Understand how healthcare professionals can stimulate vaccine adoption



Fisher KA Science Symposium. SPS2. ATS Promotes Adult Immunization Initiative: Immune Boost! Addressing vaccine hesitancy and the vaccine-preventable disease landscape. Presented at: American Thoracic Society International Conference; May 19-24, 2023; Washington DC

Fisher reports that it funded the work from NIHMD, the National Library of Medicine and UMass Chan Medical School Center of Clinical and Translational Science.

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Key points:

  • Vaccine hesitancy can be addressed with medical recommendations tailored to a patient’s individual level of hesitancy.
  • Unvaccinated people want unbiased information about vaccines from providers.

WASHINGTON — There are multiple ways to promote vaccination, and provider-patient communication is an important component of addressing vaccine hesitancy, according to a presentation at the American Thoracic Society international conference.

“[There are] different levers to increase vaccination, which can really map to different levels in the healthcare ecosystem, with vaccine requirements at the health policy level, onsite availability of vaccines in physician offices at the healthcare system level, and then all the way up to the importance of operator-patient communication” Kimberly A. Fisher, MD, MSc, associate professor of pulmonary and critical care medicine at UMass Chan Medical School, he said during the presentation.

Quote from Kimberly A. Fisher

In an experimental vignette-based survey, Fisher and colleagues evaluated 756 people in January 2021 who reported being unsure or unplanned to receive the COVID-19 vaccine to determine whether a health care provider’s messages about vaccination have an impact. positive about a patient’s intention to be vaccinated.

People who took part in this survey were asked to fit into a hypothetical scenario, Fisher said.

“In this group [of vaccine-hesitant individuals]we asked [them] imagine they were visiting their doctor for a regular checkup,” Fisher said. “At the end of the appointment, the doctor said we have the COVID-19 vaccine available, you are eligible to get it. It is very safe and very At this point, participants were randomly assigned to receive one of five different additional messages from their health care provider, then we reassessed their vaccination intent.

According to Fisher, each of the four persuasive messages were written to touch on COVID-19 vaccine concerns: “I have carefully reviewed the studies,” “This vaccine is as safe as the flu shot and is MORE effective,” “Millions of people l ‘have already got’ and ‘It’s the best way to protect the people you’re close to.’ After each message was the statement “I recommend you take it”, as well as “What do you think?”

In assessing how many participants became less vaccine hesitant, Fisher and colleagues found that the influence of different messages did not differ significantly within the “unsafe” group; however, they found that the message “It’s the best way to protect the people you’re close to and keep them healthy” led to a significant increase (P = .03) in intending to get vaccinated in the group that said they had no intention of getting the COVID-19 vaccine.

“I think these findings really support … the need for communication tailored to the degree of hesitancy, and also suggest that a prosocial message might be one of the more effective messages among more hesitant individuals,” Fisher said.

Learning patient, provider concerns

In addition to this survey study, Fisher was involved in a focus group study, in which 35 COVID-19 vaccine hesitant people shared their thoughts about communicating with their provider.

Before presenting these patient responses, Fisher said healthcare professionals should keep several things in mind when talking to patients who are hesitant about the vaccine based on what they heard from patients in this study, including that they are skeptical of information related to the COVID-19 vaccine, have difficulty navigating information that conflicts with other information, and may feel stigmatized for their unvaccinated status.

Fisher said: “One person said, ‘There’s a lot of shame. It’s all over social media. People are very hateful to people who are not vaccinated.’”

In terms of what unvaccinated patients want from their providers when discussing vaccines with them, three main wishes have emerged. Fisher said these patients want detailed, unbiased information, don’t want to feel like they’re being “force-fed” information, and want to be heard and understood.

To hear from both the patient and provider sides, 40 primary care physicians participated in focus groups, in which Fisher said four common experiences were brought up when thinking about how they communicate with patients who are hesitant to get vaccinated. In focus groups, PCPs expressed that this patient group does not seem open to information, which in turn caused them to question their reliability, reduce the time spent talking to these patients about vaccines, and feel frustrated.

Other ways to promote vaccination

While recommendations from healthcare professionals play a role in getting people vaccinated, it’s important to understand that there are other ways to promote this action, according to Fisher.

In a survey asking people where they would like to get the COVID-19 vaccine, Fisher and colleagues found that 683 people (42%) said a doctor’s office, including more people with an “unsure” intention of getting to vaccinate, responded with this position with respect to patients with an intent of acceptance. Additionally, more Black individuals preferred to get the vaccine in a doctor’s office than Latino or white individuals, and this was found in both those with acceptance intent and those with hesitant intent.

“We believe the availability of the COVID-19 vaccine in physician offices could be an important lever in increasing adoption among vaccine-hesitant individuals and also members of racial minority groups,” Fisher said.

To conclude his presentation, Fisher shared the preliminary results of a study that sought to understand why 51 people vaccinated after April 2022 chose to get vaccinated. According to Fisher, many of these people were vaccinated because it was necessary to do something, like get a job or travel.

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