Motivational Interviewing Is Paramount in Addressing Vaccine Hesitancy | APhA 2026

As vaccination rates fall and measles cases climb, pharmacists armed with motivational interviewing (MI) techniques may hold the key to rebuilding patient trust and reversing a dangerous public health trend, according to a session titled “Ugh, more vaccine misinformation? As if!” presented at the American Pharmacists Association (APhA) 2026 Annual Meeting and Exposition.¹

“When you have compassion for someone, you’re not only feeling what they’re feeling, but you are making an intentional choice to prioritize that person’s well-being,” Ashley Chinchilla, PharmD, BCACP, associate IPPE director of ambulatory care at the University of Georgia School of Pharmacy, said during the session. “Encouraging and supporting the person’s autonomy is a big component of MI.”

As of March 2026, recent surveillance data reveals that only 48.4% of children have received their influenza vaccine for the current season, and uptake for the 2025-2026 COVID-19 vaccine remains alarmingly low at just 9.3% for children and 17.5% for adults, according to the CDC.²

The stakes are increasingly high for other diseases as well. After decades of being considered eliminated, measles has resurfaced, with over 1900 confirmed cases across 43 jurisdictions reported in late 2025. Because 92% of these cases occurred in unvaccinated individuals, the need for effective clinical intervention is urgent.^1,3

Although social media remains a powerful second-place source for information among younger adults, health care professionals are still ranked as the most trusted source for vaccine information. However, changing a patient’s mind requires more than just facts; it requires a specialized communication skill known as MI.¹

READ MORE: Q&A: Why Pharmacists Staying Informed on Evolving Vaccine Guidelines is Critical

“MI started in the ‘80s in the treatment of alcohol use disorders. It since has been applied to multiple fields in health care, including pharmacy and vaccine hesitancy as well,” continued Chinchilla. “It is a specific way to have conversations about change. The interviewer—who would be either the counselor, the pharmacist, whatever health care professional is having the conversation—plays what’s called a guiding role, which is different than directing or following.”

According to the American College of Clinical Pharmacy, MI is a collaborative, person-centered guiding style designed to elicit and strengthen a patient’s own internal motivation for change.⁴ For the pharmacist, this means suppressing the righting reflex—the instinctive urge to immediately correct a patient’s misinformation or lecture them on the benefits of immunization.^1,4

Research indicates that traditional advice-giving can often backfire, causing patients to become defensive or withdrawn. Instead, MI encourages pharmacists to act as partners, recognizing that while they are vaccine experts, the patient is the expert on their own life and motivations.

A 2022 study in the United Kingdom, published in Vaccine, highlighted that though specific message framing—such as appealing to individual benefits versus community protection—has little impact on vaccination intent, emotional factors like fear of the disease and prior vaccination history are significant predictors.⁵

Pharmacists can leverage this by using the “OARS” technique: asking open-ended questions to invite conversation, offering affirmations to build confidence, using reflections to ensure the patient feels heard, and summarizing the dialogue to establish a path forward.^1,6 Rather than arguing against fears, pharmacists should use empathy to acknowledge them, which builds the trust necessary to dismantle resistance.^1,4

Practical tools like the “readiness ruler” allow pharmacists to efficiently gauge a patient’s willingness to change by asking them to rate their intent on a scale of 1 to 10. If a patient provides a midrange score, such as a 5, asking why they chose that number instead of a lower one prompts them to vocalize their own “change talk,” or the specific reasons they might consider the vaccine. This approach is particularly effective for hesitant adopters—patients who hold doubts but are still open to clinical recommendations.^3,4

By focusing on incremental, specific goals and supporting patient autonomy, pharmacists can help patients move from ambivalence to action. In a world where vaccine confidence has declined by up to 44% in some nations, the ability to turn a brief interaction into a non-judgmental, trust-building conversation is perhaps the most valuable tool in a pharmacist’s belt.^1,3,4

“Misinformation about vaccines is on the rise. Some claims are specific to certain vaccines, while there are others that are more generalized, and several vaccines are declining as a result,” concluded Chinchilla.¹ “Addressing vaccine misinformation effectively requires both accurate information and effective communication. MI can be useful in navigating [these] conversations.”

READ MORE: APhA Annual Meeting and Exposition

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REFERENCES

1. Chinchilla A. Ugh, more vaccine misinformation? as if! Presented at: American Pharmacists Association 2026 Annual Meeting and Exposition; March 27-30, 2024; Los Angeles, CA.

2. Vaccination trends. CDC. March 30, 2026. Accessed March 29, 2026. https://www.cdc.gov/respiratory-viruses/data/vaccination-trends.html

3. Mossad SB. Vaccine hesitancy: Where are we heading? Cleve Clin J Med. 2026;93(1):21-26. https://doi.org/10.3949/ccjm.93a.25104

4. Kavookjian J. Motivational interviewing. American College of Clinical Pharmacy. October 7, 2011. Accessed March 29, 2026. https://www.accp.com/docs/bookstore/psap/p7b08.sample01.pdf

5. Chapman S, Christodoulaki ME, Davey SA, et al. Understanding vaccine hesitancy: the role of fear and message framing in COVID-19 vaccination intention in adults in the UK. Vaccine. 2025;69:127999. https://doi.org/10.1016/j.vaccine.2025.127999

6. How to use motivational interviewing in your pharmacy. PBA Health. February 14, 2023. Accessed March 29, 2026. https://www.pbahealth.com/elements/how-to-use-motivational-interviewing-in-your-pharmacy/