Practice Management Alert

Prioritize sensitivity and avoid condescension.

Regardless of your specialty, if you’re part of a patient’s healthcare team, the patient may look to you for guidance surrounding healthcare at large. Since the SARS-CoV-2 virus affects so many body systems, your specialty may be implicated, so patients may come with COVID-specific questions.

One of the most important tools for controlling the pandemic is vaccination, but if patients are hesitant, then one of the best tools is blunted. Even if you’re not dealing directly with treating or diagnosing COVID-19 infections, your practice may play a role in boosting confidence in the vaccines.

“Eight in 10 say they will turn to health care providers when deciding whether to get vaccinated,” the Kaiser Family Foundation says, referring to polls it has conducted.

First, Build Trust

If you have genuine rapport with a patient, you’re that much more trustworthy in their estimation, and therefore your opinions on the vaccine may carry extra weight. Use this to your advantage, if you have the opportunity.

“Confidence starts with you. Patients will likely ask you if you’ve been vaccinated yourself,” says Lt. Stephen Perez, RN, PhD, clinical lead for the vaccine confidence team for the U.S. Public Health Service’s COVID-19 Response, in a recent Centers for Disease Control and Prevention (CDC) Clinical Outreach and Communication Activity (COCA) call.

Although there is certainly more context at play than just a clinician’s vaccination status, talking with a healthcare professional who is vaccinated may be very validating for the patient.

“Among our patients, we can address vaccine hesitancy by building vaccine confidence, which is a multifaceted concept based largely on trust. It includes the trust that patients, parents, or providers have in the recommended vaccines, and providers who administer vaccines, and processes and policies that lead to vaccine development, licensure, manufacturing, and recommendations for use,” Perez says.

Provide Basic Education — Gently

Many people polled about getting the vaccine and expressing fear say they’re worried about getting COVID-19 from being vaccinated, which highlights a crucial gap in patient knowledge. None of the vaccines approved by the Food and

Drug Administration (FDA) use live virus and therefore none of them can shed the virus. Patients may be confused about the way the mRNA vaccine technology works or have questions about why the Centers for Disease Control and Prevention (CDC) and Food and Drug Administration (FDA) paused one of the approved vaccines.

Patients also probably want to know what may happen after they receive the vaccine: Will they get a fever or other symptoms? Do they need to see a doctor if they do?

“As healthcare providers, your impact is often centered in helping patients trust in you and your role as vaccine administrators. But you can also help build trust in the processes and policies by helping your patients to understand new vaccine technologies, what to expect in terms of vaccine side effects, and how these vaccines are being continuously monitored for safety. Being honest about what you don’t know is also important for building trust,” Perez says.

“If there’s sufficient confidence and trust in ability, then people will seek out vaccines, overcoming barriers to do so. People with less confidence or motivation or ability may be less willing to overcome real or perceived barriers such as transportation or getting time off work,” Perez says.

Be Sensitive to History

Some communities who are suffering particularly immense losses during the COVID-19 pandemic have also suffered — or still suffer — systemic racism and inequitable access to healthcare. The mistrust there is real and valid, and practitioners should be sensitive to this reality. Approaching these conversations with empathy and understanding is an evidence-based strategy that may make your attempt more effective, Perez says.

“When considering strategies for building confidence, healthcare providers must be sensitive to the longstanding health and social inequities faced by racial and ethnic minority groups and other groups experiencing health disparities. Many people from these groups may also have a mistrust or fear in healthcare institutions or the government after experiencing very real trauma or mistreatment from these same institutions. Providers must show compassion and empathy in the space,” Perez says.

One way to emphasize consent — and continue to build trust — in an interaction like this is with your language, Perez notes. Instead of rattling off information about the vaccines or telling the patient that they shouldn’t be afraid, you can ask the patient’s permission: “I have some information that I think will help address your question. May I share it with you?”

Rely on your role as the patient’s clinician, Perez suggests. “Some language that can emphasize this could be, ‘My priority for you has always been and will continue to be your health and wellness. I know there’s a huge amount of information out there about these vaccines. Just as with everything I recommend to keep you healthy, you can trust I strongly recommend these COVID-19 vaccines to help protect you from getting sick.’”