Dr. Michelle Moniz
Title: OB-GYN with University of Michigan Hospitals–Michigan Medicine; assistant professor and health policy expert at University of Michigan
Location: Ann Arbor, Michigan
Many U.S. health care facilities are mandating COVID-19 vaccination for employees to prevent the spread of coronavirus to patients and fellow staff members. But some front-line and support workers in hospitals, long-term care and other settings are reluctant or outright refusing to be vaccinated.
To learn more, Moniz and a team of UM researchers surveyed all employees of the Michigan Medicine health system about vaccine hesitancy. Among the more than 11,000 respondents, the vast majority were in favor of getting the vaccine. However, more than 8% reported they were holding off for the moment, and about 3% of participants said they would never receive the vaccine. (Among U.S. adults overall, up to one-fourth are unvaccinated and do not plan to be vaccinated, according to a recent Gallup poll.)
As told to Lisa Esposito, as part of U.S. News & World Report’s “One Pandemic Question” series. Responses have been edited for length and clarity.
Q: Why are some health care workers hesitant to get the COVID-19 vaccine — and what might help?
When we surveyed our entire health care system back in February, we found that although vaccine acceptance was pretty high overall, there were clearly some folks who were not yet comfortable accepting the vaccine, including some who delayed or refused.
We drilled down to ask why. There was the perception that the vaccine had been developed rapidly. There were concerns about vaccine side effects. Some folks felt like they wouldn’t really be affected by COVID and they didn’t necessarily need the vaccine. And there were many, many concerns that we didn’t yet know enough about the vaccine, that we didn’t yet know enough about COVID.
People were grappling with this uncertainty, with some folks deciding — in the face of that uncertainty — the right answer was to get the vaccine, and some folks deciding the right answer was to wait for more information.
Health care workers are a crucial population to understand because they were the first group to have access to the vaccines as essential front-line workers. You have people from all walks of life working within a health care system: intensive care unit docs, nursing staff, technicians, medical clerks, environmental services, housekeeping, food services, and parking and security staff. So this is an important window into vaccine acceptance in U.S. communities more broadly.
Sometimes public-health messaging focuses on: ‘We want you to do this. You should do this. We recommend this.’ That may not be the most effective form of messaging.
Instead, we need to engage compassionately with folks who have concerns and validate that those concerns are reasonable. And for health care workers especially, I find it helps to emphasize that we can be protectors for our community, for our patients — many of whom are highly vulnerable to acquiring the virus.
I’m an OB-GYN. So I take care of pregnant individuals, who are more likely to become severely ill. I talk with colleagues a lot about our professional responsibility to our community, to the patients that we care for. That tactic, in my experience, has been a much more successful place to find shared values and common ground than ‘ the CDC recommends this.’
What was shocking to me in our survey was that 1 in 5 health care professionals who accepted the vaccine still reported vaccine concerns. I was not expecting that. That really suggests there is a spectrum of beliefs — and that there is an opportunity to help people move along that spectrum. That these are not fixed beliefs; these are mutable.
It also suggests the crucial importance of engaging with people from a place of empathy and not judgement. It’s addressing concerns and helping folks understand the why of the medical advice.
In the survey, folks would tell us: ‘I was initially very reluctant,’ ‘I had concerns about side effects’ or ‘I felt the vaccine had been developed too fast but ultimately I decided to get it because …’
That ‘because’ was often about someone else: ‘Because I care for my elderly mother.’ ‘Because I was concerned I might transmit this to my patients.’ ‘Because I was concerned I would bring this home and wanted to keep my children and my husband safe.’
I’m hopeful that people will become more comfortable with vaccination as we see more and more folks getting it, as we can demonstrate at a population level the benefits of vaccination, where communities with higher vaccination rates are seeing fewer COVID infections — and more importantly, fewer hospitalizations and deaths related to COVID. So, hopefully, the proof will be in the pudding.
It’s a tightrope act that we are performing: to be clear on what the recommendations are and the rationale for why we believe there’s benefit to vaccines, while also engaging from a place of humility and empathy. This cannot be about: You should do this because we told you to do it. That elicits a lot of defensiveness.
The most appropriate course of action with health care workers, based on our study, is to engage with folks coming from a place that validates concerns that there are many unknowns here, and it’s perfectly reasonable to have some uncertainty. And to engage in a way that fosters productive, meaningful conversations that focus on our shared values of keeping our community and loved ones safe.
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With Vaccine-Hesitant Health Care Workers: Try Empathy originally appeared on usnews.com