March 18, 2021

by Dr. Justin Cole

The sprint to develop vaccines effective at preventing COVID-19 infection and its subsequent complications is unprecedented in modern medicine. Presently, three companies have been granted emergency use authorization from the FDA for their COVID-19 vaccines: Pfizer/BioNTech, Moderna, and, most recently, Johnson & Johnson. More vaccine candidates continue to progress through the pipeline. As of today, millions of Americans have received at least one dose of a COVID-19 vaccine, and nearly 12% of the U.S. population has been fully vaccinated against COVID-19.

As the COVID-19 vaccines increase in availability in the United States, one significant factor affecting uptake in the U.S. and around the world is something called vaccine hesitancy. Recent studies suggest that 30-40% of Americans are unlikely to receive the vaccine. Even when accounting for those who have immunity from contracting COVID-19, this would mean that we may not reach a vaccination rate of 70% or more required to provide herd immunity in the U.S., which is when enough people become immune to a disease to make its spread unlikely.

Factors that may lead a person to express hesitancy about vaccines fall into one of three categories: confidence, complacency, and convenience.
Recently, Dr. Aleda Chen from the Cedarville University School of Pharmacy joined us on the DISRxUPT podcast to discuss the topic of vaccine hesitancy, the potential impact on COVID-19 vaccination uptake, and patient-centered communication that values personal choice and explores health beliefs collaboratively. She is an expert in the social administrative sciences and has a strong background in patient-centered communication approaches in healthcare.

Health Beliefs as the Foundation for Decisions About Vaccines

The World Health Organization defines vaccine hesitancy as “a delay in acceptance or refusal of vaccines despite availability of vaccine services.” Chen says that the most important factor affecting our health decisions, including whether or not to receive a vaccine, is our health beliefs. These health beliefs are formed through a complex interplay of a person’s background, experiences, convictions, and beliefs. This forms our idea of what causes a change in our health status, how susceptible we may be to a health risk such as COVID-19, the perceptions of the severity of any illness, and what we can do to control our health. Additionally, the model recognizes that health is much more than physical. As human beings, health is a state of well-being that includes our bodies, our minds, our spirits, and our relationships.

According to Chen, factors that may lead a person to express hesitancy about vaccines fall into one of three categories: confidence, complacency, and convenience. These can range from beliefs about the safety or efficacy of vaccines, one’s personal experience with vaccines or the healthcare system, and cultural views on the perceived benefits and risks of vaccination. These health beliefs about vaccines can also be influenced by race, ethnicity, political views, and social media, among many others.

Providing Information Compassionately and Honoring Personal Choice

The autonomy of each person to make decisions about their own treatment is something that healthcare providers have an ethical responsibility to uphold. According to Dr. Chen, “We want freedom to make our decisions. We have control over our own bodies to a certain extent, and I recognize the value of each person’s ability and need to make their own decisions.” Stemming from this desire, Chen believes that patient-centered communication strategies, such as motivational interviewing, value this ethical commitment, allow healthcare providers to demonstrate empathy, and provide an opportunity for dialog between the provider and patient. Preliminary data suggest that this may be an effective way to encourage vaccine confidence while honoring the person’s ability to make an informed decision.

Please take a moment to listen to this insightful conversation with Dr. Aleda Chen on the latest episode of DISRxUPT, which was recorded with a live audience over Zoom.

Dr. Justin Cole is the Director of the Center for Pharmacy Innovation. He also serves as Associate Professor and Chair of Pharmacy Practice in the Cedarville University School of Pharmacy. Dr. Cole’s interests include pediatrics, behavioral health, healthcare leadership, and pharmacy practice advancement.

The Cedarville University School of Pharmacy is equipping its Doctor of Pharmacy students to be on the leading edge of healthcare innovation. Cedarville’s Pharm.D. students are fully prepared to begin a rewarding career as a pharmacist and to use their calling to make a difference for Christ as they serve with excellence and compassion.

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