5 common Covid-19 vaccine concerns and how to address them 

By Monica Westhead, Practice Manager

Even before the Covid-19 vaccines received their EUAs, polling data suggested vaccine hesitancy was going to be an obstacle for public health officials to address to achieve the needed 60-80% vaccination threshold experts say the nation must meet to achieve herd immunity. And while some of the health care worker vaccine refusal figures are certainly shocking—especially in long-term care settings—right now this is anecdotal evidence: we do not have official numbers on how many health care workers have and have not been vaccinated. It's also worth noting that many hospitals across the country are reporting near-universal vaccine uptake among frontline workers.

But despite this early uptake, some staff have not opted into vaccination at this time. Whether their hesitation stems from historical medical mistrust or rampant misinformation on social media, leaders need to take an active role in dispelling rumors and encouraging vaccines in the weeks and months to come.

Medical journals have published fairly extensive data on the available vaccines and FDA has publicly shared its data analyses used for the EUAs. But when you have vaccine conversations with staff, you'll want to move beyond this information. Rather, leaders need to really listen and understand staff concerns related to the vaccine. Below, I offer five common concerns and misconceptions related to the Covid-19 vaccine and ways to address them with staff:

1. "Potential side effects, particularly side effects so significant that I could be out of work, and that may put additional burden on my already-strapped coworkers": When talking to your clinicians about potential side effects it's important to acknowledge the risk that comes with taking any drug, but you also need to fully understand what is driving their concern. For some, they may have personal reasons to be wary of a new vaccine, such as a bad experience with a previous flu shot, others may be concerned about short-term side effects temporarily impacting their work and placing a larger burden on their coworkers.

When addressing this concern leaders should reframe the conversation: the latest clinical trial data shows side effects for both the Moderna and Pfizer vaccines were generally mild-to-moderate, and both companies are monitoring instances of any additional and more serious side effects. For instance, one thing to keep an eye on is that eight trial participants who received the vaccine developed appendicitis during the follow-up period, compared to four who received a placebo. Further, regulators in Britain have advised people with a history of allergic reactions not to get the vaccine, based on two reports of anaphylaxis in early vaccine recipients. In the United States, we've seen at least 20 documented cases of allergic reactions to the vaccine. As such, guidance now recommends vaccine recipients be monitored for 15 minutes—and doctors know how to respond if a reaction occurs. 

2. "I'm skeptical of the mRNA vaccines because they are new and largely untested": This may be the toughest one to address because the mRNA vaccines are a relatively new platform and it can be tough to overcome providers who seek more long-term data. As the article above mentions, many hospitals have seen success through example. As such, leaders should consider identifying a "vaccine champion," someone who is well-respected among the staff to get the vaccine and share their experience. Some health care leaders also have tried to incentivize staff to vaccinate early through monetary and food incentives.

3. "History and personal experience have taught me to be cautious of medical institutions." The United States has a history of racist, and at times dangerous, health policies and clinical experiments have targeted particularly vulnerable Black and brown communities. This resulted in a legacy of mistrust in medical institutions, research institutions, and the federal government that lowers people of color's confidence in the safety of the vaccine. While addressing the mistrust of medical institutions should be a priority for leaders, there are additional barriers (e.g., cultural nuances and cost) to accessing care for marginalized groups that will prevent those willing to take the vaccine from receiving it. Leaders must take these concerns into account as they will influence their providers' willingness to take the vaccine. Your best bet is to unpack the nuance behind the vaccine hesitancy, amplify the voices of people of color to ease fears, and disseminate a clear message regarding how marginalized communities can access the vaccine.

4. "I don't need the vaccine because I was infected with Covid-19": The key to addressing this concern is unpacking the why. Some staff may decline the vaccine to allow someone who has no potential immunity to receive it first while others may be citing misinformation. Regardless, it's important to stress that researchers still do not how long natural immunity may last, and therefore, CDC recommends getting the Covid-19 vaccine even if you have already had and recovered from Covid-19.

5. "The vaccine will give me, or my family, Covid-19": Fear of bringing Covid-19 home to loved ones is a very real fear among health care workers. It's one that leaders have been addressing throughout the year by listening to those concerns and doing everything possible (from adequate PPE to finding a safe place for providers to rest) to protect staff. But this is a case where we have medical understanding and you can clearly state the facts. CDC notes that none of the Covid-19 vaccines available in the United States are made with the live virus that causes Covid-19, meaning the vaccine cannot give you Covid-19.

In addition to the above, health care leaders should have a dedicated set of contacts for staff to reach out to if they have additional questions, either about the vaccine or about their own personal circumstances. The important take away though is be an active listener and truly understand why your team may be hesitant to get the vaccine. It's likely that health care workers will set the tone for vaccination rates in the country as we enter the next phase of mass vaccination. That's because one of the most effective ways to address vaccine hesitancy is to see a known or trusted individual safely get the vaccine—and health care providers annually rank among the most trusted professions.

So talk with your staff, provide them the facts as you have them, and work to dispel social media myths or legitimate fears. For tips on how to talk to staff about sensitive Covid-related issues, check out the below articles:

• Want to improve your Covid-19 messaging? Use the 4 communication ‘archetypes.’
• 4 ways to use social media to rebuild patient trust
• 3 ways to shut down the Covid-19 rumor mill