October 12, 2021

'An uphill battle': Even as boosters roll out, doctors struggle with vaccine outreach fatigue

Daily Briefing

    More than half of the U.S. population is fully vaccinated against Covid-19—but some health care providers are saying that campaigns for booster shots are making it more difficult for them to convince people who remain unvaccinated to get their shots, Jan Hoffman reports for the New York Times.

    Radio Advisory episode: The unanswered vaccine questions you should be tracking

    'I just don't know what else I can do'

    According to CDC, 56.4% of the U.S. population is fully vaccinated, including 67.8% of adults and 84% of those ages 65 and older. And while more people have been getting their first shots amid vaccine mandates and concern over the spread of the delta variant, a sizable portion of the population remains staunchly opposed to vaccination.

    "This vaccine has tested me like nothing before and I've been doing this for 40 years," Gary Wiltz, director of the community health center in Franklin, La., said. "I can't tell you how many people we've tried to cajole into taking it."

    "One day we just hit a wall," Steven Furr, a family medicine practitioner in Jackson, Ala., said. "We had vaccinated everybody who wanted to be vaccinated and there was nobody left."

    As a result, some health care providers have said they've experienced "outreach fatigue" while trying to convince the unvaccinated to get their shots, Hoffman reports.

    "I just don't know what else I can do," Wiltz said. "Some people you just can't convince, and you have to accept the way it's going to be."

    How booster shots are affecting unvaccinated people's views on vaccines

    Polling has found that some unvaccinated people are expressing concern about nationwide vaccine booster campaigns. A poll from the Kaiser Family Foundation in September found 71% of unvaccinated respondents said the need for booster shots showed the vaccines weren't working.

    Christopher Poe, a 47-year-old manufacturing plant worker in Lima, Ohio, is one of those unvaccinated people who are concerned about the need for booster shots.

    "It seems like such a short time and people are already having to get boosters," he said. "And the fact that they didn't realize that earlier in the rollout shows me that there could be other questions that could be out there, like the long-term effects."

    Evidence shows, however, that the approved coronavirus vaccines are extremely safe and far less risky than contracting Covid-19.

    While providers are trying to encourage booster shots to those eligible, many have found it difficult to defend the need for boosters to those still needing their first shot, Hoffman reports.

    "Between boosters and the unvaccinated, it's now really two different types of campaigns," Jennifer Avegno, director of the New Orleans health department, said.

    And the burden of persuading the unvaccinated has commonly fallen to primary care providers, Hoffman reports. David Priest, an infectious disease specialist at Novant Health, said he's had many discussions with patients regarding Covid-19 vaccines.

    "You have to overcommunicate to an incredible degree," he said, "because we still get questions on things that I think, 'This was well-known 18 months ago.' But that's where people are, so you just have to keep answering that question and answering it and answering it."

    It's also extremely important for doctors to have vaccines on hand for patients, Priest added. "So when the patient finally says, 'I think I'll do it,' we can seal the deal. Because if you don’t have the shots in your clinic right then, people get in their car, get busy with other errands, forget, or change their mind," he said.

    Alison Buttenheim, a behavioral health expert at the University of Pennsylvania, said that while primary care providers have been extremely important in getting people vaccinated, "it definitely raises the question of what happens to people who don't have a usual source of care."

    Still, many health care providers have said they're exhausted from trying to persuade unvaccinated people to get their shots, even as they're treating sick patients who refused to get vaccinated, Hoffman reports.

    "It is an uphill battle," Uzma Syed, an infectious disease specialist in New York, said. "I can't say that these conversations don’t come with tremendous burnout. But you keep going in hopes that you reach even one person to change their mind, because that's a life saved." (Hoffman, New York Times, 10/12)

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