Today, 123.9 million people in the US have been vaccinated — and that number is something to celebrate. But the news of a pause in giving the Johnson & Johnson vaccine, due to six instances of a rare blood clotting disorder, is almost sure to give the vaccine-hesitant additional concern.
No matter what, the reality is still that a return to normalcy still requires “70 to 85 percent of the US population to be vaccinated” according to Dr. Fauci. At this time, about 2.8 million doses a day are being administered, vaccine production is ramping up, and trials with younger participants are beginning. This is all terrific news. But it will still take several months to reach the level where we’re living the pre-pandemic life we all look back on with longing.
Other than the obvious (getting shots in arms), how can care teams help this process along? One way might be thoughtfully approaching vaccine-skeptical or fearful patients to help them consider getting the vaccine in an evidence-based way. A recent poll conducted by the Associated Press and the NORC Center for Public Affairs Research suggests that a substantial percentage of Americans are reluctant to get the vaccine: 1 out of 3 say they definitely or probably won’t get it.
If care teams were able to help even a small percentage of patients get the shot, the impact would be hugely beneficial to bringing this public health emergency to a swifter close.
Here’s how you might go about it.
Listen with an open mind. We get what we give. If you kick things off with a lecture about the efficacy and importance of vaccines, you might come across as condescending (and there’s not a person alive who enjoys being made to feel stupid). But if you begin in the spirit of open-minded inquiry, acknowledging the decision is ultimately up to them, your patient will likely relax a bit more, trust that you’ll listen, and perhaps be more open to listening in turn.
Ask them what they’ve heard about the vaccine — and where they got the information. I’ve often said, with good results, “Let me look into that more and do some additional research. In the meantime, would you be open to discussing this in more detail? I have some more information that you may not have access to that might help your decision process.”
Patients need to feel heard and respected. If care teams acknowledge their concerns and show the respect of really listening, it can move the conversation to a more productive place.
Understand their fear is real. When patients are reluctant to take the vaccine, it’s often rooted in real fear. In fact, the survey revealed that of those who were definitely not going to get the vaccine, 65 percent cited worries about side effects and the same percentage said they didn’t trust the vaccine, period. Similar issues proved true for those who indicated they “probably” wouldn’t get the vaccine: 63 percent were waiting to see if it was safe and 60 percent cited side effects as their reason.
It’s fair to want to understand what could happen with something that’s put in your body. You can share some key facts. For example, the FDA generally advises a minimum of 3,000 participants in Phase III human trials. But in the case of Pfizer, the vaccine with 95% efficacy, the trial was over 13 times that recommendation or more than 40,000 participants. The Moderna trials were similarly well executed with more than 25,000 participants and a 94.1 percent efficacy rate. Additionally, the clinical data is available to anyone; they’ve made it totally transparent, easy to find online, and free to review.
It’s also important to point out that it’s not in the best interests of pharmaceutical companies or government agencies to put something out that’s not safe. When that happens, it erodes trust, hurts their bottom lines, and introduces liability — so they’re incentivized to do the best they possibly can.
Honor the impact of ongoing racial trauma. It’s important to acknowledge that different communities have good reason to exercise caution, which is why Black Americans are less likely to get the vaccine (57%) than their white counterparts (68%).
There is a deep and understandable mistrust of the medical community, fueled by a terrible historical legacy of experimentation and dehumanizing treatment (eg, the Tuskegee study). Even today, there is ample evidence that underscores why many in the Black community feel skeptical about receiving good care, from studies that show how lack of cultural diversity in care teams affects the quality of care to how they “receive less information, attention and empathy from their white counterparts.”
How do you overcome that? One way might just be to have a direct conversation about it. Another way is to make sure that if your care team is not racially or ethnically diverse, you connect patients with physicians who are to have deeper conversations. And it’s smart to ensure cultural competency training for your own staff.
You may also share that, according to the Kaiser Family Foundation:
Help patients draw their own conclusions. It’s unrealistic to expect an average patient to have the skills of an academic researcher, journalist or scientist to determine the veracity of information they encounter. Fortunately, as a care team, you likely have a great foundation of trust to draw on. Use it to teach some strategies to help people make decisions based on facts, not assertions.
You can always couch it in terms of what you yourself use to separate fact from fiction. For example, I might say, “When I’m personally researching things, I look for sources that are nonpartisan and mainstream like expert academics from accredited universities, government sites, and groups like the American Medical Association.”
I’ve also pulled up different news sites to show how each one covers the same topic and gently led them to review the other side of the argument with me. In my experience, patience, trust, and a willingness to simply ask them to consider a different point of view does pay off over time. It might not be that day, but simply giving a patient some new points to consider and then stepping back to let them think it over on their own is often effective.
Ultimately, the vaccines are a huge win for the scientific community, representing a triumphant global effort of the world’s leading scientists all focused on one single task, drawing on an abundance of resources and decades of research to bring it to fruition. It’s an incredible victory. And as more people get the vaccine and others see them do it with no ill effects, they’ll be inspired to do the same.
But as care teams, we can nurture this decision along with a kind and factual approach that underscores our respect for the patient and their autonomy to make decisions for themselves.
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