A message from Dr. Helena Swinkels, FNHA Office of the Chief Medical Officer
If you have friends or family who, although eligible for the COVID-19 vaccine, are postponing or refusing it, you are likely concerned for them – and perhaps a bit frustrated as well. This is understandable. Nobody wants to see their loved ones at risk of contracting a serious illness, potentially infecting others in their circles who may be more vulnerable. And most of us know by now that to stop this virus from spreading, almost all of the population needs to choose to get fully vaccinated (two doses).
If you hope to support your friends/family to gain confidence in vaccines and to get vaccinated for their own health, as well as others', it is important to be aware that there really are valid reasons for their hesitation. We need to approach any discussion about vaccination hesitancy tactfully, respectfully and supportively, with understanding and compassion. We also need to be positive! Honey is always more effective than vinegar, as the old saying goes – and in this case, good information, delivered respectfully, is the honey!
Following are some of the reasons some people are “vaccine hesitant," with corresponding ways to respond appropriately and effectively – and help promote “vaccine confidence."
Consider the possible reasons for vaccine hesitancy
First, as COVID-19 vaccines are new vaccines, some hesitancy is natural. Patients who have no problem getting regular flu shots may not have confidence in the COVID-19 vaccines. It might be helpful to note that as COVID-19 is a new problem, a new solution was necessary.
What's more, we've heard directly from some First Nations people in BC that their COVID-19 vaccine hesitancy is due to the colonial legacy of systemic racism, medical experimentation and mistreatment. This is absolutely understandable and must be respected. As Margo Greenwood (Cree ancestry) at the National Collaborating Centre for Indigenous Health said in a recent Globe & Mail article, “Acknowledging and supporting Indigenous peoples' right to self-determination – the right to choose – is a critical step in addressing COVID-19 vaccine mistrust. Indigenous peoples have the right to credible and culturally relevant information in order to make an informed choice. They have the right to question. They have the right to say 'no.' […] All vaccine literatures for Indigenous peoples must draw on the strengths of our cultures and our teachings. They must be co-created rather than imposed. This includes recognizing, celebrating, and drawing on intergenerational relationships and the collective orientations of Indigenous cultures. In this spirit, many Indigenous Elders and leaders from across the country have endorsed the COVID-19 vaccine as a means to protect our grandchildren and children, our families, and ultimately our communities."
This is exactly the approach we have been taking and will continue to take at the FNHA. We have been featuring Elders, leaders and community members as “VaxChamps" on social media. We hope to help everyone to see the vaccines as we do, i.e., as good medicine that complements our traditional medicines and ways of achieving and maintaining health and wellness. The FNHA's First Nations Perspective of Wellness, which was developed in partnership with BC First Nations, includes making use of the best of both worlds, i.e., traditional Indigenous approaches, and Western biomedical approaches. (Some call this blending “Two-Eyed Seeing.")
Another reason expressed for COVID-19 vaccine hesitancy is the perception that the vaccine development and approval appeared rushed. If this is the issue, you can share expert resources (such as this one) explaining that COVID-19 vaccines are built on decades of vaccine research, that all safety measures were in place through development and approval, or that agencies who approve vaccines prioritized review of these vaccines to get them to us as soon as possible due to the urgency of the pandemic.
Other people simply have a fear of needles they may be embarrassed to talk about, or are worried about having to take time off from work in the event they are one of the few unlucky ones who has more side effects in the days after the shot. In these cases, helping them to talk to a trusted doctor, community health nurse, or pharmacist about options to make sure the injection is painless (yes, it can be done!) or to problem solve about how to manage side effects can help.
And of course, some (but remember, not all!) vaccine hesitancy is a result of the misinformation and conspiracy theories that spread like wildfire through social media. This misinformation includes non-experts' inaccurate opinions about how the virus is probably a lower risk than the vaccine, how COVID-19 is no worse than a flu, and so on. Help them find well-informed resources from experts they DO trust – such as the FNHA website or other Indigenous or local community organizations.
Respond respectfully and supportively to help promote vaccine confidence
Be respectful. Regardless of the reason for vaccine hesitancy, it is important to be respectful and patient if you want people to be open to your encouragement that they get vaccinated.
Really listen! To help people change their minds about the COVID-19 vaccine, you will need to listen to their concerns and be empathetic – not judgmental. Remember, honey, not vinegar!
Be specific. Look into their specific concerns if you don't have the answers, and provide them with good sources of plain-language information. For example, a pregnant friend or family member may be swayed by information from the Society of Obstetricians and Gynaecologists of Canada that pregnant women who get COVID-19 are as likely to be hospitalized as seniors 65 and up.
Provide practical assistance. Determine if there are things holding the person back from getting vaccinated. Perhaps they need free babysitting, help booking a vaccination appointment online, or a drive to a vaccination clinic. If they're concerned about being sidelined by side effects, help them plan for the injection so any side effects do not impact work or other important events.
Download this information in PDF format here.