When clients decline vaccines

Photo: Iryna & Maya/Adobe Stock

Q: When our technicians discuss vaccinating dogs for Lyme disease with clients, some decline. What should they say to be more persuasive?

A: Client conversations about vaccinating for Lyme disease need to happen before, during, and after appointments. An American Animal Hospital Association study found repetition of the message increases compliance.

Before the appointment

List vaccines due in recall notices

When you send recall messages to clients who have pets due for care but haven’t scheduled appointments, list all services due, including Lyme disease vaccination. Depending on your practice information management software and third-party reminder service, you could include hyperlinks or client information sheets.

Send online forms with appointment confirmations

Clients will complete and submit forms before appointments. This saves 10 to 15 minutes that technicians and assistants previously spent asking history questions at the start of appointments. Clients’ answers can be reviewed before exams, resulting in more efficient use of exam time.

Ask questions related to Lyme disease on wellness forms such as the following:

• Have you seen any fleas or ticks on your pet?
• Which flea/tick preventive do you use, and when did you give the last dose?
• Do you travel with your dog to areas where ticks or mosquitoes may be present?
• Have you ever found a tick on your dog or on any other pet or person in your home?

Check the purchase history of flea/tick preventives

Technicians should know when preventives were last purchased, how many doses were sold, and how many dogs are in the home in case the client is sharing a box of preventives among pets.

Check vaccine status

Identify whether you previously discussed the need for Lyme disease vaccination with the client. Did the client accept or decline the Lyme disease vaccine on the last visit?

During the appointment

Display information on Lyme disease

Exam rooms are classrooms. Posters, digital photo frames, slideshows on computers, and brochures will help you educate clients about Lyme disease. The Companion Animal Parasite Council offers prevalence maps by county and state. In Saratoga County, New York, for example, 1 in 10 dogs has tested positive for Lyme disease this year. Preview services when starting exams At the beginning of appointments, technicians should explain their roles and summarize services that will be delivered during the day’s appointment.

Say, “I am , who will assist Dr <name>. <Pet's name> needs an exam and vaccines for distemper/ parvovirus, rabies, Bordetella, leptospirosis, and Lyme disease. We will test for intestinal parasites and heartworm/tick diseases. <Pet's name> needs refills of flea/tick and heartworm preventives. I will tell you about rebates so you may save the most. What questions may I answer before we begin?”

Use the action word of needs when discussing services due rather than the wiggle word of recommend. Clients may hear that Lyme disease vaccination is just a recommendation and is not medically necessary. If the pet owner doesn’t understand or declines Lyme disease vaccination, the technician will explain, “Lyme disease is transmitted to humans and animals through the bite of infected ticks. Symptoms may include lameness, swollen lymph nodes, joint swelling, fatigue, and loss of appetite. Lyme disease can cause serious kidney complications. Two boosters are given several weeks apart the first time your dog is vaccinated, and then it is given annually. Shall we vaccinate your dog for Lyme disease, or do you want to talk with the doctor?”

Use yes-or-yes technique to lead the client to accept the vaccine or to get more information from the veterinarian. With further education, the client may accept Lyme vaccination.

Explain the pyramid of protection

Protecting dogs from Lyme disease is like a 3-legged stool. The first leg is testing for tickborne diseases, which is a recurring annual screen. Say “recurring” instead of “routine” to communicate that the test repeats annually and is medically necessary. The second leg is vaccinating for Lyme disease annually. The third leg is giving flea/tick preventives monthly. This pyramid of protection is best. If you remove 1 of the 3 legs, the stool will fall over. Likewise, if the dog is unvaccinated for Lyme vaccine, it cannot be fully protected with the remaining 2 legs of flea/tick preventives and testing.

Have doctors reinforce protocols

Before the doctor enters the exam room, the technician will let the veterinarian know whether a client questions or declines a vaccine. The veterinarian can explain area prevalence, health consequences, and cost of treatment. This additional information from an expert may persuade the pet owner.

Almost no one refuses when Chris Brockett, DVM, owner of Saratoga Veterinary Hospital in Wilton, New York, tells clients: “ shared that you declined the vaccine for Lyme disease for your pet. We live at ground zero for Lyme disease in both pets and people. While core vaccines such as rabies, distemper, and parvovirus are important, the likelihood of your pet being exposed is quite small. On the other hand, the chances your pet will be exposed to Lyme disease are quite high. I know this because our doctors diagnose multiple dogs every week. Lyme disease can create chronic inflammatory disease and, in severe cases, kidney damage in your pet. Almost everyone I know has a friend with Lyme disease and those inflammatory problems. The vaccine is extremely safe and protects dogs against the disease they are most likely to encounter in their lives. Lyme vaccination is an important one to include with our services today. Shall I vaccinate your dog for Lyme disease, or do you need more information?”

If the client still declines, note the decision in the medical record. Revisit the need for vaccination during the next exam, as persistence may get results.

After the appointment

Have technicians make medical callbacks 1 week later

The first no is not the final no. Create a service reminder called “Lyme vaccine needed” that will print on the client’s receipt and trigger a callback in 7 days. The outpatient technician will call the client because they have an existing relationship, and the client is more likely to remember the technician who helped with last week’s appointment.

Say, “This is <technician's name> with <hospital name>. I enjoyed seeing you and <pet's name> last week. Dr <name> asked me to follow up with you on our discussion about the need to vaccinate for Lyme disease. Because is current on a doctor’s exam, we can schedule a technician appointment to give the Lyme vaccine. The cost of the vaccine is $__. Our next available technician appointments are <date, time 1> or <date, time 2>. Which do you prefer?”

Use the doctor’s name to bring credibility and authority to the call. You also communicate that Lyme disease vaccination is medically necessary. Explain the vaccine cost and that paying for another doctor exam isn’t required. Use the 2-yes-options technique to nudge the client to schedule a technician appointment.

Best known as the "Queen of Scripts," Wendy S Myers, CVJ, has taught communication and client service skills for more than 2 decades. As founder of Communication Solutions for Veterinarians, she teaches practical skills through online courses, onsite coaching, and conferences. Myers was a partner in a specialty and emergency practice. Visit Csvetscourses.com to learn more.