Vaccine Hesitancy: Communication Strategies for Primary Care That Preserve Trust

"Your goal is to persuade patients that this vaccine is the right choice for them, and to do that, you have to address a patient where they are."

That is what infectious disease physician and Johns Hopkins Center for Health Security senior scholar Amesh Adalja, MD, said to Patient Care in a recent interview. A strong, clear recommendation from a trusted clinician remains the single most important predictor of whether adults get vaccinated—a leverage point squarely in primary care. In the video above, Dr Adalja discusses how he calibrates his approach by setting: an advocacy tone for the public square, and a patient-centered tone in the exam room that protects the relationship while moving the conversation forward. For busy frontline physicians, the take-home is practical: start with your routine, confident recommendation and then personalize the discussion to the patient’s specific worry.

Amesh Adalja, MD, is an adjunct assistant professor at the Johns Hopkins Bloomberg School of Public Health and founder of Tracking Zebra, an infectious disease-related project management, consulting, media, and strategy firm.

The following transcript has been lightly edited for style and clarity.

Patient Care: What communication strategies have you found most effective in addressing vaccine hesitancy without damaging the patient-physician relationship?

Dr Adalja: It all depends on the setting and the context. When I'm on television talking about vaccines, I'm much more forceful and argumentative because I'm trying to talk to the general public and combat the antivaccine movement. When you're talking to an individual patient, you have to do it in a different manner, because your goal is different. Your goal is to persuade that patient that this vaccine is the right choice for them. To do that, you have to address a patient where they are. So that may mean asking them, what particular thing are you worried about with this vaccine, and what is the issue, and then really try and tackle that issue with information leaning on the fact that you are their doctor, that they trust you, that they tell you things that they don't tell anybody else, and you have a really sacred relationship with them, and that is very valuable. We know from studies that a primary care physician's persuasion is one of the most important tools to get a patient to take a health promoting behavior, or to do a health promoting behavior, and to stop a health negating behavior. That's something that clinicians need to recognize and rely on, and just know that there are resources for primary care physicians to look at all of these types of common antivaccine myths that get propagated by the antivaccine movement, that percolate into your into your doctor's office. You have tools to be able to address them.

Explore more from our conversation with Dr Adalja on countering misinformation and 2025 vaccine policy changes:

• How to Defuse Vaccine Safety Concerns Without Derailing the Visit
• Amesh Adalja, MD, Breaks Down 2025 Vaccine Policy Shifts for Primary Care