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How COVID-19 Pandemic Impacted Patient Understanding of Vaccination


The COVID-19 pandemic has influenced patient perception regarding many aspects of vaccination safety and efficacy.

James Lewis, PharmD, FIDSA:COVID-19 has probably had more of an impact on vaccine discussion than anything I’ve seen in my 20-plus-year career in infectious diseases. It has been a blessing and a curse. It has been a blessing in that it brought the mRNA [messenger RNA] vaccine technologies forward much more rapidly than they would have been. Frankly, those technologies had been lagging. They should have been here a lot sooner than they were. There are a litany of reasons why they weren’t, but safety and efficacy were never the issues. Now mRNA vaccines have made a light-year jump with the COVID-19 vaccines. We’ve seen how good they are.

The downside of the COVID-19 pandemic is that everyone in the United States thinks they’re a virologist thanks to Dr Google. But we all know that by on the internet and social media, you get fed things that you agree with. If you type “reasons the COVID-19 vaccine is evil” on the internet, you’re going to get results that support that viewpoint. We have a country of individuals who run to the internet and social media to have their views reinforced. Anybody can post anything on the internet., and we’ve seen that in dealing with patients. I’ve never seen anything like some of the pushback we’ve received as health care providers [since the start of] the pandemic. It has been mind-blowing.

There was always a good chunk that was a little nervous about vaccines. Now you’ve got that group that isn’t just a little nervous—they went to the internet and basically split. They said, “I think it’s OK, but I’m a little nervous,” and had that confirmed. Or they said, “I don’t know if I want a vaccine,” and had that confirmed by the internet. The middle ground was an easy sell, to put it bluntly. With a good honest conversation with a health care provider, those folks usually end up getting vaccinated. Now individuals are coming with a lot more preformed opinions. We’re going to have to work a lot harder to get anyone who’s vaccine hesitant to jump now because they’ve had their views reinforced over the last 3 years. If you look at vaccination numbers nationally, since the pandemic [started], there are some scary things going on. Our influenza vaccination numbers this year plummeted. Some of it is vaccine fatigue—individuals are tired of hearing about it. But also individuals have had opinions crystallized on social media or the internet. Unfortunately, those opinions have sometimes been crystallized with bad information.

For organizations to move the needle, the messaging has to be consistent, omnipresent, and honest. Going back to the discussion we had earlier about which age group struggles, the real reason the pediatric group struggles the least is because education is everywhere, the expectation is everywhere, and the reminders are everywhere. That’s where we have to get with the rest of the population to see numbers comparable with what we’ve seen in the pediatric space. The other thing is that health care providers have to be equipped to have these conversations. Unfortunately, patients are coming in with much more solidly formed opinions, and health care providers have to be prepared to deal with some of those opinions. A lot of health care provider organizations are going to have to do a much better job providing readily available, clear, concise education materials to their members so they have the best chance at successfully interacting with patients in this space. On the adult side, we don’t do that terribly well. That an area that we could be a lot better at, like my 2 doctor’s visits yesterday where nobody mentioned Shingrix [vaccine for the prevention of shingles]. There are a lot of things we can do better on the adult side.

Transcript edite for clarity.

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