Conversations to Understand and Overcome Vaccine Hesitancy


August is National Immunization Month. With the FDA’s approval of the Pfizer-BioNTech COVID-19 vaccine, providers will likely be having more conversations with patients on the topic. Motivational interviewing is an emerging strategy for providers to consider in their conversations with patients who are reluctant to get the vaccine.

With all the news regarding COVID-19 vaccines over the last few weeks, it is easy to forget about the fact that August is National Immunization Awareness Month. The awareness campaign around this was designed to aid in both encouraging routine childhood vaccinations and also address other vaccines including the importance of getting an annual influenza shot.

With the public health focus mainly on COVID-19, there have been reports of the pandemic negatively affecting other routine vaccines being administered.

"Amid overwhelmed US healthcare systems and fears of contracting COVID-19, routine vaccination rates declined significantly across all populations in the US, with demand plummeting as much as 95 percent for certain vaccines,” the National Foundation for Infectious Diseases wrote on their website. “These declines are dangerous to public health—the US can no longer delay life-saving vaccines and must address the concerning decline in vaccination rates.”

Certainly, providers will be expected to have new conversations or even reengage in conversations with patients on the COVID-19 vaccine and this might be an opportunity to have additional conversations with parents and families around vaccines in general. These conversations can be challenging, especially if patients have preconceived notions of the vaccines, have received misinformation, or have general anxiety associated with needles or adverse effects.

Listed below are some resources providers can use as potential guidance to aid in their conversations.

One potential strategy for clinicians to consider is a technique called motivational interviewing (MI). According to the Motivational Interviewing Network of Trainers (MINT), MI is an evidence-based approach to behavior change. For those patients who might be vaccine hesitant, this is an opportunity to probe why they have reservations and offer science-based information to them.

Within the New York-based Montefiore Health System, providers have been having conversations with patients and the community using a model called, Bridging Research, Accurate Information and Dialogue about COVID Vaccine to the Community (BRAID-CVC).

Damara Gutnick, MD, senior director, Office of Community and Population Health, Montefiore Health System; and associate professor, Epidemiology and Population Health, of Family and Social Medicine and of Psychiatry and Behavioral Science, Albert Einstein College of Medicine, and her team has been utilizing the BRAID-CVC model. The BRAID-CVC technique employs MI to help understand people’s concerns about vaccines, proactively probe people for all their questions, and to help remove doubts by providing information about the vaccines.

Contagion spoke to Gutnick about the importance of National Immunization Month, why we are still struggling with vaccine rates, and further insights into how Montefiore uses its BRAID-CVC technique.

Vaccine Conversation Resources

Here is a handbook for motivational interviewing for the vaccine hesitant.

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