Supplement Article  |   February 2010
Communicating with patients about immunizations: What your patients need to know
Article Information
Preventive Medicine / Professional Issues
Supplement Article   |   February 2010
Communicating with patients about immunizations: What your patients need to know
The Journal of the American Osteopathic Association, February 2010, Vol. 110, S3. doi:
The Journal of the American Osteopathic Association, February 2010, Vol. 110, S3. doi:
Study after study shows that patients look to their physicians for advice about vaccines. “My doctor didn't say I needed it” is a common response from patients in surveys and studies when patients are asked why they have not received a particular vaccine. 
Interestingly, in surveys and studies designed to understand the physician's point of view, physicians usually report that they believe their patients would not have agreed to pay for the vaccine had they strongly recommended it. However, studies show that patients rank “having the means to pay” low on their list of competing factors that affect their decision to receive a vaccine that their physician strongly recommended or that they perceived they needed. 
Our patients need to know how highly effective vaccines are and how extensively they have been studied. There is a misconception by our patients that vaccines are experimental, that they have not been subjected to rigorous testing, that they cause the diseases they are intended to prevent. 
Our patients deserve to understand the risks associated with having no vaccine. For example, if our patients over 60 years of age choose not to receive the vaccine for prevention of herpes zoster, they should understand their risk of acquiring zoster is one in two by age 80. And, they should understand that their risk of complications and long-term pain from one episode of zoster increases with increasing age. This risk is reduced by more than half after receipt of the herpes zoster vaccine, depending on the patient's age at the time the vaccine is given. 
If our female patients choose not to receive vaccination against cervical cancer, they deserve to know what may happen to them if they later develop cervical dysplasia and/or cancer. These young women and their mothers deserve to know how very common human papillomavirus is and that having only one lifetime sex partner still places them at risk for acquisition with subsequent cervical dysplasia. 
Our patients deserve to know how safe vaccines have proven to be. When my at-risk patients ask me if the H1N1 vaccine is really safe, while telling them “yes,” I remind them that there are still known H1N1-related deaths occurring at a high rate compared to no known deaths related to receipt of H1N1 vaccine. 
One thing I have found that my patients appreciate the most is a fair and honest answer when they ask me if I have taken the vaccine myself and will I offer the same to my children. If I can answer “yes” with confidence, my patients tell me this provides them with additional confidence. If I cannot answer “yes” and I am eligible for that vaccine, perhaps there are concerns about that vaccine I must answer for myself before I can recommend it to my patients. 
As osteopathic physicians, it is our duty and responsibility to form a strong opinion about the federal Centers for Disease Control and Prevention's (CDC's) recommended vaccines for our patients and to communicate those recommendations to our patients during routine office visits or during a hospitalization, which could have been avoided had the patient received a particular vaccine, such as that given to prevent pneumococcal disease. 
The words “Do no harm” are a critical part of our oath as osteopathic physicians. It is our responsibility to understand the risks and benefits of vaccines so that we can properly provide our patients with the information they need for informed consent. 
If we understand the safety of vaccines currently on the market as well as the fears that our patients have and are able to balance those concerns against the efficacy, we will succeed in convincing our patients about the importance of vaccination. If we do not take the time to tell our patients they need a particular vaccine, we as a medical community will not be effective in reaching target goals for vaccination in our patient population. 
  Bethany A. Weaver, DO, is board certified in internal medicine and infectious diseases. She is currently the medical advisor at the Hillsborough County Sheriff's Office in Tampa, Fla., and has been working in the correctional medicine field since 2005. Dr. Weaver is an expert in the management of HIV and other sexually transmitted diseases. She can be reached at