Your neighbour is telling you about his new baby. He feels nervous about vaccinating, and says he's considering delaying Lucy's vaccines.
Your mother's group is chatting about vaccines. One mother tells the group Jimmy isn't vaccinated, and she's using the Immune-Strengthening Diet instead.
In a Facebook parenting group, someone comments we shouldn't trust pharmaceutical companies because they're covering up studies showing vaccines cause autism.
These and similar scenarios may sound familiar. So what do you do when you're faced with someone who questions vaccination? Do you try to convince them to vaccinate? Do you ignore them? Or might something else work?
Talking about vaccination can be really difficult. Vaccination touches on strong values, like protection of children, social responsibility, and respect for science.
So, if you're a vaccination supporter, you may feel perplexed, even angry, when people don't vaccinate their children. If you're a parent who has overcome minor worries and vaccinated your child, it can be galling when another parent dismisses vaccination, putting others at risk.
But talking about vaccination can also present pitfalls. Attempting to convince someone with strong views they're wrong can strengthen their commitment to their position.
Our work, with a team of researchers, clinicians and the National Centre for Immunisation Research and Surveillance, shows the best way to respond depends on the situation.
Your approach will be very different with a person who has fixed negative views on vaccination, compared with someone who is cautious. How you respond also depends on what is most important in your relationship.
Here are some options.
1. Don't go there
This approach is handy if you encounter a person with fixed beliefs. They may say, "I've done my research."
Your automatic response may be to counter their claims, saying "The science is clear. Vaccinate your kids."
But if the relationship with this person isn't important to you, or their emphatic pronouncements are unlikely to do harm, then little is gained by engaging. People with fixed beliefs don't budge much.
You may encounter active opposition to vaccination on social media. A small number of anti-vaccination activists colonise online forums.
So avoid protracted conversations. Facebook's algorithm privileges posts with high engagement, so your interactions may bring them even more attention. Energised by the response, anti-vaccination activists may coordinate and bombard you or your organisation.
This is what happened to US clinic Kids Plus Pediatrics in Pittsburgh. The clinic eventually produced a guidebook on how to handle anti-vaccination attacks.
Increasing the visibility of anti-vaccination posts can have other drawbacks.
Onlookers may come to see vaccination as riskier, and vaccine refusal as more popular than it really is (in reality, only about 2 percent of Australian parents decide not to give their children some or all vaccines).
So which option is best? If this person's posts are getting exposure anyway or they are influential, then you may decide that responding is worth the risk. Just keep any interactions brief, factual and polite. Otherwise, don't go there.
2. Agree to disagree
Agreeing to disagree may be an option when you are with friends and family who hold firm views and whose relationship is important to you.
There could be a family get-together with your cousin who steadfastly rejects vaccination and the topic comes up in conversation. Family members start debating it. With strong views on either side, this could be explosive. Here you could say, "This is a topic we all have strong views about. We could just argue, but I propose that we leave this one alone."
Discussing vaccination would not change your cousin's mind. Her views are deeply held. Don't let arguments get in the way of these relationships.
3. Affirm vaccination and move on
This option can be useful when you want to avoid conflict, but also advocate for vaccination.
Parent group situations might warrant this approach. For example, a couple at your antenatal class declare their plan to delay vaccination. While you might feel annoyed, try to focus on a strategic goal: showing other parents it's not a group norm to delay vaccination.
You could say, "We are planning to vaccinate our baby. We think it's really important." While this probably won't persuade the couple, it may reduce their influence on others.
4. Listen, affirm and recommend
This approach may be suitable when you are with family and friends who are hesitant about vaccinating. For example, your daughter and son-in-law are hesitant about vaccinating their child - your grandchild.
These relationships may be important to you, and you probably want to encourage them to vaccinate.
- Understand people's concerns and motivation: Listen to what people say and ask clarifying questions. This helps you better understand their reasons. Avoid the temptation to jump in, and keep a check on your emotions.
- Affirm them as parents: This means acknowledging their concerns, as well as their care as parents. A person who feels respected is more likely to listen to your viewpoint. It's how we all like to be treated. You could say, "I can see you are trying to do your best."
- Offer to share information: Sharing information means giving factual information relevant to that person, explaining your view, and why you believe it. Use quality information, such as via the World Health Organisation's Vaccine Safety Net portal. Personalise it: "I believe vaccination is important because …"
- Close with a plan: This creates opportunities for future conversations. Some parents review their decisions, such as during a localised outbreak or when the child is older. It's also good to have an exit strategy because vaccination discussions can go on and on. You might ask, "Can we talk about this again some time?"
Decide how you want to spend your energy
Responding to people who question vaccination can be hard. So be judicious about where you spend your energy.
If you truly want to make a difference, avoid the temptation to reflexively correct what you believe is wrong and getting embroiled in lengthy vaccination debates or games of scientific ping pong.
Jump in without thinking, and you risk wasting your time, affecting relationships with family and friends, or even inadvertently amplifying anti-vaccine views. Instead, assess that person's position on vaccination, your goals and what is most important in your relationship.
Information for parents who have questions about immunisation is available here.