The Case for Dedicated Vaccine Communication Training: A Survey of Military Pediatricians

Vaccine uncertainty is rising among families in the United States, even among military families. The ACGME mandates that pediatric residents be trained in effective communication strategies for patients and families hesitant about recommended vaccinations, yet few validated curriculum tools exist. We aimed to understand the current landscape of vaccine uncertainty experienced by military general pediatricians and see what communication strategies were routinely being implemented in clinical practice.

In March 2025, 45 graduates of a mid-sized military pediatrics residency program from the years 2016-2024 who were currently practicing general pediatricians were invited to participate in a survey on vaccine communication in clinical practice. The survey was a mix of quantitative questions asking for experienced trends in vaccine uncertainty as well as open-ended questions about communication strategies being implemented. Three clinical researchers performed a manual thematic analysis of free-text answers to understand and quantify common themes.

Thirty-seven general pediatricians (82%) responded, and 95% of those surveyed rated a curriculum during medical training on vaccine communication as "very" or "extremely important." Only 19% of physicians were able to recall formal training in addressing vaccine hesitancy during medical school, and only 62% during residency. The 3 most commonly declined vaccines were COVID-19, influenza, and HPV. Pediatricians reported using communication strategies focused on knowledge-sharing (65%), partnership with families (62%), and normalizing vaccines (40%). Common barriers to vaccine acceptance were mistrust and disinterest, most commonly with unwillingness to engage in a conversation.

Most practicing military pediatricians who graduated from our residency program report a rise in vaccine uncertainty in their practice and agree that a residency curriculum on vaccine communication is highly important. Such curricula should encourage evidence-based communication styles using vaccine normalization while de-emphasizing the urge to combat misinformation using knowledge-sharing and should specifically address the most commonly declined immunizations.