discussion.
Motivational Interviewing
Motivational interviewing (MI) is an evidence-based approach shown to improve vaccine confidence, particularly among parents.⁶,⁷
The focus on empathy, autonomy, and collaboration makes it a natural fit for osteopathic family medicine.
Core MI techniques include:
- Asking open-ended questions.
- Reflecting patient concerns.
- Asking permission before sharing information.
- Supporting patient autonomy.
Even when patients decline vaccination, MI helps preserve the therapeutic relationship and keeps the door open for future conversations.
Addressing Common Concerns Thoughtfully
When responding to misinformation:
- Avoid confrontational or dismissive language.
- Gently correct inaccuracies.
- Focus on patient-specific values and goals.
The CDC recommends tailoring vaccine discussions to what matters most to the patient. This could include preventing hospitalization, protecting vulnerable family members, or avoiding missed work or school.⁸ Brief, relevant clinical experiences can also be effective when used thoughtfully.
When Patients Say “Not Today”
Declining a vaccine at one visit does not mean declining forever. National guidance emphasizes that keeping patient trust is more important than forcing agreement.⁹
Helpful responses include:
- “Would you be open to revisiting this next visit?”
- “What information would help you feel more comfortable?”
- Clear documentation to support continuity of care.
Family medicine’s longitudinal relationships allow these conversations to evolve over time.
Teaching the Next Generation
Medical students and residents learn vaccine counseling largely by observation. Faculty can support learners by:
- Modeling confident, respectful recommendations.
- Debriefing challenging encounters.
- Encouraging practice with motivational interviewing.
- Normalizing resistance as part of primary care.
Patient-centered communication is a core competency emphasized in family medicine training standards.¹⁰
The Osteopathic Family Medicine Advantage
Osteopathic family physicians care for patients across generations, life stages, and belief systems. This continuity is one of the most powerful tools for addressing vaccine hesitancy.
Vaccine counseling is not only disease prevention—it is relationship-building, health education, and advocacy delivered with compassion. When approached through an osteopathic lens, these conversations strengthen trust and support informed, whole-person care.
References
- World Health Organization. Immunization coverage. WHO; 2023.
- World Health Organization. Report of the SAGE Working Group on Vaccine Hesitancy. 2014.
- Nyhan B, Reifler J. Vaccine. 2015.
- American Academy of Family Physicians. Patient-Centered Communication.
- Opel DJ et al. Pediatrics. 2013.
- Rollnick S, Miller WR. Motivational Interviewing in Health Care.
- Gagneur A et al. Hum Vaccin Immunother. 2018.
- Centers for Disease Control and Prevention. Talking with Patients about Vaccines.
- CDC. Vaccination Communication Strategies.
- ACGME. Family Medicine Milestones.
Author Bio
Jennifer Shuey, DO, is a family physician with a professional interest in preventive care, patient-centered communication, and medical education. She is passionate about applying osteopathic principles to everyday clinical challenges, including vaccine counseling and addressing health misinformation. Dr. Shuey is dedicated to supporting patients, families, and learners through compassionate, evidence-based care.
