How should physicians and nurses deal with people who do not want immunizations?

People who do not want immunizations represent a small fraction of the total population. However, they may have significant epidemiologic impact. Reasons for lack of support for immunization include ignorance, fear, contraindication, general opposition based on religion or philosophy, or "informed" opposition. The category of "informed" opposition includes those who have decided, based on reliable information, that the risks of immunization outweigh the benefits in their particular case. It also includes "misinformed" opposition arising from acceptance of unproven allegations about vaccine safety or efficacy. These views may be fostered by media accounts of adverse events alleged to be caused by vaccines. Carefully developed and forthright responses to these issues are needed to assure that people make truly informed immunization decisions.