Addressing COVID-19 Vaccine Hesitancy: Eight Tips for a Better Conversation

SURASRI PRAPASIRI; DEVON FISHER CHAVEZ

Information sharing and motivational interviewing techniques can build trust and make vaccine-hesitant patients more open to getting the shot.

SURASRI PRAPASIRI, MD, MPH, AND DEVON FISHER CHAVEZ, MS-3

Fam Pract Manag. 2023;30(2):19-23

This content conforms to AAFP criteria for CME.

Author disclosures: no relevant financial relationships.

After the COVID-19 vaccine became widely available, a group of University of New Mexico medical students and residents reached out to patients to assist them in getting vaccinated. It quickly became apparent that many were resistant to getting the new shots. Students, residents, nurses, and even experienced attendings found it challenging to talk to patients about COVID vaccines at times.

Some patients had questions or concerns about vaccine safety, effectiveness, or cost that were relatively easy to address. But others had deeply held, negative beliefs about the vaccines based on misunderstandings or misinformation. The latter group included people who felt that the COVID-19 pandemic was a hoax, the vaccines were likely to seriously harm them, or the vaccines did not have any significant benefits. Sometimes these individuals had very emotional negative reactions toward the vaccines, and those discussions were often unpleasant for the health care professionals, who felt they had failed when the patient refused to get vaccinated despite being given facts and information.

The official COVID-19 Public Health Emergency is set to expire in May, but as of February 2023, hundreds of Americans were still dying of COVID every day.¹ The Centers for Disease Control and Prevention (CDC) continues to recommend vaccination, but a recommendation from a trusted primary care physician can often have a greater effect on patients' decisions.² Still, some patients will be hesitant. Dispelling misinformation with data and facts is important, but changing beliefs also requires listening, exchanging information, and building trust.

Building on previous literature regarding other vaccines,^3,4 this article provides guidance to improve conversations with vaccine-hesitant patients, based on what we learned from our own efforts regarding COVID-19 vaccination.

KEY POINTS

Conversations with a trusted primary care physician can often be more effective in convincing patients to get vaccinated than recommendations from government health agencies.
Dispelling misconceptions with facts and data is important, but storytelling, information sharing, and other techniques are also key to addressing vaccine hesitancy.
Maintaining trust while having difficult conversations about vaccines may help move patients along the hesitancy spectrum, even if they don't decide to get vaccinated at the current visit.

TIP 1: MANAGE YOUR EXPECTATIONS

Vaccine hesitancy is sometimes rooted in strong emotions and beliefs that are difficult to change. This is especially true with the COVID-19 vaccines, which were developed at an unprecedented pace⁵ and have become fraught with political baggage.⁶

COVID data tracker weekly review. Centers for Disease Control and Prevention. Updated Feb. 10, 2023. Accessed Feb. 15, 2023. https://www.cdc.gov/coronavirus/2019-ncov/covid-data/covidview/index.html

Lewis C, Nuzum R, Schneider EC. Engaging and supporting primary care providers in the fight against COVID-19. The Commonwealth Fund. Aug. 5, 2021. Accessed Jan. 12, 2023. https://www.commonwealth-fund.org/blog/2021/engaging-and-supporting-primary-care-providers-fight-against-covid-19

Fogarty CT, Crues L. How to talk to reluctant patients about the flu shot. Fam Pract Manag. 2017;24(5):6-8.

Quinn SC. African American adults and seasonal influenza vaccination: changing our approach can move the needle. Hum Vaccines Immunother. 2018;14(3):719-723.

Stulpin C. COVID-19 vaccines developed at record speed, but experts say trust the data. Healio. Dec. 14, 2020. Accessed Jan. 12, 2023. https://www.healio.com/news/infectious-disease/20201214/covid19-vaccines-developed-at-record-speed-but-experts-say-trust-the-data

Golos AM, Hopkins DJ, Bhanot SP, Buttenheim AM. Partisanship, messaging, and the COVID-19 vaccine: evidence from survey experiments. Am J Health Promot. 2022;36(4):602-611.

Breckenridge LA, Burns D, Nye C. The use of motivational interviewing to overcome COVID-19 vaccine hesitancy in primary care settings. Public Health Nurs. 2022;39(3):618-623.

Vaccine recipient education. Centers for Disease Control and Prevention. Reviewed April 14, 2022. Accessed Jan. 12, 2023. https://www.cdc.gov/vaccines/covid-19/hcp/index.html

Myths and facts about COVID-19 vaccines. Centers for Disease Control and Prevention. Updated Dec. 22, 2022. Accessed Jan. 17, 2023. https://www.cdc.gov/coronavirus/2019-ncov/vaccines/facts.html

Shelby A, Ernst K. Story and science: how providers and parents can utilize storytelling to combat anti-vaccine misinformation. Hum Vaccin Immunother. 2013;9(8):1795-1801.

COVID-19 vaccines. U.S. Food and Drug Administration. Reviewed Dec. 19, 2022. Accessed Jan. 17, 2023. https://www.fda.gov/emergency-preparedness-and-response/coronavirus-disease-2019-covid-19/covid-19-vaccines#authorized-vaccines

KEY POINTS

TIP 1: MANAGE YOUR EXPECTATIONS

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KEY POINTS

TIP 1: MANAGE YOUR EXPECTATIONS

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