October 25, 2021, 2:58 p.m. — Like most health care workers, the last 18 months have taken a toll on me. At first, I felt helpless because a virus we had no clue how to treat was ravaging our communities. We knew that if we could get through the first waves and if the scientific community could develop a vaccine, we could eventually fight back and tamp down the pandemic. After nine months of doing everything we could to keep people alive, we finally had light at the end of the tunnel: effective vaccines to significantly reduce the risk of severe infection, hospitalization and death from COVID-19.
I can remember getting my first shot of the Pfizer vaccine in December 2020 and breathing a sigh of relief because there had been many days when I was afraid to go to work. I was afraid to bring COVID back home to my family or contract a serious case myself. I had already tested positive back in June 2020, but luckily I had an asymptomatic case. I can also remember early in 2021 having so many patients ask me when it would be their turn to get the vaccine, and I worked to find places they could get their shots.
However, in the last few months my conversations with patients have been much different. The internet, cable news and social media have wreaked havoc on our ability to convince patients of the safety and efficacy of the COVID vaccines. Those same media platforms depict most unvaccinated people as crazy conspiracy theorists who chose not to take the vaccine because of some concern over Bill Gates tracking them or because they think the vaccine is a ticking time bomb and we will all eventually die after being vaccinated.
I live in Alabama, which is consistently one of the least vaccinated states, and I can tell you that an overwhelming majority of unvaccinated people are not conspiracy theorists. Almost every person I have engaged in discussions with about the vaccine in my office has had concerns about various aspects of the vaccine. Unfortunately, many of their concerns are based on misinformation from the internet or their friends. This misinformation has scared them, and they simply want to know what their family doctor thinks about the vaccines. They want to know if I would give the vaccine to my family and if I am vaccinated.
I have had so many lengthy discussions in my office during the last few months it has gotten me more than an hour behind in clinic on several occasions. I feel like those conversations are that important because my advice could be what saves that person’s life.
My approach with each patient is the same. I ask them if they have been vaccinated, and if they say no I ask if it’s OK if we discuss it, and if they have specific concerns or questions I can address for them. Many of them will say they just don’t know because they are confused by conflicting messages. I encourage my patients, regardless of their decision, that whenever they have questions or concerns about the vaccine that they reach out to me or other trusted medical sources for information, and not social media or friends and family. I often use AAFP resources such as the COVID-19 Vaccine Patient Education webpage along with resources from FPM and familydoctor.org to help guide my education and advice to patients. Many of them ask me at the end of the conversation if I can vaccinate them in the office.
Earlier this week, I had an encounter with a patient that led me to break down in tears in the exam room. One of my long-term patients was in the office for a one-month follow-up because I have been trying to help her quit smoking. The month before we had a lengthy conversation about the COVID vaccine because she had not yet received it and was hesitant. She is at high risk for severe COVID or death should she contract it. As we were finishing up our visit, she reached into her purse and gladly exclaimed, “You will be proud of me!” as she pulled out a COVID vaccine card to show me. She handed it to me so I could put the information in her chart, and as I looked at the card I broke down. She asked me why I was crying, and I told her that I’d had so many conversations in the last few months and that these last 18 months had taken a real toll on me. I was crying because her excitement showed me that all those conversations and questions answered meant something. I asked her what I said that changed her mind.
“Doc,” she said, “I listened to what you had to say, and I trust you to take care of me with everything else, so why wouldn’t I trust you in this case?”
The good thing about her decision is that I see her daughter and son-in-law as well, and she convinced them to get vaccinated because they are also high risk.
This conversation has reminded me to never underestimate the impact our reasoned and calm influence has on patients. I have never thought that berating patients who aren’t vaccinated or blaming them for this recent surge was beneficial to getting more of them vaccinated. I knew that the influence of a trusted primary care doctor would ultimately win the day. As my grandmother always taught me when I was growing up, you catch more flies with honey than with vinegar.
Tate Hinkle, M.D., M.P.H., is a practicing family physician in Alexander City, Ala. You can follow him on Twitter @bthinkle.