Talking to Patients about the COVID Vaccine
When I admit a patient to the acute rehabilitation hospital, after asking them about the history of their stroke or brain injury, confirming their past medical history, reviewing their allergies, and then asking them some social questions about their life, I finally come to the delicate question: “Have you had the COVID vaccine?”
The range of answers is fascinating to me, not only as a physician, but also as a social scientist. Why do people make the choices they make? What is their motivation and is there a pattern to their choices?
Some will say quickly, “Oh yes, Dr. Brooke, I’ve had my 2 shots and I can’t wait for the booster. Can you give it to me while I’m here?” These are often patients who have known someone infected with COVID, or even had it themselves and don’t want a repeat infection as they clearly remember their own suffering.
Then there’s the group that responds with something like, “Well, actually I haven’t had the vaccine as I wasn’t sure it was safe due to my medical issues.” These patients are eager to learn more and want the vaccine as long as the feel reassured the benefit outweighs any risk. I’ve actually had several patients decide to get the vaccine after giving them more information.
There’s also a group of patients that haven't got the vaccination because they are loners. They tell me they stay at home, never go out, and aren’t worried if they get the infection themselves, even if it killed them. I will usually then ask “Do you go to the store to get groceries?” “Do you fill up your car with gas?” “Do you visit your elderly parents?” After they respond yes, I explain the potential harm that could come to their family if they inadvertently give the infection to one of their loved ones who may not survive. This often is the information that will change their choice.
Then there’s the true anti-vaxxers, those who aren’t just hesitant about the vaccine, but strongly against the vaccine for a variety of reasons. One patient I admitted told me “I won’t get the vaccine because the government is paying people to get them, and I don’t trust the government.” Another told me “I have good friends that are scientists and virologists, and they have given me the inside story. The vaccines are dangerous.” And yet another patient told me that there were microchips in the vaccine and there was no way she was letting the government put a chip into her.
In the beginning of this third surge, I would get upset with this last group of patients, feel irritated, and after admitting them to the hospital would bitch to my colleagues about their "ridiculous" beliefs. But something recently has shifted in me, in part because of some great information I received from a friend, who forwarded the result of a from a small focus group designed to understand why people were vaccine hesitant or resistant. The five facts that helped those on the fence choose to get the vaccine were:
1. The risks of infection are vastly higher than the risks of vaccination.
2. COVID vaccines don’t stay in your body.
3. Nearly every doctor who was offered a vaccine got one as soon as possible.
4. The more people get vaccinated the faster we can return to a more normal life, back to our jobs, and back to a working economy.
5. Vaccinations could save at least 100,000 lives of Americans who would otherwise be killed by COVID.
This information was helpful because it changed the focus of my conversations with patients who are against the vaccine. I sincerely ask them with open curiosity why they don't want the vaccine, then I just objectively give them the facts associated with their reasons, without any expectations. I’m not sure that I have changed anyone’s mind yet, though the last patient that countered every scientific fact I gave him with a counter argument, did say he would talk about it with his regular physician when he got out of the hospital. I realized that I had compassion for this patient, and that it was real. I told him that due to his medical issues I was concerned that he would not survive the infection or would become disabled if he did survive.
This is part of the surrendering I discussed in my last post. I cannot stop the pandemic, I may not be able to change anyone’s belief about the vaccine, but I can do my part to educate in a non-judgmental and loving way. The rest is up to the Universe or God or whatever force greater than us that is somehow involved in the process. I have faith there will be Holy Fallout, a term that Hafiz the Sufi poet writes about in his lovely poem.
There Could Be Holy Fallout
We are often in battle,
So often defending every side of the fort,
It may seem, all alone.
Sit down, my dear,
Take a few deep breathes,
Think about a loyal friend.
Where is your music,
Your pet, your brush?
Surely one who has lasted as long as you
Knows some avenue or place inside
That can give a sweet respite.
If you cannot slay your panic,
Then say within
As convincingly as you can,
“It is all God’s will!”
Now pick up your life again.
Let whatever is out there
Come charging in.
Laugh and spit into the air,
There could be holy fallout.
Throw those ladders like tiny match sticks
With “just” phantoms upon them
Who might be trying to scale your heart.
Your love has an eloquent tone.
The sky and I want to hear it!
If you still feel helpless
Give our battle cry again,
Has shouted it a myriad times,
“It is all,
It is all the Beloved’s will!”
What is that luminous rain I see
All around you in the future
Sweeping in from the east plain?
It looks like, O it looks like
Filling your mouth and palms