In her work as a clinical psychologist in Washington, D.C., Victoria Sylos-Labini, PsyD, encounters a lot of people—both patients and coworkers—who are not yet vaccinated. Some are worried about the vaccines’ safety or are ashamed to ask questions about vaccines in such a highly polarized political environment. Others see going unvaccinated as a core part of their political identities. And some are members of racial and ethnic groups, such as Black Americans, with historic reasons to distrust the federal government’s intentions.
Sylos-Labini has successfully changed some minds. The key, she said, is to meet people where they are and encourage them to make an informed decision for themselves. And psychologists are ideally situated to do that, she said, since they can draw on the relationship of trust they have with their patients to engage in respectful, nonjudgmental dialogue.
But talking with patients about their vaccine hesitancy does require some special skills. That’s why in August, D.C. Health mandated that psychologists and other health care professionals in the city complete two hours of continuing education about vaccines from a list of approved resources (PDF, 113KB) to help them feel more comfortable recommending vaccination to their patients. Sylos-Labini, who is president of the D.C. Psychological Association (DCPA), went further: After completing her two hours, she created a more updated, psychologist-centered continuing education program covering the latest research on vaccine safety and efficacy, disparities and inequities, and motivational interviewing techniques to help other D.C. psychologists fulfill the requirement. Although DCPA doesn’t expect APA approval to offer continuing education credit to those who watch a taped version of the webinar until mid-October, the “COVID-19 Vaccine: Overview and Clinical Considerations for Healthcare Providers” webinar will be available for free to anyone at DCPA’s Facebook page and Twitter channel.
When you’re faced with an unvaccinated patient, try these recommendations from Sylos-Labini and other psychologists:
Help change social norms
Model appropriate behavior by wearing a mask and maintaining physical distance if you’re seeing patients in person, said Jay Van Bavel, PhD, an associate professor of psychology and neural science at New York University, who helped craft a “Guide to COVID-19 vaccine communications: A practitioner’s guide to the principles of COVID-19 vaccine communications” (PDF, 302KB) put out by the University of Florida’s Center for Public Interest Communications. But also educate people about what community norms are by sharing local vaccination rates, he said. “One of the things that predicts vaccination is when people think a lot of other people are vaccinated,” he said. “People don’t feel alone if everyone else is doing it.” And because health care providers are patients’ most trusted source of health information, added Sylos-Labini, mention that you are vaccinated and explain your own decision-making process.
Help depoliticize vaccination
Avoid rhetoric about identity as you talk with patients, suggested Van Bavel. Instead, he said, find leaders within the group that the patient identifies with who have done the right thing. If the patient supports former president Donald Trump, for example, point out that Trump has been vaccinated. If the patient’s hesitancy is tied to their Christian identity, point to Francis Collins, MD, PhD, who is not just head of the National Institutes of Health but a prominent Christian. For communities of color, highlighting that trusted, relatable community leaders have been vaccinated can help normalize vaccination and increase confidence in the vaccine, said Sylos-Labini.
Don’t make assumptions
You may think you know why a patient isn’t vaccinated yet, but you need to delve into their real motivations, said Lisa K. Fazio, PhD, an associate professor of psychology and human development at Vanderbilt University. “Some small minority have strong philosophical reasons to be against the vaccine,” said Fazio, who also contributed to the University of Florida’s guide. “But there are more people than we think who just haven’t gotten around to it yet or who are still in wait-and-see mode.” People in those groups may just need help coming up with a practical plan, such as getting the shot on Thursday after work, she said, adding that research has found that kind of strategy effective in get-out-the-vote efforts.
Skip the scare tactics
“Research has found that fear and shame aren’t that helpful in terms of motivating people,” Fazio said. “But connecting on shared values and care for others can be really useful.” Instead of messages about the danger of serious illness or death, emphasize core values, such as how getting vaccinated helps ensure that patients can protect their unvaccinated children and others and help ensure hospitals don’t run out of beds for people who have had heart attacks or car accidents.
Watch your boundaries
You should educate yourself about COVID-19 basics, such as how the vaccines were developed and the latest guidance from the U.S. Centers for Disease Control and Prevention. You should also steer your patients away from social media as a source of vaccine information and point them to reputable sources. But avoid giving medical advice, Sylos-Labini said. It’s appropriate to inform patients about the benefits of vaccines and address misinformation, she said, but nitty-gritty medical questions—especially about particular medical conditions—are beyond a psychologist’s expertise.