How doctors and health systems can counter vaccine skepticism

For many physicians, it’s painful to see vaccination rates declining.

To be clear, most Americans still embrace the value of vaccines. But in the 2024-25 school year, 92.5% of kindergartners had received the measles, mumps, and rubella (MMR) vaccine, below the 95% rate needed to prevent transmission of the measles virus, according to the Johns Hopkins Bloomberg School of Public Health.

This week, President Trump has issued an executive order spelling out changes in the childhood vaccine schedule. Medical societies have rejected the White House guidance and are urging doctors and health systems to adhere to the existing schedule.

Dr. Margot Savoy, chief medical officer of the American Academy of Family Physicians, says it’s disheartening to see an erosion of progress in vaccinations.

“Ideally in 2026, when we have so many options and so many really great vaccine choices, you would like to think that would be talking about the things for which we don't have a vaccine,” Savoy says.

“The idea that we are reintroducing into our children something that our parents saved us from is horrifying, and we should be embarrassed,” she says. “And we really should take a moment to think about how, as a public, we want to protect and save our children. And I think that's something that I don't think can be stated enough.”

In an interview with Chief Healthcare Executive®, Savoy offers guidance for doctors and health systems in dealing with patients and families who are skeptical of vaccines.

She says doctors need to listen to patients when they share concerns, but they also need to give clear, direct recommendations on vaccines. And she urges health systems and practices to make it as easy as possible for patients to get vaccines.

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

Creating safe spaces

Doctors should understand that conversations about vaccines involve the whole family, and not just the individual patient or a parent.

Health systems, physicians and practices need to create safe spaces for conversations about vaccines and for patients and families to ask questions. With more discussions about vaccines, patients, even those who are fine with vaccination, are likely to ask more questions.

“If you don't have a safe space to go and get answers to those questions, I think you put people at a disadvantage,” Savoy says.

Patients and families should be able to ask questions and express concerns without being dismissed or treated as if they were stupid.

“You need to be able to ask questions, and I think that's true across healthcare in general,” Savoy says.

“If you don't have a safe, trusted place to test out the thing you're hearing, I don't know how we're expecting people to get better or wiser about making their own choices,” she adds.

• Read more: Family doctors face more vaccine confusion

Offer clear guidance

While patients should be able to talk candidly about their questions or doubts about the safety of vaccines, Savoy says doctors shouldn’t be ambiguous in their answers.

Physicians need to offer clear recommendations on vaccines.

“My recommendation doesn't change whether you like what I'm about to say or not,” Savoy says. ‘So my recommendation is based on what I understand about the science and what I understand about the evidence and where I've landed clinically about what, based on your history and your record, I think is the right decision for you.”

“And it is important for me to give you that recommendation very clearly, very succinctly, and with a period at the end. When you go to the car mechanic, they don't go, ‘Well, maybe you might want to think about changing your brakes? I mean, they tell you, your brakes need to be changed, and there's a period at the end of that sentence. And so, I think that the recommendation deserves a period at the end of the sentence.”

Stop talking and listen

Doctors also need to ask patients and families about their questions.

And then they need to pay attention when patients are talking.

“Are there questions? Are there concerns? Are there things that you want to think about? And that's where I think you have to, as the clinician, as the physician, just stop talking and listen,” Savoy says.

“So we're not listening to answer. We're not listening to judge. We're just listening, getting very curious about what it is that they've heard and what it is that they're concerned about,” she adds.

These days, some of those concerns may be groundless, and even ridiculous, as Americans encounter more misinformation and disinformation in medicine. But that’s also an opportunity for doctors to ask patients where they found that information and guide them to better, more reliable sources.

“You're having a teachable moment about even just evidence finding, so that people can actually get the information and research what they need in a safe and effective way,” Savoy says.

Be curious, not combative

Doctors can balance listening to the concerns of patients and still answer questions truthfully.

But Savoy suggests physicians will have more success being curious than being combative.

“If you're going into it sort of ready to have a fight, then you're going to get a fight,” she says. “If you go into it with curiosity and wanting to make sure that they are connected to the right information to be able to make the best decision for themselves, you come out the other side with a very different outcome.”

Even if patients opt against getting the vaccine on that visit, Savoy says, “At least they walk away with some additional information, some things that they could think about.”

“Sometimes they are able to go do that additional research and figure out what resources are better, what resources are maybe not as trustworthy, and then they come back ready to receive the vaccine or have other questions they want to ask, and you have an ongoing dialogue. And for me, that approach has worked pretty well,” she says.

Stocking vaccines

Health systems and practices need to make it as easy as possible for patients to get vaccines, and that means stocking up.

“I know there's a lot of conversation about how much money everybody thinks that you make on vaccines, but the reality is actually quite the opposite,” she says. “Most people don't make a lot of money on vaccines. So vaccines are pretty expensive. Stocking them in your practice or stocking them in your health system can be pretty expensive, and you could take losses if you're buying things that you're not using.”

Health systems that are wrestling with tighter margins may be tempted to purchase fewer flu vaccines, a prospect Savoy dreads.

“To me, that's devastating,” she says. “So that if you're showing up in the office and you're ready today, I should be able to give you the vaccine you need.”

Some patients may choose to get flu vaccines and others at pharmacies, and Savoy says that’s a great option. But health systems need to have ample supplies of vaccines and make it as convenient as possible for families to get them.

Get staff on same page

Health systems and practices need to make sure all staff are working to encourage vaccination. Savoy says it’s critical for organizations to make sure that all clinicians are on the same page and aren’t giving conflicting information.

When patients call to make appointments, the person taking calls should also be explaining that vaccines are available at that location and ask if they’d like to get a shot. Patients could be reminded of that option when they arrive at the office, and doctors can also encourage patients to get a shot while they are in the office.

“That consistency, that ability to have people understand and be able to answer questions, everybody on the same page, I think is also critically important,” Savoy says.