Skip to content

COVID-19 vaccine hesitancy


Vaccine hesitancy has become a significant health concern, and is defined by the World Health Organization as “a delay in acceptance or refusal of vaccination despite availability of vaccination services”

Vaccine hesitancy is a complex issue, and its causes are unique to each individual.

While vaccine hesitancy has been an ongoing public health issue for years, the rapid development of vaccines in response to the COVID-19 pandemic has exacerbated the issue.

A survey by Fisher et al. in September 2020 revealed 11% of people in the United States plan to decline the COVID-19 vaccine, with another 32% of people undecided if they’d accept the vaccine.

With such a large percentage of the population being hesitant to vaccination, it’s imperative healthcare providers initiate and maintain an open dialog about vaccination with patients.

Patients are often willing to have a discussion about vaccination, even if they are hesitant to receive a vaccine.

When beginning a dialog on vaccines with patients, always ensure you frame the discussion in a positive, non-confrontational light.

Be respectful and truly understand the person’s perspective. Do they feel worried? Do they feel suspicious?

These are legitimate feelings that warrant a conversation about safety and the process of how vaccines get made and evaluated before they’re given to patients.

Even if the patient decides not to be vaccinated, it is important to maintain a strong healthcare provider-patient relationship so that you can continue to engage them over time.

The more opportunities you have to engage them, the more likely a skeptical patient may be to change their mind and decide to become vaccinated.

Patients are the ultimate decision makers on whether they’ll be vaccinated or not.

Your role as a healthcare provider is to be a resource to them.

Reinforcing this with the patient will help build trust and a strong clinician-patient relationship.

Highlight that both of you have shared goals, to do what is best for them, and acknowledge that there is an enormous amount of difficult to understand information around vaccines.

Let the patient know you want them to be able to make an informed decision.

Offer to help them find the best information on vaccines, and that you are available to answer any questions they might have.

As soon as possible, try to establish how knowledgeable the patient is on COVID-19 and the vaccines, as well as how strong their beliefs are regarding vaccination generally.

Knowing if a patient has strong opposition to vaccination early on will help you make decisions on how to navigate your conversation with them in order to maintain a good relationship with the patient.

Avoid making presumptuous statements, that limit what a patient can say in response, such as “Would you like me to schedule you for a COVID-19 vaccine?” or “Have you received your COVID-19 vaccine yet?”

Instead focus on more participatory dialog, and use open-ended prompts, such as “What are your thoughts on the COVID-19 vaccination rollout?” or “How do you feel about the COVID-19 vaccines?”.

Both the American Academy of Pediatrics and the World Health Organization have sample scripts healthcare providers may find helpful as they prepare to initiate dialogues with their patients.

When talking about vaccines, avoid referring to complicated statistics or using complicated terms unless the patient specifically asks for clarification.

Instead focus on the key information and broad takeaways.

You want to keep the message clear and concise to patients, but also answer specific questions they have.

When possible, personalize information to patients, explaining how information affects them specifically based on their health history.

For example, patients who are thinking about becoming pregnant, or who are currently taking immunosuppressive medications may wonder if they should take the new COVID-19 vaccines.

Contextualizing information like vaccine risks is also important.