Not All Patients Understand Multidose Vaccines

Se-A Han, PharmD, often hears, “But we’ve already gotten that vaccine” from parents who bring their children to the PAVE (Providing Access to Vaccines for Everyone) Clinic in Dunn Loring, Virginia. Han administers childhood and adolescent vaccines to children without health insurance at this multidisciplinary teaching clinic that operates through a partnership between the nonprofit NOVA ScriptsCentral, George Mason University’s Mason and Partners (MAP) Clinic, and Fairfax County Public School system.

The Fairfax County Public School system refers uninsured children to the PAVE Clinic so that they can receive the vaccines required to attend school. Through a multidisciplinary team of nursing and pharmacy professionals and students, the young patients get a physical, a TB test if indicated, and a vaccine assessment followed by all the vaccines they need for school entry, as well as any others on the pediatric immunization schedule that they agree to receive. All of these services are free of charge to uninsured patients and their families.

Although parents usually need little reassurance about any new vaccines their children need, Han has found that they often don’t understand the concept of a vaccine series when their children have already received a dose.

“They will say, ‘I think we already got that one. It’s here on our vaccine record,” when their child has only gotten one dose,” Han said.

Han takes the opportunity to explain the difference between vaccines that require only a single dose and those that require multiple doses to provide full protection against an infectious disease.

“A lot of parents lack the knowledge that many pediatric vaccines come in a series,” Han said. “You have to explain to them why it’s important to follow the schedule and complete the whole series for the vaccine to be fully effective.”

Han emphasizes that when working with parents and children, especially those with low health literacy, immunizers must allow time for education and answering numerous questions. During these education sessions, she speaks directly to the young patients and educates student pharmacists at the PAVE Clinic to do likewise. At the same time, the parents are listening and getting educated as well.

“The children might not be able to answer your clinical questions, but they are the patient, and you have to treat them like real people and not just speak only to the parents,” Han said. “If they are traumatized by their vaccine experience, it could have consequences for their attitude towards vaccines for the rest of their lives.”

Through speaking directly with her pediatric patients, Han has seen time and again that young people often ask questions that are just as important and relevant as those asked by their parents.

“Sometimes the adolescent patients tell me directly that they think they’ve already had a certain vaccine—one that is part of a series. This is also an opportunity to educate them directly about how vaccines work.”

Since the advent of COVID-19 vaccines, Han says it’s more important than ever for the public to understand why some vaccines are given in a multidose series. While many multidose vaccines are required for public school matriculation, most patients have the option to refuse the COVID-19 vaccine. Patients may be more likely to complete the full series when they understand why it is a multidose vaccine and that full protection hinges on getting subsequent doses on time.

“This is why we have to be able to take the time to educate patients,” Han said. “Health care settings are usually busy and hectic, but it is very important that we take the time to listen to concerns, answer all our patients’ questions, and eliminate any hesitancy.”

—Sonya Collins
April 2023

Resources to help Discuss the Importance of COVID-19 Vaccination, Educate Your Health Care Team, and Tailor Your Outreach to specific populations are available at APhA’s Vaccine Confident microsite.