
66% of physicians on Sermo say they frequently counsel patients on vaccines. Yet 76% also say they regularly encounter vaccine refusal.1 So, while most physicians make vaccines a routine part of care, hesitancy and refusal remain deeply embedded in patient behavior.
This disconnect raises urgent questions. If the majority of doctors are actively engaging in vaccine counselling, why are so many patients still refusing? Are current strategies falling short? Is the problem one of messaging, mistrust, misinformation or something deeper? And how are physicians navigating these conversations day to day?
This article explores how physicians manage vaccine hesitancy in clinical reality. Drawing on Sermo poll data and real-world physician insights, we look at the challenges, the tools that work and the broader context shaping today’s vaccine landscape.
Doctors say vaccine refusal is a common clinical challenge
Vaccine refusal is no longer a rare or fringe occurrence. According to a recent Sermo poll, physicians say they encounter patients refusing vaccines either “frequently” (24%) or “occasionally” (52%), while only 19% report that it’s a rare event.1 For most, vaccine conversations have moved from the margins of care to the mainstream.
As one Pediatrician shared on Sermo, “It’s a daily battle with my patients. I try my best to educate them. Most say yes, but some no.2.” The phrase “daily battle” reflects the emotional and time burden vaccine hesitancy places on physicians, one that often repeats with each new consultation.
Many clinicians also view the COVID-19 pandemic as a turning point. Vaccine mistrust, already present in small pockets, appears to have grown. “Unfortunately, it’s all too common and seems worse since the COVID pandemic,2” noted a Cardiologist. A Family Medicine physician echoed the trend: “There is a lot of vaccine hesitancy and I think it’s been increasing in recent years.2”These firsthand accounts reveal a reality for healthcare workers that vaccine refusal is just becoming part of daily clinical life.
Why are people refusing vaccines?
According to a Sermo poll of over 1400 physicians, 65% say their patients refuse vaccines due to safety concerns, followed by 11% citing efficacy, 9% citing distrust of the medical community, 7% citing distrust of government and 6% unsure.1Beneath each of these reasons for refusal of vaccines lies a deeper pattern of fear, mistrust and confusion, revealing why clinical evidence alone is rarely enough to change minds. So, what causes vaccine hesitancy?
Safety concerns
Safety is by far the leading reason for vaccine refusal.1 But what patients define as “unsafe” often includes expected, mild side effects.
As one Family Medicine physician on Sermo explains: “Usually people are concerned about the side effects. As they’re now feeling fine, taking a vaccine can ‘make them feel ill’, so they prefer not to.2”
Others, like an Internal Medicine doctor, regularly address fears head-on: “It’s our duty to clarify these doubts.2”
The challenge is often emotional, not clinical. As one Pediatrician put it, it’s “hard to convince someone if they’ve had an adverse reaction to a vaccine.2”
Even perceived past harm can cement resistance. For physicians, the task is reframing short-term discomfort as a sign of the body building protection, not proof of danger.
Efficacy concerns
For some patients, it’s not just whether vaccines are safe, but whether they work. Misunderstanding here can deepen hesitancy. “Patients may believe that vaccines are dangerous or do not work,2” adds a physician to the conversation on Sermo.
Because many patients make decisions based on personal benefit, rather than community protection, the case for vaccines must include individual outcomes as well as public health gains.
Distrust of the medical community
Hesitancy often stems not from the science itself, but from a deeper disillusionment with the institutions and professionals delivering it. “Vaccine hesitancy is part of a climate of general distrust towards the medical profession,2” observed one Pediatrician on Sermo.
This mistrust is particularly prevalent in parental vaccine hesitancy, where anxiety about risk can override reassurance. As one GP shared: “I encounter most anti-vaccs in young parents, that say ‘they want to give vaccines to their child, they just need doctor’s signature that it’s 100% safe.’ They don’t understand even getting their nails done isn’t 100% safe.2” The demand for absolute certainty reflects a lack of trust in both the message and the messenger.
Physicians also point to mixed or politicised messaging as a contributing factor. “Misinformation from officials only makes this worse,2” added an Internal Medicine specialist.
In this context, evidence alone isn’t enough. Trust must be rebuilt patient by patient through empathy, transparency and consistency. Internal alignment among clinicians is important, but it’s individual credibility and connection that often move the needle.
Distrust of government
Government hesitancy often overlaps with medical mistrust. “There is a deep distrust issue especially with Government and the effects of vaccine on the human body,2” says an Emergency Medicine physician on Sermo.
Legislation and public campaigns are useful, but as one GP warns, without empathy and transparency, they may only harden resistance.
Uncertainty
The “unsure” group reflects low information, ethical considerations, mixed messages and decision fatigue. “Many patients refuse vaccines for all the reasons mentioned,2” says an Internist. Often, there’s simply “not enough time” in appointments to dig deeper.
Reaching these patients may depend on proactive education before they even enter the exam room.
Why are vaccines important in improving patient outcomes? Physicians on Sermo have their say
Despite pushback, physicians remain firm on the importance of vaccines as a public health cornerstone. As one Oncologist on Sermo put it: “Vaccines are critical for herd immunity and to treat preventable infections. Vaccine hesitancy impairs efforts at controlling communicable infectious diseases.2”This sentiment is widely echoed across specialties.2 Yet even those who advocate strongly acknowledge the barriers. Many see their role as not only administering vaccines, but also restoring belief in their purpose; an effort that requires time, trust, and resilience.
How can healthcare professionals address vaccine hesitancy?
How do doctors talk to vaccine-hesitant patients?
Physicians rely on a mix of formal guidance and personal communication to navigate vaccine hesitancy, but the tools they choose vary widely.
According to a Sermo poll, 32% use academy guidelines, 31% rely on ACIP, CDC, or government recommendations and 20% turn to WHO guidance. A smaller segment, 7%, use no tools at all, while 6% say vaccine counselling is outside their scope.1
Academy guidelines help physicians frame vaccines as routine, evidence-based care rather than a personal opinion. As a GP on Sermo noted, these guidelines help explain “how they’re safe and how they help both the person and the community.2” Others highlight vaccination as core to family medicine and paediatrics, where promotion and prevention are standard practice.2
Government recommendations also serve as trusted references, but their impact depends on how they’re communicated. “I present what the CDC recommends… and explain why each is endorsed,2” said one Internist. This translation from policy to personal relevance can build trust and reduce resistance.
WHO guidance appeals to broader ideals. Framing vaccination as a global health achievement—“one of the best advances of humanity,2” as one pulmonologist on Sermo described—can resonate with patients wary of national institutions. Still, a frustrated few disengage entirely. “If you refuse, it goes in the chart,2” said an Internist. Others, particularly outside core vaccine-discussion roles, still feel compelled to speak up. As one Ophthalmologist shared, “I always recommend and advise on the importance.2” Regardless of title, building vaccine confidence is becoming everyone’s job.
Do physicians feel prepared—and protected—themselves?
Most physicians lead by example: 77% say they’re up to date on vaccine recommendations.1 Many, like an Anesthesiologist on Sermo, view this as part of patient education: “I recommend vaccines and question the comments of patients based on ignorance.2”
Others, including a Family Medicine expert and an Obstetrics physician, routinely incorporate vaccine guidance into care,2 reinforcing their credibility as trusted advocates.
Another 14% of physicians surveyed aren’t current but plan to be.1 Their comments reflect empathy and realism. “I feel frustrated about vaccine hesitancy but also understand it from a layperson’s perspective,2” shared one resident. These physicians may be well-positioned to connect with unsure patients, but may need more support to close the personal-practice gap.
A concerning 8% are anti-vaccine doctors who say they don’t plan to get vaccinated.1 Some, like an Emergency Medicine physician and Sermo member, actively discourage vaccination and would give reason for refusal of flu vaccine.2
This highlights a critical challenge: addressing intra-professional mistrust to ensure physician perspectives don’t unintentionally fuel broader public hesitancy.
Why trust and empathy matter more than ever
Across the Sermo community, one theme rises above all others: trust is the gateway to immunisation.
As an OB-GYN on Sermo put it: “People may refuse vaccines due to distrust of pharmaceutical companies, government agencies, or healthcare providers.2” The solution? empathy, patience and consistency. In this context, trust isn’t just a ‘soft skill’ but rather a clinical tool. By creating safe, non-judgmental spaces, physicians can turn vaccine refusal into reconsideration and hesitancy into understanding. As one GP noted, “Most take the vaccine after encouragement.2” The bridge isn’t built overnight, but it can be built.
Your takeaway
Vaccine hesitancy remains a daily challenge for physicians, rooted not just in misinformation but in fear, distrust and emotional resistance.
While most doctors lead by example and use trusted guidelines, clinical evidence alone often isn’t enough.
The real solution lies in empathy, dialogue and trust-building, the tools that turn resistance into reconsideration. As Sermo members demonstrate, vaccine conversations are no longer occasional and are now an essential part of everyday medical practice.