When clinicians and patients disagree on vaccination: what primary care clinicians can learn from COVID-19-vaccine-hesitant patients about communication, trust, and relationships in healthcare

BMC Prim Care. 2024 Dec 5;25(1):412. doi: 10.1186/s12875-024-02665-1.

Abstract

Background: In the United States, discourse on COVID-19 vaccination has become polarized, and the positions of public health officials are met with skepticism by many vaccine-hesitant Americans. This polarization may impact future vaccination efforts as well as clinician-patient relationships.

Methods: We interviewed 77 vaccine-hesitant patients and 41 clinicians about COVID-19 vaccination communication in primary care as part of a Veterans Affairs (VA) trial evaluating a vaccine-communication intervention. This paper reports the findings of a qualitative analysis focused on one aspect of those interviews-the disconnect between primary care clinicians' and patients' perceptions about COVID-19 vaccination communication and decision-making.

Results: Rapid qualitative analysis of semi-structured interviews revealed fundamental differences in how clinicians and patients understood and described the reasoning, values, and concerns underlying COVID-19 vaccine hesitancy. These differences were significant and value-laden; they included negative judgments that could undermine communication between clinicians and patients and, over time, erode trust and empathy.

Conclusion: We advocate for empathic listening and suggest communication strategies to bridge the divide between clinicians and vaccine-hesitant patients.

Keywords: COVID-19 vaccination; Healthcare communication; Healthcare relationships; Motivational interviewing; Trust; Vaccine hesitancy.

MeSH terms

  • Adult
  • Aged
  • COVID-19 Vaccines* / administration & dosage
  • COVID-19 Vaccines* / therapeutic use
  • COVID-19* / prevention & control
  • COVID-19* / psychology
  • Communication*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Physician-Patient Relations*
  • Physicians, Primary Care / psychology
  • Primary Health Care*
  • Qualitative Research
  • SARS-CoV-2 / immunology
  • Trust* / psychology
  • United States / epidemiology
  • Vaccination / psychology
  • Vaccination Hesitancy* / psychology

Substances

  • COVID-19 Vaccines