New curriculum helps residents talk about vaccine safety

For years, Mark Sawyer, MD, has heard from physicians that they are spending an increasing amount of time discussing vaccine safety with families during office visits. But many of those doctors say they don’t feel well-trained to lead such conversations, said Dr. Sawyer, professor of clinical pediatrics at University of California, San Diego School of Medicine.

To help bridge this gap, he and a team of California health professionals developed a vaccine safety communication curriculum for primary care residency programs throughout the United States. The effort included the American Academy of Pediatrics California Foundation and the California Academy of Family Physicians.

“Vaccine safety communication is an important issue for providers of all types,” not just for pediatricians, said Dr. Sawyer, principal investigator for the curriculum.

Data show that adult coverage for most recommended immunizations fall well below Healthy People 2020 targets. At least 45,000 U.S. adults die each year of diseases that vaccines could have prevented. By comparison, there are fewer than 1,000 deaths due to childhood diseases that are vaccine-preventable, said the Centers for Disease Control and Prevention.

Work on the new vaccine safety communication curriculum began in 2009. In late 2011, it was distributed to residency training programs across the country, Dr. Sawyer said.

The American Academy of Pediatrics and the American Academy of Family Physicians helped circulate the curriculum, Dr. Sawyer said. He said he is not sure where it is being implemented.

The contents of the curriculum are based, in part, on data the health professionals gathered from an online survey of 276 medical residents and focus groups that included residents and practicing pediatricians.

The data show that 22% of respondents did not learn during their residencies how to discuss vaccines with families. Eighty-six percent said it would be valuable to learn those communication skills.

The new curriculum features an online component that depicts realistic situations in which parents or patients raise concerns about a recommended vaccine. Trainees are asked about a particular case and get immediate feedback on their response.

Trainees are encouraged to explore websites with inaccurate vaccine material as well as reliable sources of information. The CDC’s site can be used as a resource by physicians and patients.

There is a lecture format that includes nearly 100 PowerPoint slides featuring vaccine safety data and information about common immunization myths. The curriculum includes a small-group discussion guide that offers a case-based approach to teach vaccine communication skills.

Giving doctors the tools they need

The goal of the curriculum is to get “tools into the hands of residents when they’re in training so when they begin practicing they can counteract this trend” of people turning down vaccines, Dr. Sawyer said.

Health professionals say the curriculum comes at a time when outbreaks of potentially fatal vaccine-preventable diseases continue to occur, due in part to some parents choosing not to immunize their children. Washington is among the latest states to battle a surge of pertussis cases. This year, the disease has reached epidemic levels, with 776 reported cases of the illness as of April 7, according to the most recent data from the Washington State Dept. of Health.

A 2010 outbreak of the disease in California killed 10 infants and sent more than 800 adults and children to the hospital, making it the state’s worst pertussis epidemic in more than 50 years, the California Dept. of Public Health said.

“We’re on the precipice here,” Dr. Sawyer said. “If more people don’t get immunized, we’re going to continue to see more patients sick with vaccine-preventable diseases.”