Navigating COVID-19 Vaccine Concerns: How to Counter Misinformation and Hesitancy

Announcer:
You’re listening to VacciNation on ReachMD, and this episode is sponsored by Pfizer. Here’s your host, Dr. Charles Turck.

Dr. Turck:
Welcome to VacciNation on ReachMD. I'm Dr. Charles Turck, and joining me to discuss the ongoing challenge of COVID-19 vaccine misinformation and strategies for addressing it are Drs. Diego Hijano and William Schaffner. Dr. Hijano is an Associate Member of Pediatric Infectious Diseases and the Medical Director of Occupational Health at St. Jude Children's Research Hospital in Memphis. Diego, thanks for being here today.

Dr. Hijano:
Thank you for inviting me.

Dr. Turck: 
And Dr. Schaffner is a Professor of Preventive Medicine in Health Policy, as well as a Professor in the Division of Infectious Diseases at Vanderbilt University in Nashville. Bill, it's great to have you with us.

Dr. Schaffner: 
Good to be with you, Charles and Diego.

Dr. Turck: 
So if we start with you, Bill, would you give us some context on how COVID-19 vaccine misinformation has evolved over time and what the current landscape looks like?

Dr. Schaffner: 
Well, Charles, misinformation took place almost from the beginning, when the vaccine was released, and has continued to be with us. It was a new vaccine technology. It was introduced very quickly, which is something we in public health and infectious diseases thought was wonderful. But there was a concern on the part of the public which we hadn't really anticipated that they thought we perhaps cut corners, particularly with regards to the safety of the vaccine, because, as I said, it was a new technology. And these concerns and all kinds of other fanciful concerns had been associated with the vaccine. There was a period of time where people were concerned that the vaccine might interfere with women's fertility, which is obviously incorrect. I mean, really, very strange things. And the caution regarding the vaccine in a variety of ways, I think, remains with us today. We're going to have to keep working with our patients to get them comfortable with the vaccine and let them know that they have choices regarding COVID vaccination.

Dr. Turck: 
And turning to you now, Diego, what pitfalls do patients face when they're exposed to misinformation, and how can it impact vaccine uptake, particularly in high-risk and historically marginalized populations?

Dr. Hijano: 
Thank you, Charles. So following up on what Bill was saying, these concerns certainly have led to a lot of mistrust from the community when it comes to these vaccines, science in general, and public health, and then the FDA and the CDC. And these mistrusts have really led to a significant decrease of vaccine confidence. And we know that when vaccine confidence decreases, people choose not to get vaccinated and choose not to get their kids vaccinated, and then all vaccination coverage declines. So this is particularly concerning because misinformation can range from just putting a number that is factually true, but in a different context, to flat out lies like Bill was mentioning. And they are very, very well executed and efficient in sort of breaking through the noise and reaching the population. And we haven't been able to counterattack those sort of misinformation posts that have been going on. And certainly the population that lacks access to healthcare or to information in their language or that don't have cultural representation in the health community are the ones that suffer the most.

Dr. Turck: 
For those just joining us, this is VacciNation on ReachMD. I'm Dr. Charles Turck, and I'm speaking with Drs. Diego Hijano and William Schaffner about how we can effectively address misinformation about COVID-19 vaccinations.

So Bill, when it comes to you tackling these misinformation issues, how do you recommend approaching tough conversations with patients without seeming alienating or dismissive?

Dr. Schaffner: 
Charles, it has to be done one patient and one family at a time. And when you're recommending COVID vaccine, if the patient expresses any hesitation, first of all, don't be surprised or look disdainful. You've got to say, “Oh, I get a lot of questions about the vaccine. What's yours, Mr. Smith or Miss Jones?” And then answer that question.

And now, as the behavioral psychologists have told us, information is absolutely critical to changing behavior, but it's often not sufficient. Information goes to the brain. What we try to do is influence how the patients feel about something, and that goes to their heart, so we try to make them feel comfortable and reassured that this is a good thing for them to do, that everyone is doing it, and that we want them to join everyone else. And so I bridge very quickly from the factual response to their concern to saying, “I'm vaccinated. My wife and everybody in my family is vaccinated. So is everybody in this office. We would like to provide that protection for every one of our patients.” You can see I'm trying to make them feel comfortable and make it the social norm. “Everyone's getting vaccinated. Join the crowd.”

Dr. Turck: 
And Diego, what types of tools or take-home resources do you find most helpful in reinforcing key messages for patients after the visit?

Dr. Hijano: 
Thank you, Charles, that's a great question, and I echo Bill's approach that we really need to first understand why those individuals in our office at that time do not want to get the vaccine. There are different concerns that different families have, and we need to listen. And based on that, we can provide resources.

So one resource I use a lot with all my patients is the healthychildren.org. That's the American Academy of Pediatrics’ website for parents. So it's very well curated. It's factual and not affiliated with any government entity, which today seems to be very important for individuals. So obviously, the CDC and the FDA have a lot of really good information, but I found that sometimes families are a little bit concerned about those resources, so the American Academy of Pediatrics remains a very good website.

Dr. Turck: 
And as we come to the end of our program, I'd like to ask each of you to share one key takeaway about addressing misinformation that you'd like to leave with our audience today. Bill, let's start with you.

Dr. Schaffner: 
One patient at a time, and we're not going to be able to convince the patient every single time. Then we say it's all right that they don't receive the vaccine, but “Mr. Jones, the next time I see you, we'll talk about this again,” and say it with a smile. It's a promise, not a threat.

We've known for years that the single most important persuader for the patient to be vaccinated is a strong, empathetic recommendation by the provider. So make that recommendation in a warm and very positive way.

Dr. Turck: 
And Diego, I'll give you the final word.

Dr. Hijano: 
Thank you. So I think the most important thing, as Bill mentioned, is that facts are not enough, and we don't need to remember all the science, we just need to lean on the importance of storytelling. We all got vaccinated. We got kids that got vaccinated, and nieces, nephews, neighbors, and grandparents, and we can lean on those stories to make a compelling argument to our vaccination. I've used the driving through of my daughters for the COVID-19 vaccination when they were teenagers a lot of times to bring people onto the table. So I think that you should lean on the storytelling; you definitely have a story to tell.

Dr. Turck: 
Well, with those important insights in mind. I want to thank my guests, Drs. Diego Hijano and William Schaffner, for joining me to discuss strategies for effective patient communication about the COVID-19 vaccine. Diego, Bill, it was great having you both on the program.

Dr. Hijano:
Thank you so much, Charles.

Dr. Schaffner:
My pleasure.

Announcer:
This episode of VacciNation was sponsored by Pfizer. To access this and other episodes in our series, visit VacciNation on ReachMD.com, where you can Be Part of the Knowledge. Thanks for listening!