Combating vaccine hesitancy among staff: 4 healthcare leaders weigh in

Four leaders told Becker's Hospital Review what their hospitals or health systems are doing to address COVID-19 vaccine hesitancy among their staff — an issue that's affected 29 percent of healthcare workers, according to a Kaiser Family Foundation survey.  

Editor’s note: Responses are presented alphabetically and were lightly edited for length and clarity.

Sandra Brooks, MD. Senior vice president and CMO at Jefferson Health Center City Division (Philadelphia): 

Although approximately 73 percent of 10,000 Jefferson staff responding to a recent survey about the COVID-19 vaccine said they were likely or very likely to receive it, the responses were uneven among some subgroups. In speaking to some of our front-line non-clinical staff, a number of themes arose indicating questions, concerns and misconceptions about the vaccine. To address these concerns, we launched our Real Talk initiative designed to recruit a multiracial, multiethnic, multidisciplinary group of influencers. We trained our influencers to engage in one-on-one and small-group conversations to share factual material and raise awareness about the safety and efficacy of the vaccine.

Since the launch of our Real Talk initiative, we realized that, despite our best efforts, some have not received the print or digital materials we prepared in advance of the vaccine rollout. Through Real Talk, we have been able to provide information specific to employees’ concerns. The initiative also represented an opportunity to communicate our concern for our employees’ well-being. The recruitment of influencers is ongoing. People who have formal and informal influence within our workforce are assisting us so that we may reach as many people as possible.  

It keeps me up at night when I think that while we finally have vaccines that enable us to envision an end to this deadly pandemic, some of our employees from the very communities devastated by this virus are fearful and hesitant. We acknowledge that for some, the hesitancy is based on historical misdeeds related to research and experimentation. We discuss the safeguards, the participation rates of minorities in the studies, and highlight the involvement of lead investigators such as Kizzmekia Corbett, PhD. We are very open about the potential side effects and acknowledge what is not yet known. Whatever we can do to leverage trusted relationships and serve as a bridge to provide factual information in an empathetic way, that is what we aim to do. We want our employees to be able to make an informed decision. We care deeply about our employees and we approach these conversations from a position of care and respect.

Wanda McClain. Vice president of community health and equity at Brigham and Women's Hospital (Boston): 

The hospital has employed several strategies to educate those who may have questions or are hesitant. We have scheduled Q&A sessions – primarily for employees who do not use computers as part of their role – with medical experts to share information and answer all questions about the vaccine. For those unable to make these sessions, managers have been provided key points of information about the vaccine, details on vaccine eligibility and instructions for employees about how to schedule an appointment – both online and in person.

We have also launched an employee ambassador program, recruiting staff that have received the vaccine to speak to their peers about their decision to be vaccinated. To amplify the voices of these employees, we have featured them in our internal communication channels and on our social media platforms. Additionally, we are developing videos in multiple languages, which feature employees sharing information about the vaccine as well as their experiences.

Felipe Osorno. Executive administrator of continuum of care operations and value improvement at Keck Medicine of USC (Los Angeles):

We are making steady progress toward vaccinating our workforce. About 80 percent of our physicians have been vaccinated and approximately 65 percent of our staff have received the vaccine. We are moving ahead with several initiatives to ensure that as many people as possible have the information they need to make informed choices about vaccines. It’s especially important given the current surge in Los Angeles as a large percentage of our staff are Latinx, and they are receiving the vaccine at lower rates than our general population.

Our primary goal is to reach people where they are. That means recognizing and respecting how our staff want to receive information and understanding what type of information they are seeking. Email isn’t the communication medium of choice for many of our staff members, so big email blasts are not getting through to everyone. Instead, we’re trying other options like posters in both English and Spanish with QR codes that link directly to registration. 

We’re using face-to-face interactions, such as meetings in their work areas before and after shifts. Digital communication is very efficient, but it doesn’t replace answering questions in person, in both English and Spanish. Video and social media channels are being used to share the stories of diverse role models from Keck Medicine who explain why they chose to receive the vaccine. We also are developing plans to reach out directly to family members of our environmental services staff who are 65 years and older. We know this is a high-priority group to reach given that we have staff living in multigenerational homes and have had the highest infection and mortality rates in LA County.

The types of information people are looking for is mostly fact-based. Rather than us trying to convince them to get vaccinated, they have fair questions about logistics and how to weigh the risk of not feeling well for a day or two versus the risk of getting a serious case of COVID-19. We’re hearing questions such as, I have or have had COVID-19, when should I get vaccinated? Is there a better vaccine that I should wait for? Will the side effects keep me from coming to work? What happens if I miss work? 

They also want to know how the vaccine works and how we know the vaccine is working. Those questions have required us to be even more informed about the vaccine — a hopeful sign that we’re making progress. As more and more folks are getting vaccinated and our team sees they are doing well, it’s also helping us get more folks excited about their vaccination.

Gopi Patel, MD. Associate professor of infectious diseases and member of the vaccine task force at Mount Sinai Health System (New York City):  

Healthcare personnel are not immune to COVID-19 vaccine hesitancy. Many were thrilled and could not wait to be vaccinated. Others elected to “wait and see” their colleagues be vaccinated first. Reasons for vaccination deferral have changed as we enter week seven of vaccination. Initially concerns regarding safety, accelerated production, and distribution were common. Many staff who are hesitant to be vaccinated are not fundamentally anti-vaccine and uptake is increasing but slower than anticipated.

Frequent virtual town halls, broadcast emails and an up-to-date website with videos and frequently asked questions only gets us so far in addressing deep-rooted concerns about COVID-19 vaccines. Staff does not necessarily have access to these platforms. We need to literally and figuratively meet individuals where they are without judgement. This is an opportunity for us to really listen to our staff and build trust. We need to openly acknowledge and accept that there are reservations, and some are due to disparities that long preceded the offering of a COVID-19 vaccine. Public health agencies and healthcare institutions have a lot more work to do to address the trust deficit in healthcare. Messaging needs to continue to be accurate and tailored, but we need to reconsider the medium and the messenger.

We are encouraging those who have received the COVID-19 vaccine to tell their vaccine story. Are they comfortable leading by example? What information did they need to come to the decision to be vaccinated? Traditional content experts continue to be available for questions when there is a personal health concern. However, peers can be influential for building COVID-19 vaccine confidence among colleagues and their communities. People want to hear from those who look like them who have shared experiences. Leaders must be open and patient and ensure staff knows when they are ready to be vaccinated, institutions are ready to vaccinate them.

More articles on leadership and management:
North Carolina health system CEO apologizes for COVID-19 vaccine sign-up problems
What Dr. Rochelle Walensky said on her first day as CDC director
3 healthcare executive actions expected from Biden this week 


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