Communicating With Families About How to Protect Against Fall and Winter Respiratory Viruses

Viral respiratory season has arrived. Now is the optimal time to immunize patients against the fall/winter respiratory viruses.

For children and adolescents 6 months through 17 years, rates of vaccination are less than 40% for the seasonal flu vaccine and less than 10% for the updated COVID-19 vaccine. As a pediatrician, your patients depend on you as a trusted source of accurate health information and actionable guidance. You can help patients and their families stay safe and reduce the risk of severe disease by strongly recommending vaccination.

Consider the tips below and sending reminder and/or recall messages to families to get immunized before they gather for holidays.

Here are 3 tips and sample scripts to start the conversation with patients and families.

During the clinical visit, talk to families about immunizations needed to protect their children and family.

Make a strong recommendation for routinely recommended vaccines and immunizations.

Sample Language for COVID-19 and Influenza Vaccines

“Your child is due for your flu and COVID-19 vaccines today. I’ve gotten these vaccines myself as have my children (grandchildren), and I recommend them for you too.”

Sample Language for RSV Immunization

For parents of baby: “Your baby is due for nirsevimab today, which will help protect them from severe respiratory illness.”

For expecting families interviewing a prospective pediatrician or if a child’s family member is pregnant:

Discuss the two options and make a strong recommendation for the one the patient prefers.
“I recommend an RSV immunization to protect your unborn baby from severe respiratory illness. There are two options available—one is a vaccine for you, that you can get from your provider’s office. The other is an immunization for your baby after birth. I recommend either one of these options for you, and most babies don’t need both.”

Avoid missed opportunities for immunization – try saying:

“Your baby can get these vaccines today—flu, COVID-19 and RSV. They might experience some side effects, like fever, but these are usually mild or moderate and only last a day or two. Getting all your baby/child’s vaccines today means your family won’t need extra appointments and will help your child/baby be protected against these respiratory diseases sooner.”

Use motivational interviewing when patients are hesitant or resistant to a strong recommendation – tips include:

Be empathetic: Approach the conversation with compassion, show empathy and be genuinely curious about the reasons why the parents/families feels the way they do. “It’s okay to want more information before making a decision.”
Ask permission: If a parent/family is resistant to your strong recommendation, ask to discuss vaccines further. “If it is okay with you, I would like to spend a few minutes talking about fall and winter respiratory vaccines.” Respect the family’s decision if they say no and ask if they would be willing to talk about vaccines at their next visit.
Use open-ended questions, affirm positive behaviors, reflect what you hear and summarize the conversation: “What have you heard about these immunizations?” “How does that make you feel?” “On a scale of 1 to 10, how likely are you to get an flu vaccine?”
Respond to questions: Answer questions within the boundaries of your competence, ethics and scope of practice. If you do not know an answer, discuss how your patient can find a good source of information.

Discuss why regular vaccinations are important and respond to any questions or concerns.

Why immunization is important: “Flu, COVID-19 and RSV can cause serious illness. Some people, including young children, pregnant people and patients with underlying medical conditions, are at higher risk of severe illness from these fall and winter viruses. However, even healthy children can get severely ill. Immunization are the best way to help prevent or reduce severe illness.”
How immunization works: “Immunization helps the body learn how to defend itself from disease without the dangers of a full-blown infection. Vaccines work by imitating an infection to engage the body’s natural defenses. This doesn’t cause illness, but it does cause the immune system to produce immune cells to fight off what it thinks is an infection. The body is left with a supply of these cells and will remember how to fight the real infection in the future.”
Immunizations are safe: “Flu, COVID-19 and RSV immunizations are safe and are the most effective way to keep your family healthy this fall and winter respiratory season. Side effects tend to be mild and temporary; serious adverse events are rare. For example, you may experience a sore arm or low-grade fever.”
Benefits of immunization: “Getting a flu, COVID-19 or RSV immunization is a safer, more reliable way for your body to build protection than taking the risk of getting very sick with a respiratory virus. Your child could still get sick after getting immunized. But their symptoms will usually be milder and less severe than if they did not receive the vaccine.”

Administer vaccine(s) and schedule the next vaccination appointment.

Schedule the next vaccination appointment: “To stay up to date with all your recommended vaccines, let’s schedule your next vaccination appointment today.”
Reminder about tools and everyday actions you can take: “You can also protect yourself and your family from respiratory viruses by covering coughs and sneezes, washing hands, staying home when sick, wearing a well-fitted mask, physical distancing, and improving airflow or ventilation in the places where you live work and play.”