Patient Education and Vaccine Hesitancy

​​Influenza Implementation Guidance


Updated September 2019

​Pat​ient Education and Vaccine Hesitancy

Patient education is an important part of vaccine delivery. Despite vaccinations having an excellent safety record and being tremendously successful at preventing serious diseases, some parents still have questions and concerns. Pediatricians can let parents and patients know that getting the influenza vaccine is the single best way to protect themselves and their children from getting the influenza. While the influenza vaccine is not 100% effective, we do know that those who get influenza after having been vaccinated are less likely to be significantly ill, be hospitalized, or have serious complications. 

Articles for parents about influenza are available on AAP's parenting Web site, HealthyChildren.org. In addition, a revised patient handout will be posted to Pediatric Patient Education (PPE) — AAP's online subscription resource for healthcare professionals.

From AAP: 

From CDC


Vaccine Hesitancy: How to Talk With Parents and Guardians

So why do parents not vaccinate their kids? It sounds so simple, a vaccine to prevent influenza. Some of the reasons parents/guardians give are below, with possible responses:

  • My kids have never had influenza.

    • I'm glad to hear that and I hope they don't get it this year, but avoiding the influenza in the past is not a predictor of who will get the flu in the future. Getting vaccinated is the single most important thing you can do to prevent influenza. Influenza kills up to 49,000 people in the US each year and makes many more sick. Many of these deaths occur in healthy individuals. Even one unnecessary death is too many.

  • I got the flu shot once and it gave me the flu, or the year I got the flu shot was the sickest I've ever been.

    • It’s important to distinguish influenza from what many parents call “the flu.” It’s important for parents to understand that the flu shot only prevents influenza, not the hundreds of other types of viruses that children and adults can get that cause things like colds or vomiting and diarrhea. 

    • Consider framing influenza as one of the most severe viruses that children can get – yes, other viruses can cause similar symptoms, but influenza is really the worst of the viruses commonly encountered by children, and it can be prevented.

    • The strains of influenza that are put into the flu shot are "killed" viruses. The flu shot does not and cannot cause the flu. 

    • If someone gets a flu shot in the middle of flu season, they may already have been exposed to influenza and be coming down with it or another virus (colds are very common during influenza season and can vary in severity). Because the shot and getting sick happened at the same time, they think the flu shot gave them influenza. Many times, parents attribute any illness around vaccination as caused by the flu shot, but almost always, these illnesses are simply coincidental, and are not actually influenza.

    • It also takes about 2 weeks for the body to build protection after the shot, so some people get sick just before or during that time period and blame the shot.

    • The most common side effects of an influenza vaccine are soreness at the injection site and sometimes a low-grade fever. Sometimes people who experience side effects seem to think "they got the flu."

  • It doesn't work; my kid got a flu shot and still got influenza.

    • While the flu vaccine is not 100% effective, we do know that those who are vaccinated and who later get an influenza virus are less likely to have severe illness, to be hospitalized or to have serious complications.

    • Each year scientists determine the 3 or 4 most common strains of influenza virus circulating and that's what's included in the upcoming year's flu vaccine. Most of the time when parents say that they or their child got “the flu,” it was a virus other than influenza that made them sick. While it’s still possible to get influenza after getting the flu shot, it tends to be less severe.

  • Influenza is not really that bad, no worse than a bad cold.

    • Although it is sometimes challenging to tell the difference between a cold and influenza, influenza can have serious implications and even lead to death, especially for the very young, very sick, or very old. It tends to last for several days, keeping you out of work and your child out of school. Getting vaccinated not only protects you, but those closest to you as well.

  • Thimerosal—is it safe? Does it cause autism?

    • Thimerosal is a preservative that is included in multi-dose vials. It keeps the vaccine sterile. Studies have proven that thimerosal is not linked to autism. Before the studies were done, manufacturers took thimerosal out of many shots, so there are preservative-free shots available.

Tools and Resources

Parent and Family Resources

AAP Policies & Reports
Online Courses

  • AAP PediaLink Course – Influenza Update – Prevention, Treatment, and Management of Influenza (Coming this fall!)

  • AAP Free Online Course–Influenza Prevention and Control Strategies in Childcare (Coming this fall!)

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