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Healthy Hesitancy and COVID Vaccines: A Call to Action

Cleveland Francis, Jr., MD

Disclosures

July 09, 2021

Currently, approximately 55% of the US population is not fully vaccinated against COVID-19 and vaccine hesitancy remains a significant barrier. Lack of trust in institutions such as pharma, health systems, and government is pervasive. Conspiratorial as well as frank political motivations promote misinformation and anti-vaccination stances. Solutions to these types of hesitancy are challenging.

But for some, hesitancy reflects a healthy skepticism that is amenable to targeted interventions. I call this "healthy hesitancy." These people have not yet decided to be vaccinated but, importantly, they remain open-minded. I believe that they can be persuaded through trusted relationships and that an aggressive campaign to reach them would be the most productive use of our time.

As clinicians, we see patients demonstrating healthy hesitancy about many aspects of medicine every day. We don't dismiss them or shame them. Instead, we listen and encourage, and we give them time and information to make a decision. In my 40-plus years of cardiology practice, I have seen many patients who are anxious and resistant to having an invasive, risky procedure while they "feel fine." Vaccination hesitancy is similar because we are asking people with no symptoms or illness to subject themselves to an injection with a foreign substance and trust that it will benefit them.

Meeting people where they are with cultural, ethnic, and racial sensitivity is key to fostering decision-making, particularly for scary, but needed treatments. I have found that patients don't require perfection. They understand if I don't have complete answers to all of their questions. When they believe that I am being honest and care about them, and that I would recommend the same procedure for myself and my family under the same circumstances, they are comfortable engaging in shared decision-making.

We are in hand-to-hand combat with the virus, and it will take heart-to-heart communication between us and our patients to resolve. I worked with the Inova Health System to develop short, scripted messages in 15 different languages. Here are some examples in English and Spanish and one targeted to pregnant women. Feel free to copy and use.

I encourage you to talk to your healthy-hesitant patients and let me know how you get on.

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About Dr Cleve Francis
Cleve Francis, MD, is a staff cardiologist with the Inova Heart and Vascular Institute (IHVI) in Northern Virginia. He is former president and founder of Mount Vernon Cardiology Associates, co-chairman of the IHVI Antiracism/Equality Taskforce, diversity advisor of IHVI, and a member of the Inova Inclusion Counsel.

Dr Francis is also a songwriter and performer. He is a former recording artist on the Capitol Nashville Country Music Label (1992-1995), and his music has been featured at the National Museum of African American History and Culture in Washington, DC.

Connect with him:
Website: clevefrancis.com
Twitter: @muzicdoc2
Facebook: Cleve Francis
Instagram: @muzidoc

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