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CME: Vaccine hesitancy and denial: A problem for the ages coming into sharp focus during the pandemic


Activity Description / Statement of Need:

In this online, self-learning activity:

The WHO defines vaccine hesitancy (VH) as a “delay in acceptance or refusal of vaccines despite the availability of vaccination services.” Despite substantial progress in rates of routine immunization over the decades prior to the most recent one, more recent trends suggest that immunization rates are beginning to plateau. Beyond VH and skepticism, there is also the embrace of outright vaccine rejection or denial fostered by the presence disinformation on conventional and social media platforms including claims that vacines are unsafe or unnecessary. Recent outbreaks of largely eradicated diseases such as measles, mumps, and diphtheria suggest that herd immunity may have suffered, putting those ineligible for vaccination at additional risk of infection. These developments have been attributed in part to VH and denial.

One large group with increasing VH is parents. A 2019 national survey found that approximately 1 in 4 parents reported serious concerns towards vaccinating their children. Another study saw that in up to 35% parents of well-vaccinated children demonstrate VH. Parents may raise issues that many providers feel ill-equipped to answer, due to lack of thorough knowledge of all vaccines or lack of evidence-based communication strategies. Unfortunately, only few evidence-based strategies exist to guide providers in their discussions with vaccine-hesitant parents.

Providers play a crucial role in vaccinating populations, but it is not and should not be their sole responsibility. Clinical practice sites, community organizations, health organizations, and government all contribute to addressing VH. Understanding potential solutions outside the office, such as media campaigns and policy changes, also provide insight into vaccine hesitancy and potential directions for future use.

Target Audience:

The following HCPs: Primary care physicians, pediatricians, and public health professionals; physician assistants, nurse practitioners, nurses, and pharmacists who practice in adult internal medicine and pediatrics; and any other clinicians who commonly encounter patients eligible for protection against vaccine-preventable diseases.

Commercial Support Disclosure: This program is supported by educational grants from Merck.

This activity is free of charge.

Release Date: December 10, 2021 -- Expiration Date: December 10, 2023

Faculty: Shira Shafir, Ph.D., MPH


Defining the problem

-  Rise of VH and rejection

-  VH in different communities

o   People of color

o   Parents & children

o   Patients with dementia

o   Healthcare professionals

o   Other

- Vaccine-specific reasons for VH

Vaccine denials vs. VH

Vaccine exemptions

Provider interventions and communication strategies

- Framing techniques

- Motivational interviewing

- Myths and misconceptions

- Presumptive communication

- Political sensitivity

- COVID-specific considerations

- Tailoring information, including to members of different communities

Patient case(s)

Institutional or community interventions

- Electronic communication or reminders

- Policy improvements

- Vaccine education

Learning Objectives

By the end of the session the participant will be able to:

  • Recall factors associated with VH.
  • Identify vaccine-specific reasons for VH and how to address them.
  • Describe effective communication methods to discuss VH.
  • Formulate strategies to address VH at the individual, institutional, and community levels.


ACCME Activity #201800404


Faculty Disclosure and Resolution of COI

As a provider of continuing medical education, it is the policy of ScientiaCME to ensure balance, independence, objectivity, and scientific rigor in all of its educational activities. In accordance with this policy, faculty and educational planners must disclose any significant relationships with commercial interests whose products or devices may be mentioned in faculty presentations, and any relationships with the commercial supporter of the activity. The intent of this disclosure is to provide the intended audience with information on which they can make their own judgments. Additionally, in the event a conflict of interest (COI) does exist, it is the policy of ScientiaCME to ensure that the COI is resolved in order to ensure the integrity of the CME activity. For this CME activity, any COI has been resolved thru content review ScientiaCME.

Faculty Disclosure:

Shira Safir, MD, PhD, Associate Professor, UCLA Fielding School of Public Health, has no relevant financial disclosures.

Disclosures of Educational Planners: Charles Turck, PharmD, BCPS, BCCCP, President of ScientiaCME, has no relevant financial disclosures.

Commercial Support Disclosure: This program is supported by educational grants from Merck.

All relevant financial relationships have been mitigated.

ScientiaCME adheres to the ACCME’s Standards for Integrity and Independence in Accredited Continuing Education. Any individuals in a position to control the content of a CE activity, including faculty, planners, reviewers or others are required to disclose all relevant financial relationships with ineligible entities (commercial interests). All relevant conflicts of interest have been mitigated prior to the commencement of the activity.

Faculty will not discuss off-label uses of a commercial product.


  • Read the learning objectives above
  • Take the Pre-Test (optional). Completion of the pre-test will help us evaluate the knowledge gained by participating in this CME activity.
  • View the online activity. You may view this is in more than one session, and may pause or repeat any portion of the presentation if you need to.
  • Minimum participation threshold: Take the post-test. A score of 70% or higher is required to pass and proceed to the activity evaluation.
  • Complete the activity evaluation and CME registration. A CE certificate will be emailed to you immediately.

Cultural/Linguistic Competence & Health Disparities

System Requirements

Windows 7 or above
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Mac OS 10.2.8
Safari or Chrome or Firefox
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Internet Explorer is not supported on the Macintosh

*Required to view Printable PDF Version

Perform Pre-Test (optional)

Please take a few minutes to participate in the optional pre-test. It will help us measure the knowledge gained by participating in this activity.

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