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Eight Tips for Addressing COVID-19 Vaccine Hesitancy Among Patients

Early December 2020 marked the beginning of a COVID-19 vaccination programme throughout the UK. This heralded the start of the long and complex journey towards ending a pandemic that has taken an enormous toll on society.

The ongoing global COVID-19 pandemic continues to cause millions of infections and deaths across the world, and vaccines to prevent it are likely to be the most effective way to control the pandemic. It is of paramount importance that the various COVID-19 vaccines now approved by The Medicines and Healthcare products Regulatory Agency (MHRA) are delivered to as many of those eligible, as possible, safely and effectively.

Although the initial vaccination rollout will be reserved for high priority individuals identified by the Joint Committee on Vaccination and Immunisation (JCVI), more widespread vaccine availability will occur in the spring and summer of 2021, allowing the general population to begin receiving initial doses.

Large-scale distribution and administration of COVID-19 vaccines pose many challenges for the government, NHS, other healthcare providers and public health officials, for example, vaccinator training, maintaining the cold chain, storage of the vaccines, prioritising and tracking individuals. However, another hurdle for inoculating the population at large and achieving herd immunity looms that isn’t logistical: vaccine hesitancy.

Numerous polls conducted throughout 2020 show that the number of the UK population willing to agree to receive a COVID-19 vaccine has fluctuated. A poll, commissioned by the Royal Society for Public Health, between 4-6 December 2020, on a representative online sample of 2,076 UK adults, found that 76% of the UK public would take a COVID-19 vaccine if advised to do so by their GP or health professional. This figure was reduced to 57% of respondents from Black, Asian and minority ethnic (BAME) backgrounds (199 respondents). However, in this group, 35% said they would likely change their minds and have the vaccination if given more information by their GP about how effective it is.

There may be many reasons for vaccine hesitancy, and these may include:

  • concerns about pain and/or adverse reactions

  • worries about the thoroughness of vaccine research and development

  • lack of awareness or false beliefs about COVID-19

  • concerns about freedom of choice

  • distrust of the government, pharmaceutical companies, or healthcare officials

  • concerns about vaccine effectiveness.

Addressing vaccine hesitancy

Healthcare providers are likely to encounter patients with vaccine hesitancy and, because of the complexity involved in these issues, might have to spend time educating, raising awareness, providing guidance, and having potentially difficult conversations. Fortunately, most people trust healthcare providers as a credible source for vaccine information, and the time spent addressing vaccine concerns can prove valuable for patients and society.

We are aware that some of our PMP policyholders may be involved in the vaccination programme. However, some doctors, although not directly involved in the programme, might be asked by their patients for advice about the vaccination. Therefore this document may be useful for those discussions.

Eight tips

To proactively prepare for the rollout of vaccines in the coming months, clinicians should consider how to engage patients in vaccine discussions and effectively address concerns and misinformation. The following eight tips may help frame these conversations and help improve communication with patients:

  1. Consider opportunities to engage patients early and often in discussions about COVID-19 vaccines using credible, fact-based information. Direct patients to the NHS website. Easy-to-read patient resources are also available from the UK website.

  2. Acknowledge that conflicting information about COVID-19 vaccines, from various sources, has created confusion and contradictions. Let patients know what you have done to build your knowledge base about vaccines, and reassure them that you are following national recommendations and best practices – and that you will continue to monitor for new information and guidance.

  3. Listen to patients without interrupting and acknowledge their fears and concerns. Showing patients that you care about their point of view will help foster trust and may help alleviate anxiety about COVID-19 vaccines.

  4. Be aware of how nonverbal communication can affect the provider-patient encounter. Certain facial expressions might be interpreted as judgmental (eg, raising eyebrows, head shaking), which may cause patients to be less willing to share concerns or listen to advice or guidance.

  5. Keep in mind that patients’ confusion or misperceptions about vaccine information might be related to health literacy and comprehension issues. Provide patients with verbal and written information in plain language that highlights the most important points they need to know. Gauge their understanding of information using a method such as teach-back.

  6. Use a presumptive approach rather than a participatory approach when communicating with patients about vaccines. A presumptive approach assumes that patients are planning to accept your vaccine recommendation. A research study found the presumptive approach effective in addressing other types of vaccine hesitancy, such as with parents of paediatric patients. However, this approach is not meant to coerce patients into getting a vaccine. Each patient is different, and providers should determine which communication approach is appropriate.

  7. Have honest conversations with patients regarding the benefits and risks of vaccination, including potential side effects and adverse outcomes. Let patients know that all vaccines carry risks, but the decision not to get vaccinated also has risks. Give patients rational guidance for weighing risks versus benefits.

  8. Encourage patients to ask questions and be prepared to answer them. Patients will undoubtedly have numerous questions about vaccine development, safety, efficacy, side effects, immunity, and more. Understanding their concerns and providing information in a way that they can understand will help patients make informed decisions about their care.

For further information about the UK’s vaccination programme, please visit the GOV.UK COVID-19 vaccination programme. UK vaccine policy can be found in the online publication commonly referred to as the “Green Book”. This can be found on the Immunisation page of the GOV.UK website.

This document does not constitute legal or medical advice and should not be construed as rules or establishing a standard of care. Because the facts applicable to your situation may vary, please contact your solicitor, legal advisor or other professional advisors if you have any questions related to your legal or medical obligations or rights, applicable law, contract interpretation, or other legal questions. © 2021 Premium Medical Protection Ltd. All rights reserved.

 

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