Vaccine Hesitancy: Swaying the ‘Movable Middle’ to Acceptance

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Primary care physicians (PCPs) can be key players in the movement to building confidence in the COVID-19 vaccine, according to panelists at a Bipartisan Policy Center (BPC) and GTMRx Institute webinar.

Since last November, CVS Caremark has surveyed thousands of Americans about their intentions regarding the COVID vaccine, explained Sree Chaguturu, MD, CVS Caremark chief medical officer, noting that 45% combined said that they definitely would, or definitely would not, get the vaccine, while 55% considered themselves to be in the “movable middle.”

But as vaccine efforts advanced, vaccine hesitancy began to drop off, according to Chaguturu, and “Hearing the messages around vaccines from trusted clinicians [is] critically important.”

At the Tuesday webinar, Chaguturu discussed the ways CVS Caremark is bringing PCPs on board, starting with a training program to answer patient questions about the vaccine. Additionally, CVS Caremark plans to develop offsite vaccination centers as supply expands, and to partner with ride-sharing organizations to increase vaccine access, he said.

Chaguturu emphasized that the “network effect” — knowing others who have received the vaccine and that it was “safe” and “efficacious” — can also be a strong factor in vaccine uptake.

Lisa Fitzpatrick, MD, MPH, MPA, founder and CEO of Grapevine Health, and other panelists supported “place-based approaches” to reduce vaccine hesitancy, such as working with churches and other community partners. For instance, the church is a “powerful influencer” in the Black community, although many of the “movable middle” aren’t influenced by churches, she stated.

As a result, it will be important to identify other influencers, Fitzpatrick said, and it will be critical to “take the vaccines and the education” to those vaccine-hesitant groups. “We have a last-mile problem now,” she said.

While PCPs can act as “trusted messengers” to promote vaccination, the message needs to be uniform. Fitzpatrick said she was caught off-guard during a question-and-answer session with patients, when one said his doctor had advised him not to get the COVID-19 vaccine. “‘Why should I believe you over my doctor?'” she recalled the patient asking.

She stressed that the public health community should not assume that all providers will understand the research: “Sometimes, some of us need a little bit more help and more support” with vaccine education.

As for communicating with patients, Fitzpatrick pointed out that not all patients understand terms like “antibody” and “immunity,” so it’s important to use metaphors and other “relatable examples” to explain these concepts.

“It’s possible to be scientifically credible and also speak in plain language, so that people understand what we’re saying, because otherwise we’re just leaving them behind,” she said.

Donald Berwick, MD, MPP, former CMS administrator and founder of the Institute for Healthcare Improvement, emphasized that “trust is everything… trust in science … trust in accumulated experience, and trust in the helpers.”

Bill Frist, MD, former Senate majority leader and a senior BPC fellow, noted that the largest divide among those who are vaccine hesitant, and those who aren’t, is a political one.

A recent Kaiser Family Foundation poll found Republicans and white evangelical Christians are the most likely to say that they definitely will not get the vaccine.

Frist called for removing the “political undertones” in conversations around vaccines in order to increase trust.

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    Shannon Firth has been reporting on health policy as MedPage Today’s Washington correspondent since 2014. She is also a member of the site’s Enterprise & Investigative Reporting team. Follow

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