How to Talk to People Reluctant to Get a COVID-19 Vaccine
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Dr Mitchell A. Kaminski was still feeling joy and relief after recently being vaccinated against COVID-19 when a patient's comments stunned him. A middle-aged man with several comorbidities had declined a pneumonia vaccine and added, without being asked, that he would not get a coronavirus vaccine either. The patient had heard that vaccination could kill him.
Kaminski countered with medical facts, including that extremely rare side effects had killed no one in the United States, whereas COVID was killing thousands of people every day. He recalled the patient saying, "Then I'll just take the risk of getting COVID". The conversation ended there.
A Patient Conversation That Opened New Perspectives
The experience prompted Kaminski, director of the population health program at Thomas Jefferson University in Philadelphia, to rethink how he talks to patients who are undecided or skeptical about COVID-19 vaccination. If he saw that patient who feared dying from the vaccine now, Kaminski said, he would be more curious.
Instead of directly contradicting the beliefs of a patient who does not want vaccination, Kaminski now gently asks why they oppose it and provides information about vaccines. Mostly, however, he listens.
Eligibility for vaccination is becoming more widespread as conversations between doctors and patients about the risks of COVID-19 vaccination increase. Doctors use various methods to communicate about the safety and importance of vaccination in ways they believe will lead most of their patients to get a COVID-19 vaccine.
According to Kaiser Family Foundation research, approximately 80% of Americans say they will turn to doctors, nurses, and other healthcare professionals for help deciding whether to get a COVID vaccine.
Moving beyond Distrust
Although patients often feel a strong connection with their doctors, distrust of the medical establishment persists, particularly in some communities.
The Kaiser Family Foundation reported that one third of Black people were taking a "wait and see" approach, while 23% would get vaccinated only if required or not at all.
Distrust stemming from historical racist episodes in medicine, such as the notorious Tuskegee experiments in which treatment was withheld from Black men with syphilis, persists. However, Krys Foster, a family physician at Thomas Jefferson University, said doctors should not assume that all Black patients have the same reasons for vaccine hesitancy.
"In my experience caring for patients who are undecided or have concerns about getting vaccinated, many are simply seeking more information and even want my approval that vaccination is safe given their medical history", she said.
Resources such as the COVID Racial Data Tracker have found that Black Americans have a higher COVID mortality rate than other racial or ethnic groups, making vaccination even more vital. Still, Foster said fear of vaccination may be triggered by misinformation found in various places online.
To encourage vaccination and dispel misinformation, Foster takes time to discuss how safe COVID-19 vaccination is and the vaccines' side effects, then quickly explains how to get vaccinated.
- Related topic: Why Should I Get a Coronavirus Vaccine? Can a Vaccine Developed So Quickly Be Trusted?
Foster also said, “Some people may find it difficult to obtain an appointment or access testing sites. Failure to get vaccinated should not automatically be characterized as 'hesitancy'”. "It is the medical community's responsibility to help correct the health injustices inflicted on communities of color by providing equal information and access, and to stop blaming them for having the 'wrong' vaccination attitude"
Provide a Personal Reference
Dr Jamie Loehr of Cayuga Family Medicine in Ithaca, New York, said he has always had an above-average number of patients who refuse or delay their children's vaccinations. Loehr does not dismiss them from his practice; he continues to educate them politely about vaccines.
When patients ask Loehr whether he trusts the vaccine, he confidently replies: "I not only believe in it, I've had it, and I recommend it to everyone who can get it"
Recently, he was surprised when a mother who had expressed reluctance to vaccinate her young children came for a checkup and said she had already received a COVID vaccine. "She decided on her own that it was important enough to want it", he said.
Hesitancy among Healthcare Workers
Concern about some healthcare workers being at the front of the vaccination queue may be another source of vaccine hesitancy among the general public that doctors need to address. In a survey of approximately 3,500 healthcare workers conducted in October and November 2020 and published in Vaccines in January 2021, only one third (36%) said they would get vaccinated as soon as it was available. By mid-to-late February, according to the Kaiser Family Foundation COVID-19 Vaccine Monitor, 54% of healthcare workers reported having been vaccinated and another 10% planned to do so as soon as possible.
Vaccines coauthor Dr Eileen Barrett, an internist serving on the editorial advisory board of Internal Medicine News, says addressing doubts about vaccines requires a considerate approach to healthcare workers. "We should meet people where they are and do our best to hear their concerns, listening thoughtfully without condescension. Affirm how important their role is in endorsing vaccination, and also affirm asking questions"
Barrett, who cares for COVID-19 patients and the internal medicine department at the University of New Mexico in Albuquerque, emphasized: "Strong personal statements from physicians and other healthcare workers matter. Not only to influence patients but also as a model for healthcare professionals."
Do It for Your Loved Ones
The Reagan-Udall Foundation, a nonprofit organization established by the US Congress to support the US Food and Drug Administration (FDA), tested some messages with focus groups. Participants responded positively to this explanation of why vaccines were developed so quickly: "Vaccine development moved faster than usual because everyone is making it the highest priority"
The foundation's CEO, Susan Winckler, said people were not motivated to get vaccinated. However, they considered the following a good reason to do so: "By getting vaccinated, I could protect my children, parents, and other loved ones"
Doctors can also work with community influencers, such as faith leaders, to build confidence in vaccines.
Messages provided by general practitioners can also be powerful and affirming.
In conclusion, the way forward is to create space for people to ask questions.
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