Facts combat fear

It’s hard to believe the first COVID-19 vaccine was administered in the U.S. only a year and a half ago. Like many others, I welcomed the COVID-19 vaccine as a triumph of global cooperation that leveraged decades of research and a beacon of hope that life could eventually return to normal. Yet I was so surprised the first time a pregnant patient told me she believed the vaccine’s speedy development was proof that vaccine developers were trying to control population growth.

With over 20 years as a practicing OB/GYN and health policy expert, I have focused on patient education and understanding. But traditional methods have not proven effective in countering the fear, uncertainty, and suspicion that we are facing today around the COVID-19 and other vaccines. As one of my patients said, “I don’t want to be an experiment.”

In September 2021, the Centers for Disease Control and Prevention (CDC) issued an urgent health advisory urging COVID-19 vaccination for women planning to become pregnant and those who are pregnant. This recommendation is based on evidence from the V-safe pregnancy registry that deems vaccination safe and effective when administered during pregnancy.

Despite this fulsome scientific endorsement of COVID-19 vaccination in pregnant people, misconceptions about the vaccine still linger and even thrive.

Struggling to unlock “truth.”

I was not completely surprised when 61 percent of physicians recently polled by Sermo said their pregnant patients are hesitant to receive the COVID-19 vaccine. One in three physicians (34 percent) heard from patients that they believe the vaccine can cause infertility.

But it doesn’t stop there. Patients also say they don’t need a vaccine if they’ve already had COVID-19 or that vaccines can modify their DNA. Nearly three in 10 physicians said patients believe getting vaccinated means you’re being injected with a microchip.

Patients have told me they’ve relied on a variety of sources for non-scientific information about COVID-19 and vaccines, including family members, co-workers, neighbors, and others – but the most common sources are online. You may have seen reports that a dozen anti-vaxxers spread two-thirds of online myths about COVID-19 vaccines. Very concerning is that over half of surveyed physicians believe patients expressing COVID-19 vaccine hesitancy may stop getting other vaccines that have long track records of protecting pregnant women and their infants. Parents who are vaccine-hesitant are also reluctant to vaccinate their children.

There’s no doubt we are entering a crisis as false information about COVID-19 gains momentum and impacts general vaccine perceptions. This false information undermines a shared belief in science and the scientific principles that are the foundation of medicine.

Pandemic-related pregnancy risks

We know that pregnant people are at higher risk of developing severe illness from COVID-19 due to physiological changes during pregnancy. When you are pregnant, it can feel like you are trying to breathe with a watermelon in your belly – the lungs cannot expand and contract as efficiently, increasing the risk for pulmonary infections like COVID-19. In fact, pregnant people with COVID-19 symptoms are more than twice as likely to be admitted into intensive care and have a 70 percent increased risk of death compared with non-pregnant symptomatic people.

Let’s close information gaps.

It is well understood that the development of safe and effective vaccination against diseases that cause substantial morbidity and death has been one of the greatest scientific advances of our century. Yet vaccines as a class of preventive medicine don’t typically show clear and immediate results. So, while the science clearly shows that COVID-19 vaccines don’t cause infertility or genetic changes, the evidence that they prevent serious illness and death isn’t making an impact.

Connecting and educating

To turn the tide, I strongly believe we need to meet our patients where they are when it comes to vaccines. Before we can offer the science, we need to ensure we have established a line of communication with our patients predicated on compassion, understanding, and respect. Only then can we counter the false information that is costing lives.

Personal connection drives my COVID-19 patient conversations. As an OB/GYN, I know firsthand about gaining people’s trust. After all, my patients typically encounter me in their most vulnerable state, often complete with stirrups and speculum.

My best patient conversations are ones where:

• I take my patient’s concerns seriously – without ridicule or dismissiveness.
• People who walk into the room feeling judged receive my listening ear.
• Together, we explore the source behind the misconception.
• I make space for people’s unique experiences.
• I try to dissolve uncertainty with science.

I always ask people to tell me what they have heard about a vaccine. What exactly are they fearful of? I really want to understand what they most want to value and protect. I focus on listening and fighting the urge to interrupt to get to those answers. I find that the answers to these questions usually match my own values regarding ensuring they or their baby is safe. Rather than focus on dispelling myths, I center on what my patients value and what they want to preserve.

To maintain critical connections with our patients, we as providers also must remain self-aware. In a pressure-filled profession impacted by administrative burdens, personnel challenges, constantly evolving science, and the needs of our patients, it’s easy to lose sight of the importance of relationships. But studies have shown that when we juggle many cognitive tasks, we tend to become more dismissive and make biased judgments. Focus matters.

Despite tough external circumstances, it’s important to remind ourselves to mentally recalibrate when we’re with our patients. That centering will help us go beyond our own difficulties to reach our patients.

Progress is about human touch.

When people don’t see the benefit of the COVID-19 vaccine, they may be less likely to believe in it. So, we need to rely on our patient relationships to drive trust. We need to hear each other’s differing views. We need to discuss patients’ fears with an open mind and address their concerns with facts.

What we know about COVID-19 will change as new information becomes available. As providers, we have a unique opportunity to help patients get the right fact-based information, help them understand the scientific process, and provide them with trusted sources to rely on in the future. By building that bridge of respect and compassion one conversation at a time, we can strengthen our patient relationships and help ensure that facts win the day.

Joanne Armstrong is an obstetrician-gynecologist and health care executive.

Image credit: Shutterstock.com