As flu season begins, many patients remain unsure about which vaccines they need — and whether they need them at all. In August 2026, the FDA approved Moderna’s mFLUSIVA — the first mRNA-based flu vaccine — for adults 50 and older, with availability expected for the 2026-2027 respiratory season.
As more mRNA-based options reach the market, patients may have more questions, and providers should be prepared to answer them. According to the National Foundation of Infectious Diseases, 44 percent of U.S. adults say current guidance on respiratory vaccines feels either unclear or neither clear nor unclear.
While patients may not always seek out vaccinations on their own, a provider’s recommendation can make a real difference. That guidance may be especially important for Black patients, who have had lower RSV vaccine uptake. During the first two seasons of vaccine availability, just 14 percent of non-Hispanic Black adults ages 60 and older received an RSV vaccine.
Ahead, Alana J. Arnold, MD, MBA, a board-certified pediatric emergency medicine physician, and Louis Lerebours, MD, a family medicine physician at Freeman Recovery Center, break down why patients hesitate — and how providers can approach vaccine conversations in a way that leaves patients feeling informed and respected.
Vaccine hesitancy often has layered roots: ongoing medical mistrust dating back to the Tuskegee syphilis study, confusion from COVID-19 guidance, and ongoing misinformation online. Together, these factors have left many patients unsure who — or what — to trust.
For Black patients, these conversations often exist within a broader history of mistrust in the healthcare system. But Dr. Arnold cautions against providers assuming hesitancy from the start. Rather than starting from suspicion, she says, providers can find out what information or reassurance a patient may be missing.
Dr. Lerebours sees this play out often in his own practice. Some patients mistake common, temporary vaccine reactions — fatigue, soreness, a low-grade fever — for early signs of the very illness the vaccine is meant to prevent. Others simply don’t see themselves as at risk.
“This provides a chance for me to discuss how recommendations for vaccinations take into account many considerations beyond how well someone feels today,” Dr. Lerebours said, “factors such as age, medical history, potential exposures, and serious complications that may arise from certain illnesses.”
When providers take the time to walk patients through their individual risk, it can shift a vague, hesitant “maybe” into an informed decision.
“A provider’s recommendation can be enormously influential,” Dr. Arnold said. “The most effective recommendation is clear and personal — something like, ‘I recommend this vaccine for you because…’ followed by a brief explanation based on that patient’s age, health and risk factors.” Simply asking, “Do you want the vaccine?” isn’t enough, she adds. “As clinicians, we need to meet patients and families where they are to make sure we are understanding and communicating effectively.”
Dr. Lerebours takes a similarly individualized approach. He walks patients through the illness a vaccine is designed to prevent, how it could affect them specifically, and what temporary reactions to expect based on their age, medical history, and prior vaccine experience. That context, he said, helps patients weigh not just the risks and benefits of the vaccine — but also what could happen if they remain unvaccinated and get sick.
A patient’s hesitation isn’t the end of the conversation — and pushing too hard can shut it down for good. “The first step is not assuming that every Black patient is hesitant or distrustful,” Dr. Arnold said. “If someone raises a concern, I would ask what specifically worries them, listen without judgment, and then respond to that concern with clear evidence rather than reciting every myth they’ve encountered.”
Research in Black communities consistently shows that physicians and other trusted community messengers can play an important role in vaccine decisions, but trust is strengthened through transparency — not by dismissing questions, Dr. Arnold added.
She recommends a specific kind of honesty: “Here’s what we know, here’s what we’re still learning, and here’s why I recommend this for you.” That framing, she says, acknowledges uncertainty where it exists without suggesting that well-established facts are uncertain.
Over time, providers will increasingly need to explain not just familiar vaccines, but newer technology patients haven’t encountered before. As more mRNA-based options reach the market, Dr. Arnold said providers should be ready to answer patients’ most practical questions: How does the vaccine work? How was it studied? What are the risks — common and rare? How much benefit should a patient realistically expect? And why is this specific vaccine being recommended for them?
Making vaccines a routine part of regular visits, rather than addressing them once a year, gives providers time to answer those questions before a patient needs to decide on the spot. It also helps patients stay current on what they need in the future, rather than encountering an unfamiliar vaccine for the first time when it’s already being recommended. “A good vaccine conversation should leave a patient informed, respected, and clear about what their clinician recommends,” Dr. Arnold said, “even if they aren’t ready to say yes that day.”
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