Doctors can’t be vague on vaccines

With more patients having questions about vaccines, particularly in light of shifting federal recommendations, doctors need to be willing to listen to patients and avoid being judgmental or condescending.

But doctors still need to give patients clear, direct advice about getting vaccinated, and vaccinating their children, Dr. Margot Savoy says.

Savoy, chief medical officer of the American Academy of Family Physicians, says doctors need to be as clear and straightforward as a car mechanic saying the brakes need to be fixed. Doctors should be similarly emphatic when it comes to guiding patients to get vaccines.

“I think that the recommendation deserves a period at the end of the sentence,” Savoy says.

Physicians are also talking to families about getting vaccines for children, and new federal data released this week suggests rising skepticism of vaccines.

During the 2025-26 school year, exemptions from one or more vaccines among U.S. kindergartners rose to 4.2%, up from 3.6% the year before, according to data from the Centers for Disease Control and Prevention. About 155,000 kindergarten students were exempt from one or more vaccines, with exemptions rising in 41 states and Washington, D.C.

• Read more: How doctors and health systems can counter vaccine skepticism

Savoy says doctors need to engage patients in conversation, ask questions, and listen to their concerns about vaccines. He says doctors should also be willing to ask questions about where patients are getting their information about vaccines and guide them to more trustworthy sources. She also says patients deserve empathy and curiosity, rather than condescension or judgment.

But she says doctors need to give unambiguous recommendations about vaccines, and be willing to do so again if patients don’t opt for vaccines initially.

She says she’ll tell patients that she’d fight them if they were family, but since they aren’t, she’ll simply try again next time.

“What you don't want is someone getting hurt and not realizing that they're hurting themselves, and they didn't know that there was a thing that could happen to them,” Savoy says. “So like you just want to make sure that they have what they need to make the best decision for themselves.”

• Read more: Medical groups reject Trump’s order on childhood vaccines

Give professional opinions

Some doctors, perhaps out of a desire to avoid alienating patients, become too vague in their advice.

Savoy says she’s done workshops with doctors in having conversations about vaccinations with patients, and she’ll ask physicians to recite how they’d guide the patients. After hearing some examples, Savoy says she wasn’t even sure what the doctor was recommending.

“I don't actually know whether they're telling me to get the shot or whether they're asking me if I want to get a shot,” Savoy says.

“You're doing all this talking, but I don't know what you're asking me,” she adds. “And I'm like, I just need to know what you're recommending.”

Granted, most people don’t look forward to vaccinations, because as Savoy says, “There are very few people who are excited about needles.”

Savoy says it’s not about being maternalistic or paternalistic, but she says it’s actually easier to be direct and blunt about recommendations.

“You pay good money for me to come and give you my professional opinion, and I've given it to you clearly and succinctly,” Savoy says. “And then you also pay good money to get advice and counseling, and that advice and counseling comes in the part where I hear your concerns and think about it.“And when you separate those two apart, I really think it helps clinicians think about it differently,” she adds.

No time to be ‘wishy-washy’

If a patient was having a heart attack, the doctor wouldn’t hesitate to deliver the right treatment.

And the flu, measles and other vaccine-preventable diseases can have lasting consequences, and can even be fatal. So even if doctors are leery of being perceived as telling patients what to do, she says physicians should focus on being direct with their best medical advice.

“This isn't a place to be wishy-washy,” Savoy says. “The answer is still the same. You have a recommendation for a reason, and that evidence may be because you're worried they're going to end up in the hospital, or that they may die, that they may infect someone else. Those are valid reasons that you're allowed to have a statement.”

And being direct with recommendations isn’t forcing a patient to do anything differently, she says.

But she adds, “You are taking away their opportunity to understand where you stand if you're being wishy-washy in your recommendations. So you’ve got to get really clear and concise on that, and then talk about whatever you need to talk about to help them reach their conclusion or make their decision.”

• Read more: Measles cases reach 35-year high: What doctors and hospitals should do