Medical assistants talk to families about vaccines in about half of visits, study finds
Meghan HolohanToday at 2:44 p.m.
Childhood Vaccines
Public Health
When families visit their pediatrician’s office, they often ask the medical assistant (MA) about vaccines, such as whether their children are due for vaccines or if the flu shot is available. Yet few studies have examined how MAs and receptionists communicate with patients.
“Medical assistants talk with parents about vaccines all the time,” David Higgins, MD, MPH, an assistant professor of pediatrics at the University of Colorado Anschutz, told CIDRAP News. “We, unfortunately, have left them out of the many efforts to improve vaccination rates in primary care, and it really is a gaping hole.”
Higgins is the lead author on a study published late last week in Pediatrics that examines how MAs talk about vaccines.
“This study is one of the first that shows that other members of the care team, like medical assistants are already [communicating about vaccines],” he said. “However, they don’t consistently use some of the best practices for communicating, and that’s in part because no one trained them how.”
The study highlights the importance of all staff in a practice being trained in vaccine communication.
“A lot of these staff followed informal protocols, or their communication styles were self-taught,” Jessica Malaty Rivera, MS, executive director at the Infodemiology Initiative at Public Good Projects, told CIDRAP News. “If you’re not trained to talk about vaccines in a way that’s not misleading or perhaps incorrect, that could be a problem.” She was not involved in the study.
The study did not provide a definition for the role MAs play. Higgins explained that MAs are unlicensed staff that train through certificate and diploma programs. “In primary care, MAs are typically the first clinical team member a family sees and does vitals, rooming, screenings, and immunizations," he said.
Receptionists much less likely to mention vaccines
The research took place in two different pediatric practices in the Denver area in summer and fall 2024. One practice treated mostly privately insured families, and the other treated mostly publicly insured families.“We did this just to see how communication may differ between practices,” Higgins explained.
Researchers observed 25 different MAs in 127 encounters with patients and 47 receptionist-family interactions. About half of MA and parent encounters (51%) involved a conversation about vaccines.
Anybody who’s working in the medical office should be an ambassador for the flu vaccine, in the context of flu season, especially.
Jessica Malaty Rivera, MS
Only 6% of receptionist-parent conversations involved vaccine discussions. Vaccine recommendations occurred more often at the practice that provided care for privately insured patients. “Receptionists barely engaged in vaccine communication, [and] that’s sad,” Malaty Rivera said. “Every moment is an opportunity to teach, to encourage, to normalize [vaccination].”
During flu season, MAs mentioned only flu vaccines in 59% of visits, only non-flu vaccines in 17%, and both types of vaccines in 21%.
“Talking about the flu vaccine positively is not like giving medical advice,” Malaty Rivera said. “Anybody who’s working in the medical office should be an ambassador for the flu vaccine, in the context of flu season, especially.”
The researchers added, “Notably, despite being stocked and routinely recommended by clinic policy at both sites, a presumptive recommendation for COVID-19 vaccines was not given by frontline staff during any of the 174 observed encounters.”
Talking about vaccines likely more challenging today
While observation allowed the researchers see communication in real time, being watched could have influenced how office staff acted.“The staff were told that we were there to study communication about preventive care topics. That being said, it’s very possible that they tied that to vaccines,” Higgins said. “If anything, it likely would have changed their behavior to talk about vaccines in an even more positive way.”
Following the observations, the researchers conducted 10 interviews with five MAs at each site. This allowed them to compare the observations with survey results.
“We know that people on a survey say they do something, but when you observe them, they don’t do it,” Higgins said. “That’s a strength of this study—that we did observations. And a limitation is that we were observing, and that might have changed some of their behavior.”
The practical takeaway is that tailored training for your team members, such as medical assistants, on how to communicate can really enhance the consistency and quality of communications about vaccines.
David Higgins, MD, MPH
Another limitation to the study is that the evaluations took place in only the Denver area, so the researchers can’t generalize the results to other geographic areas. “Whether this is the same or whether there are differences in clinics in other areas, we need to study it more,” he said.
Also, the team conducted the study in 2024, before the vaccine landscape began changing dramatically in January 2025.
“With the current uncertainties and shifting federal guidance, it’s very possible that communication has changed,” Higgins said. “My speculation is that, if anything, it has made communicating about vaccines even more challenging.”
The study shows the importance of best practices when communicating about vaccines for all practice staff. “The practical takeaway is that tailored training for your team members, such as medical assistants, on how to communicate can really enhance the consistency and quality of communications about vaccines,” Higgins said.
One way that staff can better talk about immunization is by explaining the vaccines patients need. “That’s something that is easy for a medical assistant to do, and we did observe them doing it at times,” he said. “Saying something like ‘Hey, Sam is due for his flu shot this year’ and stating it that way is an evidence-based way to introduce the idea of a flu vaccine.”