May 2021
Vaccine Confidence: Removing Barriers to Getting Shots in Arms Across Illinois
By: Dr. Derek J. Robinson, M.D., MBA, FACEP, CHCQM, Vice President and Chief Medical Officer, Blue Cross and Blue Shield of Illinois (BCBSIL)
In March and April, our free Blue UniversitySM events for providers included two webinars hosted by Dr. Suzanne R. White, M.D., MBA, FACEP, FACMT, a Regional Medical Director employed by Merck & Co. These webinars focused on the following topics: What is Vaccine Confidence? and Implementation Science: A Discussion on Vaccine Process Improvement.
Dr. White presented a wealth of information, with special emphasis on vaccine hesitancy. What’s preventing parents from obtaining recommended childhood vaccinations, what’s preventing individuals in general from getting the COVID-19 vaccine, and what can providers do to help address patient concerns?
As discussed during the webinars, common barriers affecting vaccination decisions may include lack of awareness or questions around safety and efficacy. Additional barriers for some individuals, such as the Medicaid population, may include issues with access to care.
The Centers for Disease Control and Prevention (CDC) website and other resources are available to help educate your patients on vaccine recommendations and related information. However, as Dr. White noted, the most trusted source of vaccine information for many patients is typically their own doctor. So, what can you do to help turn vaccine hesitancy into vaccine confidence?
Dr. White offered some ways to accentuate the positive, like talking about vaccines at every appointment and asking open-ended questions, like “Why is prevention important to you?” She also suggested switching from a “participatory” (“Are we doing some shots today?”) to a “presumptive” (“We have some shots to do today!”) approach. For patients who remain hesitant, Dr. White emphasized validating the patient’s concerns (“You’ve done a lot of thinking about this…”) and then actively listening and summarizing points the patient raised. In this way, the physician and patient can work together toward “change talk” – shifting away from negative perceptions to begin considering vaccines as a safe and sensible option.
Vaccination efforts have achieved uneven success across communities, with some subpopulations lagging behind. Some members may face barriers in getting to the doctor in the first place, such as lack of transportation, childcare, time off from work or health care coverage concerns. Dr. White offered these suggestions:
- Reach out using whatever information is available to identify individuals who may have vaccines due (electronic health records, immunization registries, health plan data, etc.);
- Encourage patients to make appointments for annual wellness visits;
- Remember that every visit is a wellness/vaccination opportunity: If patients come in for an acute problem, check history and promote necessary vaccinations;
- Also take the opportunity to ask about other family members;
- If administering vaccines that are part of a series, make sure to schedule any follow-ups immediately, before the patient leaves the office; and
- Recommend other vaccine locations that may be more convenient for the patient.
BCBSIL is working to help improve vaccine awareness, confidence and accessibility too, especially among underserved neighborhoods hit hardest during the pandemic. For example, we’ve teamed up with an existing community resource – a Federally Qualified Health Center (FQHC) – to increase access to COVID-19 vaccines at two of our Blue Door Neighborhood CenterSM (BDNCSM) locations. The FQHC is scheduling and administering the vaccine on weekends to their patients who reside in our BDNC communities in Chicago’s South Lawndale and Morgan Park neighborhoods. These additional COVID-19 vaccination sites give eligible patients in-neighborhood options to make appointments, receive vaccines and learn about other health education and wellness resources.
What ideas do you have to help promote vaccine confidence? What challenges have you faced, especially regarding the Medicaid population? Please feel free to email us to keep the discussion going on this important topic. Also watch our News and Updates for information on upcoming Blue University events.
Learn more about Dr. Derek J. Robinson
The above material is for informational purposes only and is not a substitute for the independent medical judgment of a physician or other health care provider. Physicians and other health care providers are encouraged to use their own medical judgment based upon all available information and the condition of the patient in determining the appropriate course of treatment. The fact that a service or treatment is described in this material is not a guarantee that the service or treatment is a covered benefit and members should refer to their certificate of coverage for more details, including benefits, limitations and exclusions. Regardless of benefits, the final decision about any service or treatment is between the member and their health care provider.