Patient concerns and physician strategies for addressing COVID-19 vaccine hesitancy

Abstract

Objective: COVID-19 vaccination is critical for reducing serious illness and hospitalizations, yet many remain hesitant. We conducted a survey of frontline physicians to identify patient concerns and physician strategies to address COVID-19 vaccine-hesitancy.

Methods: A national random sample of physicians in frontline specialties selected from a comprehensive list of practicing physicians in the U.S. were emailed a survey in August 2021. Multiple choice and open-ended questions inquired about patient concerns related to the COVID-19 vaccines and strategies used by physicians to counter vaccine misinformation and encourage vaccine-hesitant patients. Weighting was applied to achieve representativeness and reduce non-response bias. Network analysis examined co-occurring patient concerns. Open-ended responses on communication strategies were coded via thematic analysis. Multi-variable logistic regression examined associations between physician and pandemic characteristics with patient concerns and use of communication strategies.

Results: 531 physicians responded: primary care (241); emergency medicine (142); critical care (84); hospitalists (34); and infectious disease (30). Weighted response balance statistics showed excellent balance between respondents and nonrespondents. On average, physicians reported four patient vaccine concerns. Safety, side effects, vaccine misinformation, and mistrust in government were most common, and often co-occurring. 297 physicians described communication strategies: 180 (61 %) provided vaccine education and 94 (32 %) created a safe space for vaccine discussion. Narrative responses from physicians provided compelling examples of both successes and communication challenges arising from misinformation. Compared with emergency medicine, critical care (OR 2.45, 95 % CI 1.14, 5.24), infectious disease (OR 2.45, 95 % CI 1.00, 6.02), and primary care physicians (OR 1.66, 95 % CI 1.02, 2.70) were more likely to provide communication strategies.

Conclusions: Many physicians engage with vaccine hesitant patients using a variety of strategies. Dissemination of effective system and physician-level communication interventions could enhance physician success.

Keywords: COVID-19 Vaccines; COVID-19/prevention and control; Health Communication; Health Promotion; Patient Education; Physician’s Role; Vaccine Hesitancy.