The term “vaccine hesitancy” is a relatively recent term in medicine, a term used to describe patients who are worried about the safety, efficacy, or necessity of receiving immunizations. Vaccines are safe and have a proven track record of saving lives. As a result, doctors been caught somewhat off guard by the notion that anyone would have second thoughts about the benefits of immunization.

Recommendations commonly publicized on how to respond to the vaccine hesitant patient are admirable, and have a calm, respectful tone.  For example, doctors are encouraged to engage patients and respond to their concerns, while giving a clear message to recommend vaccination. Since treating patients disrespectfully or with disdain will only serve to alienate them further, being respectful, calm, and clear in our communication is our best chance at tipping the scales in favor of vaccination.

The problem with this approach, however, is that physicians are on the defensive before a discussion even begins. And as in sports, a good defense without an offense will not win the game. Because of where we talk to patients, doctors are at a critical disadvantage: the physical place in which physicians engage patients about vaccines is typically the exam room, and by the time patients have arrived to the clinic they may well have already formed their opinions about vaccines.

As a result, physicians are forced to respond and react to concerns, and must attempt to reclaim ground that has already been lost. In other words, because of the nature of where physicians physically interact with and engage patients, we are by default always on the defensive as we work to dispel myths and misinformation regarding vaccine safety or efficacy.

To make a true difference on vaccine hesitancy, I think doctors must engage patients where the dialog is happening in real time: in the world of social media.  Every day patients acquire information, discuss concerns, and formulate opinions within the realm of social media.  By the time a patient enters the exam room, their mind may already be made up about vaccines. While our discussions with individual patients in exam rooms will always be important, it is becoming equally important for physicians to enter the dialog where it is being created, before the patient arrives at the clinic. Physicians need to pay attention to what patients are talking about on social media, and need to be a part of that dialog.  If we don’t, we will always be on the defensive.

If we are to advance vaccination, physicians must leave the safety of the exam room and meet patients where their opinions are being created.  Start a blog, tweet an opinion grounded in science, or engage patients online; by having a stronger voice in social media, doctors have the opportunity to be more influential in shaping opinions before our patients have become “hesitant.” It is time to go on the offensive, and is the only way we will win the game.

John Merrill-Steskal is a family physician who blogs at Triple Espresso MD.

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