COVID-19 Vaccines: Effective patient communication strategies

COVID-19 vaccination has become a tricky subject for providers to navigate during patient visits. While we need to understand our patients’ vaccination status to care for them, we must also remain sensitive to potential vaccine hesitancy. Against this backdrop lies a golden opportunity for us to help our patients make sound, educated decisions about whether to get the COVID-19 vaccine.

Only about 55% of the U.S. population is fully vaccinated.1 Despite a slight rise in vaccination rates due to the Delta variant, daily vaccination rates remain far below their peak.2 Providers may assume that people who are not vaccinated do not want to be vaccinated; however, many other factors may be at play including misinformation and social determinants of health.

Know the situation

Recent data suggests that most Americans trust their doctors and other health care workers.3,4 Therefore, providers can play an integral role in increasing vaccination rates across the U.S., but only if we first understand each patient’s unique situation and concerns. We must get to the root of existing barriers.

Some of the most common potential barriers include lack of transportation or health care access, lack of education/guidance, misinformation, and financial misunderstanding. Although providers may not be able to address all barriers, many can be overcome by connecting patients with existing community resources.

For example, free transportation services available through health plans, ride-sharing companies, and other community groups can make vaccination clinics accessible to those without transportation. Other patients may mistakenly believe they have to pay for a vaccination or are worried about vaccine side effects. Providers can alleviate such anxieties by offering accurate information.

Apply motivational interviewing

The process of motivational interviewing can help identify and address health barriers. It is a collaborative, patient-centered way to guide conversations, and it is just as effective for informing COVID-19 vaccination decisions as it is for overcoming medication non-compliance and other challenges.

Motivational interviewing entails four steps represented by the acronym OARS:

• Ask open-ended questions; those that require more than a “yes” or “no” response. For instance, rather than asking, “Are you planning to be vaccinated?” ask, “Why haven’t you received the COVID-19 vaccine yet?” That opens the door to begin discussing both perceived and actual barriers.
• Affirm that you want what is best for the patient. Take a moment to appreciate the patient’s apprehensions with a statement such as, “It is natural to be apprehensive…” Then, emphasize that you care about the patient, their family, and their loved ones. For instance: “This shot is especially important for you because of your [insert appropriate job/underlying health condition/vulnerable family here].” Or, “I care about you, and because your health puts you at risk of complications from COVID-19, I strongly recommend you receive a vaccine.”
• Reflect on what you hear from the patient about why they are hesitant to receive a COVID-19 vaccination, but then start to reinforce their commitment to change their behavior. Explain the importance of immunization, offer solutions to barriers, and share reliable evidence and resources.
• Summarize the conversation to remind patients you are engaged in their care and want to guide them to healthier behaviors.

Many patients look to their health care providers for up-to-date knowledge, which gives us an excellent opportunity to combat misinformation. For example, providers can explain that researchers were developing mRNA vaccines years before COVID-19 emerged, so they are not using new technology rushed to market. We can explain how the vaccines benefit individuals, their families, their friends, and their communities’ “normal” way of life. 

Move the needle on vaccination rates

As providers, we cannot discount our power to persuade. Patients who receive accurate intelligence from a trusted source like their doctor may better understand the benefits of COVID-19 vaccination and therefore increase vaccination rates nationwide. 

Through motivational interviewing, providers can identify and start to overcome barriers to care. We can help patients make educated choices about protecting themselves, their loved ones, and their communities.

References

1. Centers for Disease Control and Prevention. COVID Data Tracker. https://covid.cdc.gov/covid-data-tracker/#vaccinations_vacc-total-admin-rate-total

2. Centers for Disease Control and Prevention. COVID Data Tracker. https://covid.cdc.gov/covid-data-tracker/#vaccination-trends

3. Funk, C. and Gramlich, J. Amid coronavirus threat, Americans generally have a high level of trust in medical doctors. Pew Research Center. 13 March 2020. https://www.pewresearch.org/fact-tank/2020/03/13/amid-coronavirus-threat-americans-generally-have-a-high-level-of-trust-in-medical-doctors/

4. Yi, J. and Sawyer, J. Americans are most likely to trust healthcare workers and doctors. Ipsos. 12 March 2021. https://www.ipsos.com/en-us/americans-are-most-likely-trust-healthcare-workers-and-doctors

_{About the Author}

_{Dr. Joe Nicholson is the Chief Medical Officer at CareAllies, providing strategic direction, business development expertise, and clinical oversight. Learn more at Careallies.com.}