It's Vaccine Time! How to Agree to Disagree in Healthcare

It's Vaccine Time! How to Agree to Disagree in Healthcare
Lisa Mathis MSN, FNP-BC

Fall is descending upon us; the leaves are turning a beautiful mix of orange and yellow. Big hairy legged spiders are spinning their ornate webs on front porches. Halloween décor is popping up on every corner, setting the tone for this fun season. But with those good things, other ominous beings lurk in the darkness. (No I am not speaking of vampires and zombies) I am talking about those seasonal viruses that haunt us yearly. Colds, Influenza, RSV and now the new norm, COVID.

“While the burden of flu can vary, each year flu places a substantial strain on the health of people in the United States each year. CDC estimate ranges for flu by year are 9.3 million – 41 million illnesses, 100,000 – 710,000 hospitalizations and 4,900 – 51,000 deaths annually between 2010 and 2023. (1)”

It is time to discuss with your patients’ their yearly vaccines. (Scarier than a zombie at times). Whether it is the mom with her baby, toddler, or the 65-year-old COPD patient the conversation can be difficult. Vaccines are the staple of prevention that we must use against these monsters that torment us every year.

However, with today’s social media and the trauma of the pandemic, more and more people are refusing vaccinations for various reasons. What caused this? Who is to blame? Is it the increased number of autism cases? (The fear of many parents). Is it the media coverage? Many people say, “ I saw on the news….or I read on the internet….”

As healthcare providers some of us get very upset and offended when a mom refuses to vaccinate their child, or when a 65-year-old COPD patient refuses the flu and Covid vaccine. Many providers have refused to see unvaccinated patients. Let’s think about that… is that morally /ethically acceptable? Do you stop seeing patients that still smoke? Do you refuse a patient who continues to abuse drugs? Do you refuse the end-stage cirrhosis patient that still drinks vodka daily? You see there is really no difference in these situations. As healthcare providers our job is to provide healthcare not judgment. We should be a safe place for the mom, the dad and the elderly to tell us their fears and reservations. Instead of being “judgmental” be understanding and try an open dialogue to determine the causes of their anxiety. If they refuse because they don’t want four vaccines at one time… just split them up. If they read something untrue… show them factual data. No need to eye roll, fire the patient or lecture them. You get the idea…

Despite your best efforts some will refuse. Overall, in the US children are vaccinated well. DPT is at 80.4%, Polio 92.5%, Hib 80%, Hep B 91.4 % Varicella 90.3%, PCV 81.4%, (2)

However, in adults in 2018 only 34% had the Shingles vaccine. Regarding the COVID vaccine 81% received 1 dose. Thereafter the numbers dropped for consecutive shots. On average in past years 49.4%-51.4% of the population gets the influenza vaccine.

So, what do you do when the patient says “NO”? The best way is to understand their “why”. Some patients will never change, their perception is their reality. Your job is to explain the risks and benefits and move on. Educate them on what to do if they become ill.

Some patients you can educate and come to a compromise, as stated above, i.e. breaking the vaccine schedule up. Due to the public perception of COVID, some patients will never want that vaccine, do you get mad and give up? NO! Try to talk about the other vaccines, like RSV and Flu.

As healthcare providers we are like a priest, people come to us when they need help, not judgment. Be that safe space for your patient and you may be surprised how many will change their opinions when they trust you. Let’s make this season not so scary!

“Sometimes people don’t want to hear the truth because they don’t want their illusions destroyed.”- Friedrich Nietzsche

See below for the latest guidelines in 2024-25

https://www.cdc.gov/vaccines/hcp/imz-schedules/adult-schedule-vaccines.html

1:https://www.cbc.govflu-burdenphp>about

2: Health, United states 2020-2021,Table Vax Ch