By Margaret Ben-Or, MPH, and Evan Benjamin, MD, MS, FACP
Even as the Centers for Disease Control and Prevention (CDC) eases COVID-19 restrictions, we still have work to do to bring the pandemic under control. Troubling statistics about the reluctance to get vaccinated among certain U.S. population groups could threaten to derail progress and prolong the pandemic.
These population groups include individuals across race, geography, gender, and political affiliation — and their questions and concerns vary as well. No single message or public figure will reach everyone. Some people have formed opinions based on poorly informed sources even before talking with their health care provider. We believe primary care and other health care providers are the right messengers who can individually deliver evidence-based information with conversations that emphasize empathy, credibility, and clarity.
Ariadne Labs, a joint center for health systems innovation at Brigham and Women’s Hospital and Harvard’s T.H. Chan School of Public Health, has developed the COVID-19 Vaccine Confidence Toolkit to support primary care teams and other medical providers in having these conversations. The toolkit was developed after careful research, direct feedback from health care providers and patients, and by listening to the concerns of the people it is designed to reach. It is designed to help health care providers and practices to have respectful and science-based conversations with patients.
The contents of the COVID-19 Vaccine Confidence Toolkit: overview information, a conversation guide, suggested language, and a patient-facing handout.
Available from a free download, the toolkit contains a step-by-step conversation guide for health care teams and a patient-oriented handout on the vaccine that addresses common concerns and questions. Primary care providers and practices are well-positioned to promote equitable vaccine information and to reach those individuals and populations who may still feel unsure about receiving the vaccine. Three-quarters of American adults have a primary care provider, including Latino (64%), Black (71%), and Asian (74%) Americans. Primary care teams have established relationships with patients, are trusted professionals, and provide care across the lifespan. They have existing vaccination processes, having collectively delivered nearly half of all U.S. vaccinations in 2017, and patients prefer to receive their medical advice and COVID-19 vaccination from their own doctor’s office.
Second, the conversation guide in the toolkit draws on principles of motivational interviewing, allowing patients to express their concerns and ask their questions and and then receive evidence-based information that is delivered in terms that are easy to understand. The goal is to be empathetic and not shame people for feeling unsure.
…Patients [can] express their concerns and ask their questions…The goal is to be empathetic and not shame people for feeling unsure.
While the questions and concerns will vary, the important messages to convey are:
> COVID-19 vaccines work
The vaccines protect you very well against the worst effects of COVID-19. If you get the vaccine, you are very unlikely to need hospital care or die from COVID-19.
> COVID-19 vaccines are safe
COVID-19 vaccines can’t make you sick with COVID-19. Some people may have flu-like reactions after getting the vaccine. These reactions are normal and mean that the vaccine is helping your body build protection against COVID-19. Serious reactions to the vaccine are very rare (about 1 in a million). Allergic reactions are also very rare. Just in case, you will be watched for 15–30 minutes after receiving the vaccine, and the CDC continues to check on people who get the vaccine.
> COVID-19 vaccines are backed by science
Medical experts have worked on the science behind the COVID-19 vaccines for many years. Experts built on this science to make the COVID-19 vaccines quickly. Governments gave more money than usual for vaccine research. The FDA’s process for approval was rigorous and based on the same key data points (efficacy, safety) as other vaccine approvals. Though vaccine acceptance does vary even among health care workers, most have received the COVID-19 vaccine. They trust the vaccine to protect themselves, their families, and their patients.
By providing a framework to have these conversations, we hope the COVID-19 Vaccine Confidence Toolkit will help health care providers and teams listen to patients and guide their decision-making with equity, empathy, and evidence.
Evan Benjamin, MD, MS, FACP, is the Chief Medical Officer at Ariadne Labs, an Associate Professor of Medicine at Harvard Medical School, and an Associate Professor of Health Policy and Management at the Harvard T.H. Chan School of Public Health.
Margaret Ben-Or, MPH, Ariadne Labs Project and Business Development Manager, helped lead the team creating the COVID-19 Vaccine Confidence Toolkit.