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Overcoming Vaccine Hesitancy

CE / CME

Overcoming Vaccine Hesitancy: From Concerns to Confidence at the Point of Care

Pharmacists: 0.75 contact hour (0.075 CEUs)

Physicians: maximum of 0.75 AMA PRA Category 1 Credit™

Nurse Practitioners/Nurses: 0.75 Nursing contact hour

Released: March 06, 2026

Expiration: March 05, 2027

Rupali J. Limaye
Rupali J. Limaye, PhD, MPH, MA
Richard Zimmerman
Richard Zimmerman, MD, MPH, MA
CME/CE Information

Activity

Progress
1 2 3
Course Completed

Addressing Common Safety Concerns About Vaccine Components

Rupali J. Limaye, PhD, MPH, MA:
Many people have concerns about a specific ingredient in a vaccine. I think the best way to answer this is to start with the notion that vaccines have been developed through extensive studies using strict safety protocols with regulatory bodies, including involvement with parents and other people in the community.

If there is a specific question regarding a particular ingredient, then I address those concerns directly; I do not dismiss any of the patients’ concerns related to specific ingredients.

For example, a situation I frequently encounter is fear of formaldehyde in a vaccine. I usually answer that by saying, “I understand that you have that concern. Yes, there is formaldehyde in vaccines. However, there’s more formaldehyde in a pear. The reason there’s formaldehyde in a vaccine is because it’s needed to be as effective as possible to protect you from disease.”7 

I would also advise that you make sure you understand all the ingredients in vaccine adjuvants. People do not normally bring up the word “adjuvant,” but they will say things like, “I’ve heard that there might be aluminum in this vaccine.” You need to be able to address that and explain why that specific ingredient is in that vaccine.

Richard Zimmerman, MD, MPH, MA:
Many people are also concerned about the safety of mRNA vaccines. I like to tell them that mRNA is like a cookbook. It provides information for the protein-building apparatus in a cell to create the proteins to cause an immune response. It is just delivering a set of instructions. It never enters the nucleus of the cell where the DNA determines the characteristics of a person. People will not pass on mRNA-based vaccine traits to their children. Then, I explain that there are alternative vaccines that are protein based if people will not take an mRNA vaccine.17

For an example on how to discuss safety concerns with patients, including those stemming from social media and disinformation/misinformation, view the following demonstration video:

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Addressing Concerns About a Link Between MMR Vaccine and Autism

Richard Zimmerman, MD, MPH, MA:
This is an extremely common concern, but the measles, mumps, and rubella (MMR) vaccine and autism should be a nonissue. In controlled studies, the MMR vaccine has never been linked to autism. The issue was reviewed by the Institute of Medicine, a blue-ribbon panel of scientific experts, which found no link between the two. No study has established a link. In fact, the person who promoted that hypothesis has lost his position in his medical school and lost his medical license. The article he published was retracted. This is a prime example of someone claiming adverse effects that were not there and creating real problems with vaccine acceptance.18

Rupali J. Limaye, PhD, MPH, MA:
So many parents, unfortunately, believe that there is a link between the MMR vaccine and autism. In fact, a recent survey showed that 1 in 4 parents still believe that there could be a link. The great news is that there have been many studies with millions of children that examined whether or not there is an association between the MMR vaccine and autism. The amazing news is that there is absolutely no association.19-21

That is generally what I would go through when a patient asks me about this. I would also say that there are a lot of unknowns related to autism. I think the reason this myth persists is because it gives parents an explanation for why their child might have autism.

We are still learning more about autism every day, but we know for certain that it is caused by multifactorial factors, so it is not just one thing, and it is certainly not caused by the MMR vaccine.

For an example of addressing caregiver questions and concerns about a link between the MMR vaccine and autism, view this demonstration video:

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Vaccine safety systems in the US

Richard Zimmerman, MD, MPH, MA:
So, how do we reassure patients that vaccine safety is tightly regulated? I start with how there are 5 vaccine safety systems in the United States.

The Vaccine Averse Event Reporting System is a passive system, which is great for alerting researchers to new safety signals. However, it has no control group, so we do not learn anything about causality.22

The V-safe is a self-reporting system that can be done on the app, on the web, by text, or by email. Again, this system has no control group, but it gives us temporal relationships on large numbers.23

The Clinical Immunization Safety Assessment Project tackles specific issues related to vaccine safety.24

The Vaccine Safety Datalink has 11 sites with electronic medical records on more than 10 million persons annually. That's 3% of the country.

This system has produced more than 350 published articles on vaccine safety. They have been very active across the United States, and they are able to perform controlled studies with either a self-control period or other patients. They can do record reviews to look at past cases of vaccine administration, and rapid cycle analysis of predefined things to look ahead.

This has been a wonder of information and should give us assurance that we have ways to assess if there is a safety signal or an anticipated possibility of a new safety signal.25 

The final vaccine safety system is the FDA PRISM system that uses computer algorithms over large amounts of health insurance claim data to look for safety signals.26

The primary point we can tell our patients is that vaccine safety is reviewed. These vaccines have been studied over many years.

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Key Takeaways

Rupali J. Limaye, PhD, MPH, MA:
In conclusion, I think addressing vaccine hesitancy comes down to just a few factors. Did you build trust and rapport with the patient? Did you use empathy? Did you not dismiss concerns? Did you try to use at least 1 evidence-based technique? Did you make sure you ended with an action, either to encourage same-day vaccination or, if the person is still hesitant, leaving the conversation to further education or future vaccination?  

Ending with an action is really important because I think so many HCPs miss the point. The whole point is to close. You have to ask for something, even if it is a follow-up conversation at the next appointment.

Do you plan to make any changes in your clinical practice based on what you learned in today’s program?
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