With a large percentage of the U.S. population unsure whether they will get vaccinated against COVID-19, rheumatology patients remain vulnerable. On May 13, the ACR hosted a virtual town hall highlighting ways rheumatology providers might effectively approach their patients who have not yet decided to get a COVID-19 vaccine.
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Kimberly Dylan Manning, MD, FACP, FAAP, a professor of medicine and the associate vice chair of diversity, equity and inclusion at Emory University School of Medicine, Atlanta, gave the meeting’s initial presentation. Following her talk, she and the moderators fielded questions submitted by ACR members.
Get the Slow Yes
At the outset, Dr. Manning expressed her dislike of the term vaccine hesitancy. She prefers the term deliberation, the act of thinking and deciding carefully about something, which she believes imparts more power to both patients and providers. As she pointed out, we all face choices in our lives—buying a car, perhaps—that require time and information to reach a final decision. Different people need different information to be comfortable making big decisions.
Repeatedly, Dr. Manning emphasized the importance of going back to basics to build rapport and trust between patient and physician. “What kind of therapeutic alliance have you worked at to make sure that [your patient] wants to say yes to you?” she asked. Body language and inviting intonation are key, as are respectfully listening to patients and showing you have heard them. “It’s a lot of the things that we learned as medical students, which we may forget as we get very busy,” she added.
From attentive listening, clinicians can gain valuable information they can use to influence their patients over time. Eventually, some patients will slowly turn from a no toward a yes. “That’s one of the most encouraging things,” said Dr. Manning. “Depending on who you are, your deliberation process might require a little bit more. Just keep planting that seed [with patients].”
Not all patients have the same questions about, or knowledge of, COVID-19 vaccination. Asking patients about their specific concerns and considerations allows clinicians to tailor the response to the patient. Dr. Manning underscored the value of giving tailored information to patients to aid them in their deliberation.
For example, a patient may bring up a concern about how quickly the vaccine was created. It’s helpful to acknowledge and validate the concern. Then a clinician may provide specific reassuring context—explaining how researchers had been studying other coronaviruses for years and that work on mRNA vaccines is not new.