Recognising and Addressing Vaccine Hesitancy That Is Not Always Directly Voiced by a Child's Parents

A mother brings her nine-month-old child for a routine visit and everything is normal.You say 'We will give your child the measles, mumps, rubella, chickenpox vaccine today'.The mother says nothing for 2 s and looks at the father.Then she puts the child's health record into her bag and says 'I'd rather not do it now.We'll book something in a month or two.'She has not refused, raised a concern or mentioned autism, aluminium or anything you have been trained to answer.What sounds like a scheduling decision is, in fact, hesitation.She is putting the vaccine off without saying so.Every published algorithm for the vaccine conversation assumes something she has not said or done.All the guidance recommends a two-step sequence.The first is to initiate the conversation with the parents, based on the assumption that they will agree.The second is to use empathic communication with those who resist.Motivational interviewing is the most widely adopted form of this.A clinical practice review published in 2026 [1] restated that this was about consensus and it was explicit about when the second step should begin.Recommend the vaccination, present it as the norm and go to step two if the parents express concerns or decline to have their child vaccinated.The clinical report from the American Academy of Pediatrics in 2024, from the same lead author, promoted the same approach and so has the training programme derived from it [2].