Mind the Brain: Vaccine Hesitancy in the Time of COVID-19Dec 8, 2020
In our second episode of the new season, we discuss why some Americans may be hesitant to get COVID-19 vaccines and strategies for effectively addressing concerns related to new vaccines. It is critical that there is high acceptance of the vaccines, given that 70% of the population must receive the vaccination in order to reach herd immunity.
Dr. Neill Epperson discusses these various barriers to participation in an insightful conversation with Dr. Chad Morris. A professor of Psychiatry at the University of Colorado Anschutz Medical Campus, Dr. Morris also serves as the director of the Behavioral Health & Wellness Program and the co-director of the interdisciplinary Wellness Leadership Institute. The Behavior Health & Wellness Program is a whole-health program that works across the United States to serve at-risk populations including communities of color, the socioeconomically disadvantaged, individuals with psychiatric illness, those in the criminal justice system and the LGBTQ population among others. The program has spent over 15 years researching and developing various evidence-based guidelines for healthcare and public health agencies to facilitate health systems change that supports wellness practices as a standard of care. The program focuses heavily on research and data collection to ensure that wellness practices are tailored to the unique needs of health disparity populations.
The COVID-19 Vaccines are Almost Ready, but are the People Ready to get Vaccinated?
Epperson and Morris start their conversation by confronting the doubt that has been cast on science from the onset of this pandemic. Political polarization has created mass resistance to and/or failure to adopt non-pharmaceutical COVID-19 prevention interventions, like wearing face masks and social distancing.
Additionally, the fast, wide, and uncontrollable spread of fabricated data claiming that childhood vaccinations can cause autism has had a significant impact on the number of individuals who trust vaccines.
Although Morris acknowledges that we can’t be sure what will happen, if scientifically unfounded information continues to be spread and accepted as truth, he believes that diminished participation in COVID-19 vaccination could be a real threat—and a major obstacle to reaching herd immunity.
Confronting Systemic Inequality and Historical Abuse
“Historically, unfortunately, those most in need of vaccines are often the least likely to either have access to them or accept them, due to a variety of factors,” Morris explains.
Morris states that data from previous vaccination efforts (influenza, SARS, etc.), shows that those who need vaccinations most- such as communities of color and those living in poverty——are the least likely to get them. He points out that a gap in access to and/or trust in healthcare systems is glaring – as evidenced by the hugely disproportionate impact that COVID-19 has had on at-risk communities.
He also identifies mistrust of vaccinations, specifically in the African American population, resulting from governmental abuses such as the Tuskegee Study which happened from 1930-1972. The combination of reduced access and (understandably) reduced trust in government recommended care creates a sizeable barrier to the success of vaccination efforts.
How Can We Reduce Vaccination Confusion and Resistance in the Average American?
So what can be done from, a behavioral health perspective, to clear up the confusion and resistance that the average person feels when considering whether to get vaccinated? Morris answers that trust is the primary factor needed to make people comfortable with getting vaccinated. Healthcare providers and community leaders alike need to be honest with and non-judgmental of individuals who express their concerns about the vaccine.
They must honest, for example, by acknowledging the COVID-19 vaccination long-term affect data that is -- and will remain – unknown until more time has passed. They must also be non-judgmental of ambivalence or distrust; and individuals won’t be receptive to the opinion or informational offered by healthcare professionals or others who they feel is judging them or questioning the integrity of their values.
The tool Morris recommends to facilitate these open, honest, and safe conversations is motivational interviewing. Motivational interviewing is a counseling method that helps people resolve ambivalent feelings and insecurities to find the internal motivation they need to change their behavior. It is a practical, empathetic, and short-term process that takes into consideration how difficult it is to make life changes.
Epperson asks how providers and community leaders can reconcile the desire to persuade individuals to get vaccinated with the fact that Motivational Interviewing is, by definition, not used to persuade or force an opinion.
Morris explains that while there is of course a desired outcome from the motivational interviewing process, it is patience with the process of behavior change that should be focused upon, given that the primary goal of motivational interviewing is to create a safe space for exploration and learning during times of change or difficult decision making.
Morris’ final message: “The bottom line is, vaccines don’t save lives, vaccinations save lives. So until people come in and roll up their sleeves and get that vaccination, we haven’t done our jobs.”
Listen to the episode: Dr. Neill Epperson and Dr. Chad Morris Discuss Vaccine Hesitancy in the Time of COVID-19
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