Wednesday, April 21, 2021

by Aaron Medaris – Publisher, Physicians Office Resource

Vaccine hesitancy is nothing new. Even before unsubstantiated claims of autism, social media misinformation, and antivax websites, many people have struggled with vaccinations. In the smallpox outbreak of the 1800’s the United Kingdom saw so much opposition that it finally had to require vaccination against the disease mandated by law. 

In the early 1900’s the case of Jacobson v Massachusetts made its way the US Supreme Court. In the end the US Supreme Court supported the rights of states to pass laws mandating the smallpox vaccine. In 2019, before the pandemic even struck, the World Health Organization listed combating vaccine hesitancy as a top ten priority. Though vaccine hesitancy is nothing new, its effect on public health has never had a greater potential impact than on today’s world. In just over one year of battling the pandemic on US soil, there have been over 525,000 COVID-19 related deaths. We now have three FDA authorized COVID-19 vaccines that have fully vaccinated over 30,000,000 people. Recent data suggests that about 80 to 85% of Americans would need to be vaccinated to achieve herd immunity against COVID-19. Given that the population of the United States is about 328,000,000, we still need to vaccinate roughly 70 to 75% of the population. Which brings up the question, how much will vaccine hesitancy play a role in the US gaining heard immunity? If recent surveys are correct, it could have a major impact. According to national poll sponsored by the University of Michigan in the fall of 2020, just 58% of adults aged 50 to 80 said they’d get vaccinated against COVID-19. If in the end those numbers prove to be accurate, we will have fallen well short of required vaccinated population to achieve heard immunity. We need to be prepared to help the population and their vaccination concerns.

Five Common Concerns or misunderstandings with the COVID-19 Vaccine leading to vaccination hesitancy:

1. How quickly the vaccine was developed

2. Side effects of the vaccine

3. Only the vulnerable need to be vaccinated

4. Don’t know how long the vaccine will last

5. How the vaccine work against COVID mutations

There are a variety of concerns and misunderstandings that lead to vaccine hesitancy. Not only should a healthcare practitioner be prepared to address the above, but they should do their best to completely understand why a patient may be hesitant to receiving the vaccine and then provide the necessary resources for them to resolve their concern.  

Here are 10 ways that physicians and other healthcare practitioners can help combat COVID-19 vaccine hesitancy:

1. Ask Why the Patient is Hesitant 

Whether their concern is one of the five listed above or something completely different, it is essential that a physician understand a patient’s concerns. In the end every patient must make the decision for themselves to be vaccinated, but you will want to do all that you can to understand where the patient is coming from and what their concerns are. Sometimes people’s concerns are like an iceberg with only a small portion visible above the surface. Concerns like this can be difficult to resolve that is why it is essential to ask questions and listen intently to the patient’s response. Jumping to conclusions rather than listening to the patient can damage trust and cause further vaccination hesitancy.  

2. Listen

Asking questions will only get you so far when helping others with their concerns. When you listen carefully to others, you understand them better. When they know that their responses are important to you, they will open up more. One common habit many of us have is when someone is speaking, we often think about what we will say in response. This practice often leads us to only hear part of their message. If we listen with intent, we will better grasp what they are saying which will allow us to provide a more appropriate response. When you feel like you understand what is being said verify that by using such statements and questions as, “So what you’re saying is________. Is that right?” or If I understand correctly, you’re concerned with _________. Is that correct?”

3. Share Empathy and Provide Emotional Support

Empathy can be a difficult attribute to attain. However, proper development of cognitive, emotional, and compassionate empathies will allow you better understand your patient and share in their feelings. Empathy doesn’t mean you have to agree with their concerns, it means that you understand them and understand the impact those concerns can have on someone’s mental and emotional state. Reaching that level of understanding can only be obtained through a sincere desire to help and in the case of a physician, a sincere desire to heal. Vaccination concerns often arise because of distrust, when a patient see’s and recognizes that you have empathy for them regardless of where their concerns are coming from, they will come to trust you more.

4. Acknowledge Uncertain Risk

We face risk every day and take precautions every day to minimize risk. We take risks every time we get into a vehicle and travel 70 miles per hour on the interstate. We minimize the risks involved with the activity by wearing our seatbelt, staying attentive, and obeying traffic laws. People respond very differently to new risks. When I was a teenager first learning to drive, diving on the interstate for the first time was terrifying and probably even more terrifying for my parents who were teaching me how to drive. However, with practice and appropriate skill, I no longer look at that task as terrifying. In fact, I look at it as a necessity to go about my everyday life. Some people may look at getting the COVID-19 vaccine as terrifying because to them it’s new and with that new experience comes unknowns. However, getting vaccinated is like putting on a seatbelt and following traffic laws that will help you go about your everyday life. The real risk would be choosing not to be vaccinated or in a sense not wearing your seatbelt and not obeying traffic laws with the hope of arriving safely at your destination.

5. Discuss Known Risks

Be upfront. Make sure that patients understand what side effects are possible with getting vaccinated, such as fever, muscle aches, flu like symptoms. Also discuss the rare risk of allergic reactions (2.5 anaphylaxis cases per million Moderna COVID-19 vaccine doses administered) and what is being done to respond to those situations.

6. Provide Information

Proper information can be a powerful tool to the vaccine hesitant. There are many who fall into the undecided category when it comes to getting the COVID-19 vaccine. A large reason why they fall into that category is because they haven’t had a chance to educate themselves on the vaccine. They’ve heard snippets on the news and hearsay from friends and family, but rarely have they received proper professional information regarding the COVID-19 vaccine. Referrals to appropriate websites such as the following can provide answers to the questions that are standing in the way of their decision to vaccinate:

Questions and Answers about the COVID-19 Vaccine

https://www.cdc.gov/coronavirus/2019-ncov/vaccines/index.html

https://www.health.harvard.edu/coronavirus-and-covid-19/covid-19-vaccines

Myths and Facts about the COVID-19 Vaccine

https://www.cdc.gov/coronavirus/2019-ncov/vaccines/facts.html

https://www.mayoclinic.org/diseases-conditions/coronavirus/in-depth/coronavirus-vaccine/art-20484859

7. Partner with Communities

Many who are vaccine hesitant are dealing with familial or societal situations that are skeptical of the COVID-19 vaccine. It’s important as a physician, healthcare provider, or public health administrator to partner with those that have longstanding relationships with various communities to provide appropriate and accurate information regarding the COVID-19 vaccines.

8. Get the Vaccine Yourself and Tell Others About Your Experience

You are your patient’s expert on all things health. Your word, advice, and treatment mean a lot to them. In a pandemic, we’re all facing the same disease and we luckily for us all have the same defensive measures. Get the vaccine yourself and tell others about your experience. Share the good, share the side effects, share why you chose to get vaccinated. Your words and personal experience can be the motivating factor your patient needs to get vaccinated.   

9. Tell Your Patients They Need to Get Vaccinated 

Obviously, there are cases where a patient should not be vaccinated and you should be aware of those. But in most cases, vaccination is a must. Tell your patients to get vaccinated. Plain and simple. You tell patients every day to stop smoking, eat better, lose weight, and take their prescribed medicines. Telling your patients to get vaccinated should not be any different.

10.  People Have a Natural Desire to Protect Others

We’ve seen the statistics, there is a portion of the population that is extremely susceptible to the devastating effects of COVID-19. Many of those are our loved ones. What if we could do something that could provide those people at risk many more years of quality life? Well, we can. We can get vaccinated. Tap into that desire people have to protect others. Their selfless act of being vaccinated could mean life or death for someone else.

There will always be those with concerns regarding any type of vaccination. I’m ok with that. Those with concerns are concerned about their health and the health of those they love. But I also don’t think we should look at those with vaccine hesitancy as a lost cause. I believe with the proper approach many of their concerns can be resolved and ultimately lead to proper vaccination.

It’s been a long year of battle against this pandemic. We are so fortunate to have three approved vaccines that could eventually bring it to an end. We offer our sincerest gratitude to you physicians, healthcare providers, and scientists. I can’t imagine what this past year would have been like without you on the front lines.