Talking with Patients about COVID-19 Vaccination

As a trusted source of health information and healing, your approach to a conversation with patients and families who are hesitant about receiving COVID-19 vaccines can influence their willingness to consider vaccination.

Here are four steps to apply motivational interviewing rapidly (1–5 minutes) during a patient visit.

• Be compassionate, show empathy, and be genuinely curious about the reasons why the patient feels the way they do.
• Be sensitive to culture, family dynamics, and circumstances that may influence how patients view vaccines.
• Remember: Arguing and debating do not work. Taking a strong initial stand may also backfire, especially with people who have concerns about vaccines.

Start by asking permission to discuss vaccines. Say something like, “If it is okay with you, I would like to spend a few minutes talking about COVID-19 vaccines and your family.”

• If the patient says no, respect that.
  • Option 1: Move on and say, “I respect that, and because I care about your overall health, maybe we could talk about the vaccines at a future time.”
  • Option 2: Based on the patient’s demonstrated emotions and your assessment of the patient’s worldview and values, you could spend several minutes curiously exploring why the patient doesn’t want to talk about it. The goal is to understand, not to change their mind.
    Remember: These conversations may take time, and they may continue over multiple visits.

• If the patient says yes to talking about the vaccines, move to Step 3.

• If the patient asks a question about COVID-19 vaccine safety, vaccine risks, or their health or mental health, see potential responses in Step 4.

Ask the patient a scaled question. For example, “On a scale of 1 to 10, how likely are you to get a COVID-19 vaccine?” (1 = never; 10 = already have an appointment to get vaccinated).  Then explore both sides of whatever number is given.

• Example: Let’s assume someone says 4. This is where curiosity comes in. You can say, “Okay, why 4? And why not a lower number?” Let them answer, and ask a follow-up question like, “What would help you move to a 5 or 6?”

The goal is to help the patient become more open to moving toward higher numbers—in other words, getting vaccinated.

• You want them to talk about this out loud because talking actually changes how they process their choices and can develop forward momentum.
• People hesitant about vaccines usually have more practice explaining why they haven’t gotten vaccinated, so it’s good to reverse that. Ask them to express their vaccination benefits out loud.
• Be compassionate and curious about the patient’s mixed feelings, both the part of them that wants to trust that getting a vaccine is important and safe and the other part that feels hesitant. It is important to show support for the patient to incorporate their personal values and the health needs of their family and community as they make their decision.

If a patient asks a question about vaccine safety, vaccine risks, or their health or mental health, respond within the boundaries of your competence, ethics, and scope of practice.

• If you feel competent and aware of how to answer the patient’s question, respond with empathy and provide scientific information as needed. Refer the patient to resources on the CDC website, which are listed below.
• If the patient’s question is outside of your competence or awareness, recommend that they speak with their medical or mental health provider or a knowledgeable expert, as needed.

Content developed by the American Psychological Association (Jared Skillings, PhD, ABPP; Erin Swedish, PhD; Robin McLeod, PhD; Mitch Prinstein, PhD, ABPP; and Stephen Gillaspy, PhD) in partnership with U.S. Centers for Disease Control and Prevention