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‘Are You Vaccinated?’ Should Be a New Vital Sign, Doctors Say

June 10, 2021, 9:36 AM

Doctors should ask all patients if they’ve gotten a Covid-19 vaccine as a routine practice and use easy-to-understand, nonpolitical messaging about why they should get the shot, industry professionals say.

“I would encourage every physician to make it a vital sign,” Brian C. Castrucci, president and CEO of the de Beaumont Foundation, said during an American Medical Association webinar on debunking Covid-19 vaccine misinformation.

“If their patients reply, ‘Not yet, but I want to get it,’ make sure they have information for how to get it. If they say no, make sure to give them the facts,” he said.

More than 60% of U.S. adults have gotten at least one dose of the Covid-19 vaccine and those rates could soon reach 70% in the next couple months. Yet fewer unvaccinated people are eager to get their first shot, according to research from the Kaiser Family Foundation.

Getting vaccinated also means people are most protected from different Covid-19 variants, according to Megan Srinivas, infectious disease physician and translational health policy researcher at the University of North Carolina.

Local physicians typically live in the community they serve so they are able to tailor their messaging to the people in their community more easily. People are more likely to listen to facts from apolitical sources and people they trust, like their doctors, faith leaders, and peers, Castrucci said.

“Messaging needs to be simple, relatable, and repeatable. Get a good script together, know what you want to say and stay away from complicated messaging,” he said.

“You could say: ‘Wear your seat belt in a car. It’s not because you know you’re going to get in an accident. You do it to make sure that if you get in an accident, you’re protected.’ The vaccine is the same thing. If you were to get Covid, it keeps you safe.”

Like Making a Pizza

The quick development of the Covid-19 vaccine is a major source of confusion. Many people hesitant to get vaccinated credit their wariness to the shot being created too quickly, Srinivas said.

That’s a misunderstanding. The shots created by Moderna Inc. and Pfizer Inc. use technology that’s been in development for more than two decades.

Moderna and Pfizer’s shots use a messenger RNA platform, or mRNA, which instructs cells in the body to make proteins that fight off or prevent disease.

“This is not new technology. We’ve used it to develop the flu and other vaccines. We know how it works. When the pandemic hit, we were already hitting the ground running,” Srinivas said.

Industry professionals are struggling with how to simplify explaining the vaccine approval process to patients.

Typically, vaccines can take a decade or more to become available to the general public. The Covid-19 vaccines took less than a year, with stages of development and testing running concurrently.

“I talk about ordering a pizza,” Srinivas said.

“When I order two pizzas, it takes longer if they make the first pizza and then go on to make the second pizza. But when they overlap that process and are able to make them simultaneously, either because they have another worker with them or they’re able to do them at the same time, you have all the pizzas done in 10 minutes instead of 20. And that’s what the FDA, the CDC, and private industries did. They worked together to make their pizzas (or vaccines) more quickly.”

Castrucci said it more succinctly. “We didn’t cut corners. We cut red tape.”

The best way to talk to patients about the vaccine is to encourage them to ask questions, make sure they understand that it’s natural to have concerns about something new, said Susan Bailey, AMA president and immunologist from Fort Worth, Texas.

Avoid terms that alienate people, such as “anti-vaxxer” or “vaccine hesitant,” Srinivas said. “It puts a label in your mind as a confrontational relationship instead of a relationship where we can discuss concerns and get to a similar point because we have similar values to build upon.”

One of the best ways to combat vaccine hesitancy among the larger population, is to change the language around which we address it, Srinivas says. Guidelines from the Public Health Communications Collaborative recommend phrases such as: “A safe and effective vaccine” and “Keep your family safe; keep those most vulnerable safe.”

Misinformation

Physicians should fight the desire to combat misinformation on social media platforms. It takes away from the main message—getting a vaccine saves lives.

Debunking conspiracy theories online actually brings that information forward so more people can view it, according to Castrucci. The best way to handle harmful information on social media is to ignore it.

When patients bring wrong information to their appointments, Castrucci said doctors need to stick to the facts and also point to the downside of not getting the jab. “We need to explicitly say how devastating it is to get Covid-19.”

Those who are concerned about the vaccine and buy into conspiracy theories about it may be harder to reach on social media because the correct factual information isn’t on their timeline. According to Lu Tang, a health communications professor at Texas A&M University, most of what people see on social media is what they agree with.

“To combat misinformation about Covid and to persuade more people to get the vaccine we really need to think about where these people are coming from. Is it the rational kind of uncertainty about a new medicine or is it political bias towards the vaccine?” Tang said.

“The second half is probably more difficult to persuade and so we cannot use the same message to persuade different people.”

They need to feel like it’s their choice. If wary people feel like they’re being pressured, “the message will just backfire and make them believe the conspiracy theory even more,” she said.

Make It a Social Norm

Not all people are rational. It isn’t enough to use science and fact when it comes to persuading people to get the vaccine.

“We are all social animals, we want to fit in, and we want people to like us. So if we can create a social norm, like if we were in high school, to persuade people to get it without having to persuade them scientifically, we’ll get people vaccinated,” Tang said.

Tang believes that appealing to the part of them that wants to help others might work.

There are some people you just can’t reach, but we still have to try, Tang said.

“We need to make sure we keep these conversations about health. There’s a very fine line between having a health conversation and having a political conversation. The second people think you’re trying to persuade or manipulate, it becomes a conversation about liberty and government overreach,” Castrucci said.

“We want people to know that this is their decision. We have to do everything that we can to depoliticize the conversation. By politicizing a public health crisis, you delay the end of it.”

The message becomes simpler as more people get their shots. “Tens of thousands of people have received this vaccine and it will help you get back to what you want to be doing. It’s the path back to normalcy,” he said.

To contact the reporter on this story: Lesley Torres in San Francisco, CA at ltorres@bloombergindustry.com

To contact the editors responsible for this story: Fawn Johnson at fjohnson@bloombergindustry.com; Alexis Kramer at akramer@bloomberglaw.com

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