When clinicians and patients disagree on vaccination: what primary care clinicians can learn from COVID-19-vaccine-hesitant patients about communication, trust, and relationships in healthcare.

Purcell N, Usman H, Woodruff N, Mehlman H, Tobey-Moore L, Petrakis BA, Oliver KA, Kaplan A, Pyne JM, Manuel JK, DeRonne BM, Bertenthal D, Seal KH. When clinicians and patients disagree on vaccination: what primary care clinicians can learn from COVID-19-vaccine-hesitant patients about communication, trust, and relationships in healthcare. BMC primary care. 2024 Dec 5; 25(1):412.

Related HSR&D Project(s)

• SDR 21-141 – Developing and Testing a COVID-19 Vaccination Acceptance Intervention

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Abstract:

BACKGROUND: In the United States, discourse on COVID-19 vaccination has become polarized, and the positions of public health officials are met with skepticism by many vaccine-hesitant Americans. This polarization may impact future vaccination efforts as well as clinician-patient relationships. METHODS: We interviewed 77 vaccine-hesitant patients and 41 clinicians about COVID-19 vaccination communication in primary care as part of a Veterans Affairs (VA) trial evaluating a vaccine-communication intervention. This paper reports the findings of a qualitative analysis focused on one aspect of those interviews-the disconnect between primary care clinicians' and patients' perceptions about COVID-19 vaccination communication and decision-making. RESULTS: Rapid qualitative analysis of semi-structured interviews revealed fundamental differences in how clinicians and patients understood and described the reasoning, values, and concerns underlying COVID-19 vaccine hesitancy. These differences were significant and value-laden; they included negative judgments that could undermine communication between clinicians and patients and, over time, erode trust and empathy. CONCLUSION: We advocate for empathic listening and suggest communication strategies to bridge the divide between clinicians and vaccine-hesitant patients.