One at a Time: Encouraging Vaccination in Communities

When ACOG and SMFM came out with recommendations for COVID-19 vaccination of pregnant people, our practice was all over it. We posted flyers in exam rooms and committed to speaking with every patient at every visit about vaccination. Our maternal-fetal medicine service had admitted too many critically ill patients, had a maternal death, and delivered too many premature babies because of COVID-19. We made it a mission and a practice to talk with every patient about the vaccine.

Many patients were vaccinated as soon as they were able, including our pregnant colleagues in health care and some of our patient population. Other patients were firmly against vaccination, and their reasons started to sound familiar: “I’ve done my own research,” or “I don’t like vaccines.” Many patients wanted the vaccine but felt it was too risky for their babies, not wanting to potentially cause harm through a vaccine they viewed as new and untested with little known about long-term effects.

We would listen, then try to convince them as clinicians by describing the devastation we were seeing in our critical care units, our ICUs, and our NICUs as mothers and their babies suffered from this unpredictable disease—but our warnings were often written off as fearmongering. Patients would say, “I don’t want to talk about it anymore, and please put it in my chart not to ask me about it again.” We try to explain the science and the importance of the protection: the vaccine development, the safety profile, the effectiveness, and the untested effects of treatments being used for severe COVID-19. We were often met with disbelief, with incredulity, and with suspicion.

We had little success changing firmly set views, but if someone was ambivalent or simply “waiting for the right time,” we found that we could have a real impact. One of my colleagues worked with a woman who had become critically ill from COVID-19 and been lucky enough to recover; she became an advocate for vaccination within her community and insisted that her family and friends be vaccinated. Another colleague had success telling her patients that a vaccine is like giving your body the weapons it needs to fight a battle against a virus: just as you wouldn’t send an army to fight an unknown opponent without appropriate weapons, you wouldn’t expect your body to fight off a new virus without training and the most effective tool—in this case, the vaccine.

It is possible to open minds—even those with firmly held beliefs—to the idea of vaccination. It takes time, trust, and the support of community. We will keep trying—one at a time.

 Susan Bryar, NP, is a women's health nurse practitioner at Obstetrix Medical Group in Issaquah, WA.

Disclaimer: The thoughts and opinions in the Frontline Voices initiative reflect experiences of individual ACOG members and do not represent official organizational opinions of ACOG.