You are an FY2 in GP
Personal Details:
Name: Child (Max), Mother (caller)
Age: 1 year old
Medical Record:
Past medical history: Fit and well. No chronic conditions.
Regular medication: None.
Allergies: None known.
Notes:
Telephone consultation. The mother of a 1-year-old child has called. The child is due for his routine flu vaccine, but the mother is hesitant and questioning whether it is necessary.
Task:
1. Explore the mother’s concerns about the flu vaccine.
2. Address her specific questions and misconceptions.
3. Explain the benefits of the flu vaccine for her child and persuade her to accept it.
Opening Sentence: “Hi, Doctor, I’m calling about the flu vaccine for my son. The nurse said he’s due for it, but I’m not sure he needs it.”
Open History (to give freely): “He’s a really healthy and active boy, he’s never been sick. It just seems unnecessary to give him a vaccine for something he might not even get. I never get the flu vaccine myself.”
Cues to give: “I’ve heard some things about the vaccine…”
ICE (Ideas, Concerns, Expectations):
Ideas: “I think the vaccine is only for old or sick people, not healthy children.”
Concerns: “Why is the flu vaccine given? What are the side effects? I heard that the flu vaccine shot can give you the flu. Is it true?”
Expectation: “I want you to tell me why he needs it. I’m not going to give him something unless I’m convinced it’s safe and necessary.”
How to Act: You are not aggressive or anti-vax, but you are cautious, questioning, and a bit sceptical. You are a loving mother who wants to do the right thing but is influenced by misinformation.
More History (only if asked): Your child is 1 year old, physically fit, and has no medical conditions. You yourself are fit and well and have never had the flu vaccine.
Social History: You are a first-time mother.
Questions to ask:
“But if he’s so healthy, why does he need it?”
“Are the side effects serious?”
“Can’t we just wait and see if he gets the flu?”
Hi. I’m calling from the GP surgery. I understand you’ve declined the offer of the flu vaccine, and I just wanted to have a chat to make sure you have all the information you need to make that decision. Is now an okay time to talk?
Exploring the Refusal (Open Questions): Can you tell me a little bit about your reasons for not wanting the vaccine at the moment? What have you read or heard about the flu vaccine?
ICE (Ideas, Concerns, Expectations):
What are your main thoughts about the flu jab?
What is your biggest concern? Are you worried about side effects or the safety of your baby?
Assessing Understanding of Influenza: What do you know about the flu itself? Do you see it as just a bad cold or something more serious? Have you heard about how the flu can affect pregnant women and their babies specifically?
Risk Factor Assessment: Apart from the pregnancy, do you have any other health conditions, like asthma?
Past Vaccine History: Have you ever had the flu vaccine before? If so, how was that experience?
Thank you for calling and for asking these questions. It’s really important to feel comfortable with any decision you make for your child’s health. It’s great to hear that your son is so fit and active. The reason we offer the flu vaccine to all young children, not just those who are unwell, is because flu can be a really nasty illness, even for healthy kids. It’s not like a common cold; it can cause high fever, aches, and can sometimes lead to serious complications like pneumonia or bronchitis, even in healthy children.”
Addressing and answering the patient’s ICE:
You’ve asked a few very important questions. Firstly, about the side effects. The vaccine is very safe. The most common side effects are mild, like a sore arm from the injection or a bit of a temperature, but these usually pass in a day or two. You also asked if the vaccine can give you the flu. That’s a very common myth, but it’s not true. The vaccine is inactivated, meaning it can’t cause the illness. It just teaches your son’s immune system how to fight off the real virus.
Next Steps:
The best way to protect your child from what can be a very unpleasant illness is to have the yearly flu vaccine. It significantly reduces his risk of getting the flu and, more importantly, reduces his risk of being hospitalised with a serious complication. We can book him in with the nurse at your convenience.
While you’ve been lucky not to get the flu yourself, children are what we call ‘super-spreaders’. They pick up germs easily and spread them around the family. So, by vaccinating your son, you’re not just protecting him, but you’re also protecting everyone around him, including grandparents who might be more vulnerable.
The vaccine is offered every year because the flu virus changes slightly each year. So, the vaccine is updated annually to match the new strains. That’s why it’s important to have it each autumn.
Addressing ideas, concerns, and expectations: Systematically and clearly debunk her misconceptions (vaccine causes flu, it’s only for the sick). Address her specific questions about side effects and necessity.
Persuade and reassure. The goal is to get her to agree to the vaccination.
What is scenario testing? This case tests the candidate’s ability to handle vaccine hesitancy with empathy and clear, factual information. It is a test of health promotion and communication skills. The candidate must be non-judgmental, build rapport, and use a structured approach to address concerns and explain the individual and community benefits of vaccination.