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Understanding vaccination hesitancy


Pets need their shots to remain healthy and safe, but what happens when an owner is skeptical?



Vaccine hesitancy has been on the rise within human and veterinary medicine; in fact, the World Health Organization identified this trend as one of the top 10 threats to global health in 2019.1 When the client wearies of allowing vaccinations or is refusing them, it can have a snowball effect on the health of their pet and of any other animals the pet interacts with daily.

During her lecture “Maybe, I Think So, I’m Not So Sure”—How to Effectively Combat Vaccine Hesitancy in Practice at the American Veterinary Medical Association (AVMA) Convention 2023 in Denver, Colorado, Natalie Marks, DVM, CVJ, shared how veterinary teams can strategically fight vaccination hesitancy at their practice.2

Helping clients understand vaccinations

Clients are always trying to do what is best for their pet. Hesitating or denying vaccinations for a pet may not make sense to the veterinary team, but it makes sense to the client. A client could have had a bad experience with a veterinarian vaccinating a different pet or even an unpleasant experience as an individual.

Understanding how your clients are thinking and viewing vaccinations can help you find a way to show them why shots are necessary for the pet and can help with adherence. “The first thing is, we need to ask clients. We cannot assume base knowledge. Had they had previous negative experiences, or have they witnessed a vaccine administration? Find out the facts, then we listen,” Marks said.

“We do the inhale/exhale technique, which is really effective to practice, and it works really well for me,” she continued. “I think it’s incredibly helpful for body language, self-awareness. And that’s when we hear concerns, we take a deep breath in, we listen to the concerns of the clients and imagine ourselves in their shoes. Then as we exhale, we do a self-check of our body. Because if you think about, if somebody sees something that conflicts with what they’re thinking in the exam room, whether we know it or not, our body language shows quickly.”

It can be awkward in an exam room when speaking to a client whose beliefs or ideologies on vaccinations do not align with what professionals know and what the research says. However, if teams are presenting to the patients with bad body language or cutting off the client, that will further implant clients in their stance because they are not being heard on their issues. Taking the time to pay closer attention to how you react instead of how you want to can open that door of communication. This can lead to an honest discussion on vaccinations and their benefits, which can then encourage the client to have their pet vaccinated.

Vaccination hesitancy research

A study conducted at the Boston University School of Public Health in Massachusetts, in partnership with YouGov, surveyed more than 2000 adults with dogs in the United States from March 30, 2023, to April 10, 2023.3 The survey found that more than half of the adults who participated had some level of hesitancy toward vaccinating their dog. More in-depth analysis found that 40% of respondents thought vaccinations were unsafe for the dog, 20% thought they were ineffective, and 30% thought they were medically unnecessary.

Among the notable findings in the study was that there is a spillover effect on vaccinations from COVID-19 in the United States. Because people have developed or already had existing negative attitudes toward vaccinations, they become more likely to oppose any policies that encourage widespread vaccinations and will be less likely to make any effort to vaccinate their pets.4

“The vaccine spillover effects that we document in our research underscore the importance of restoring trust in human vaccine safety and efficacy,” says study lead and corresponding author Matt Motta, PhD, assistant professor of health law, policy, and management at Boston University.4 “If nonvaccination were to become more common, our pets, vets, and even our friends and family risk coming into contact with vaccine-preventable diseases.”

In conclusion

Veterinary teams that hear out clients who are hesitant to vaccinate their pets will have a better understanding of where the disconnect is. There could be many reasons why clients are not willing to vaccinate their pets, coming from a bad personal experience, inaccurate information being shared online, or somewhere else.

If this is the case, veterinary teams can give these clients accurate information or reading materials to review and use for decision-making, or show them social media accounts or even influencers that they trust, because the basis of what is causing the hesitancy can be the solution to bypassing it.


  1. Ten threats to global health in 2019. World Health Organization. Accessed November 14, 2023. https://www.who.int/news-room/spotlight/ten-threats-to-global-health-in-2019
  2. Marks N. Mentoring: “Maybe, I Think So, I’m Not So Sure”: How To Effectively Combat Vaccine Hesitancy In Practice. Presented at: American Veterinary Medical Association Convention 2023; July 14-18, 2023; Denver, CO.
  3. Motta M, Motta G, Stecula D. Sick as a dog? The prevalence, politicization, and health policy consequences of canine vaccine hesitancy (CVH). Vaccine. 2023;41(41):5946-5950. doi:10.1016/j.vaccine.2023.08.059
  4. McKoy J. Nearly half of dog owners are hesitant to vaccinate their pets. Boston University School of Public Health. August 31, 2023. Accessed November 14, 2023. https://www.bu.edu/sph/news/articles/2023/nearly-half-of-dog-owners-are-hesitant-to-vaccinate-their-pets/
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