Electronic health records and online scheduling simplify the process of setting automatic reminders for immunizations and ensuring that immunization records are on hand during every patient checkup. Reminders sent by phone, text or mail can remind parents and caregivers of upcoming recommended vaccines, a well as recalls that encourage families whose children and adolescents are overdue for immunizations to return to the office so vaccines can be administered. Research shows that these reminders increase immunization rates.

Every clinical encounter with a patient represents an opportunity to administer needed immunizations. When a patient is in the office for a preventive medical checkup or acute-care exam, health-care providers are encouraged to review immunization records, provide any vaccines that are due and catch up on any missed vaccinations. If an immunization is not administered during a checkup – for example, because the child is running a fever – make a note in the medical record and schedule a return appointment to complete the immunization.

The CDC’s Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach considers key factors including balance of vaccine benefits and harm and type or quality of evidence. Evidence tables for its recommendations are published in the Morbidity and Mortality Weekly Reports (MMWR). Find more information on the ACIP Evidence-Based Recommendations - GRADE web page.

The American Academy of Pediatrics (2017) recommends following these steps to overcome vaccine hesitancy:

• Strongly endorse all universally recommended vaccines as important. If parents express hesitancy about vaccines, begin a discussion and address their concerns.
• Use motivational interviewing techniques such as asking open-ended questions, affirming the parent’s or patient’s efforts and strengths, being a reflective listener and assessing readiness to change behavior. Parents who ask questions may not be hesitant, but may just be seeking more information.
• Focus on the benefits of the vaccine. Recommendations include educating families about the effects of vaccine-preventable diseases such as pertussis, meningitis and HPV, which can cause various types of cancer.
• Promote administering the vaccine on the recommended schedule. For example, make parents aware of the ages when HPV vaccine can be given, when to return for the second dose, and the benefit of receiving both doses before an adolescent is likely to be sexually active.
• If parents decline a vaccine, providers are encouraged to offer the vaccine at the next most appropriate time. Two surveys suggest that between 30 and 47 percent of vaccine-hesitant parents ultimately accept vaccines when health-care providers pursue the recommendation to immunize.