Tips on How to Approach Conversations with Patients about the COVID-19 Vaccine

Early in the fall, when Ashley Wenaas, MD, an otolaryngologist based in Cypress, Texas, talked to colleagues about the expected availability of vaccines for COVID-19, she heard enthusiasm, but it came with a dash of hesitation.

“People would say, ‘I’m going to get the vaccine, but I’m not going to be the first one,’” Dr. Wenaas said. “‘I’ll be in the second wave. I don’t want to be the guinea pig.’”

She suspected this outlook had to do with a lack of communication on how the vaccine development process works. Recently, as treasurer of the Houston Society of Otolaryngology–Head and Neck Surgery, she helped arrange a virtual meeting with a vaccine expert as a guest speaker, helping to illuminate the process and sparking a productive conversation. Her own eyes were opened as well, she said.

The federal effort to get COVID-19 vaccines to the American population quickly, dubbed Operation Warp Speed, expedited some manufacturing aspects and laid the groundwork for fast distribution. The speaker, Peter Hotez, MD, PhD, dean of the National School of Tropical Medicine at the Baylor College of Medicine in Houston, reassured the 40 attendees that the science aspect of the initiative—the investigation of the vaccines’ safety and efficacy—has followed the usual rigorous process.

Such exchanges of accurate and important information are vital, infectious disease experts and otolaryngologists say, as patients turn to their physicians for information and guidance on the vaccines—especially since conversations like these, when multiplied by the millions, can have profound public health implications in determining how quickly COVID-19 transmission is interrupted.

Still, many physicians are often hesitant to raise the subject of vaccinations. Becoming comfortable raising the topic and having a smart approach with patients who might be skeptical of whether vaccinations for diseases including COVID-19 and HPV are safe and can truly work starts with being armed with the correct information.

COVID-19 Vaccines: Where We Stand

According to the U.S. Department of Health and Human Services (HHS), vaccines generally fall into four categories:

• Live-attenuated (vector) vaccines (MMR, smallpox, chickenpox), which use a weakened form of the germ that causes a disease.
• Inactivated vaccines (hepatitis A, flu shots, rabies), which use the dead version of a disease-causing germ.
• Subunit, recombinant, polysaccharide, and conjugate vaccines (hepatitis B, HPV, shingles), which use specific pieces of the germ, such as a protein, sugar, or capsid, to form the immunity.
• Toxoid vaccines (diphtheria, tetanus), which use a toxin made by a disease-causing germ.

The first two COVID-19 vaccines (as of press time) approved by the FDA are mRNA vaccines that contain material from the SARS-CoV-2 virus that acts as instructions for the body to make the virus’ spike protein, which, by itself, is harmless. Recognizing the protein, the immune system then ramps up and is poised to fight off an actual infection from the virus.