Conversations with Unvaccinated New Parents about COVID-19 Vaccines

Concerns The COVID-19 Vaccine Was Developed Too Quickly

Some patient families of Tiffany Munzer, MD, FAAP, feel the vaccine is too new to make a decision about getting vaccinated. The Ann Arbor, Mich., pediatrician, says questions about mRNA vaccines remain, “even in areas that may be highly educated.” When pressed, she says, many parents can't tell her what or how much information would be enough.

Dr. Munzer believes personal attention to each concern hits harder than rattling off data points.

When parents and caregivers say they worry the vaccine was rushed, she doesn’t lead with the fact that scientists have been developing the technology for mRNA vaccines for more than 30 years. Or that COVID-19 vaccines have been extensively tested in some of the largest vaccine clinical trials ever done.

Instead, she starts by unpacking parent concerns. She asks, “Would it be ok to chat more about your concerns? What specifically are your worries? Let me take a look into that for you, dive into the data and share with you what we do know.”

She then follows up with an answer that weaves data into their specific interest.

The other way Dr. Munzer handles vaccine questions is by using motivational interviewing techniques. She asks, “How likely are you to get this vaccine? Are you even thinking about it? Is there any room for persuasion? On a scale from 1-10 how likely are you to get it and why? How can I get you from a 4 to a 7?”

She concedes it takes more time, but also sets a more collaborative tone.

Debunking Concerns About COVID-19 Vaccine Side Effects

To pediatrician Lisa M. Costello, MD, MPH, FAAP, parents frequently bring up long-term side effects and side effects in general. “Understandably, people worry about the unknown,” she says.

As a lifelong West Virginian, she identifies with her community and offers personal stories and vaccine guidance as recommendations, options and choices. “Sharing my personal story about my vaccination journey allows me then to address the patient’s and caregiver’s related questions.” Costello finds that those she cares for tend to trust her most when she is open about her own experiences and transparent about what is known and unknown when it comes to the vaccines and the virus.

That said, even after in-depth and candid conversations, Costello recognizes that ultimately the vaccination decision is made by parents and caregivers — and one they still might not be ready to make. She provides her personalized recommendation and leaves the door open for future discussions.

Dr. Costello likens her interactions to planting and watering a seed — over time it starts to grow. “I sometimes talk to someone on one day, and a few days later they come back and ask a question.”

With so much polarization around the topic, for those open to discussion it will likely take more than one conversation to grow their confidence.

Addressing Religious Concerns About The COVID-19 Vaccine

North Carolina pediatrician Theresa McCarthy Flynn, MD, FAAP, recalls a parent telling her why he refused to get the COVID-19 vaccine because “It’s God, and he has commanded us to not be vaccinated. It shows a lack of faith.”

Fellow North Carolina pediatrician Christoph Diasio, MD, FAAP, says he hears faith-based reasons to decline the vaccine often.

His opening response is simple: “I think the Lord helps those who help themselves.”

He follows this up with points like: "This is not a choice between faith and science. Leaders from all faiths are in favor of the vaccine, and many physician scientists are religious and helped to develop the vaccine. As a Catholic, I know Pope Francis has called getting the vaccine a moral obligation. And it’s not hard to find religious leaders from other faith traditions who look upon this vaccine as lifesaving and a blessing."

Addressing Fertility Misinformation About The COVID-19 Vaccine

“The anti-vaccine crowd always talks about fertility. They’ve done it with many vaccines and they’re just wrong,” says Dr. Diasio. Unfounded claims linking COVID-19 vaccines to infertility have been scientifically disproven.

No loss of fertility has been reported among participants in the vaccine trials nor among the millions of people who have received the COVID-19 vaccines.

A study of more than 2,000 females aged 21-45 years and their partners found that COVID-19 vaccination of either partner did not affect the likelihood of becoming pregnant. And studies in vaccinated men show that sperm does not change after vaccination.

Dr. Diasio turns vaccine skepticism into an opening to pivot to a warning: It’s the virus they should worry about. It causes damage to the small blood vessels. This leads to complications ranging from premature labor to losing the baby — and possibly their own lives.

And COVID-19 causes a greater risk of erectile dysfunction in men. “Would you rather get the vaccine or get erectile dysfunction?” he asks rhetorically.

He also uses personal stories. For younger parents who think they’re not in any real danger, he shares how one of his son's friends thought the same thing, and for months post COVID-19 infection, tomato sauce tasted like gasoline. "My last name is Diasio. I need tomato sauce to taste like tomato sauce," he quips.

General Fear and Disinformation About The COVID-19 Vaccine

California pediatrician ChrisAnna Mink, MD, FAAP, says, “The biggest problem is fear. That they’re gonna be harmed by the vaccine. Because there’s so much mis and disinformation. The facts just aren’t getting through. Data alone no longer convinces anyone,” Dr. Mink said.

But there is some new information specifically about vaccination during pregnancy that could help reassure those who are pregnant or thinking about becoming pregnant.

Hundreds of thousands of pregnant people living in the US have been vaccinated with no safety problems for them or their baby. Data from three safety monitoring systems found no safety concerns for people who received the COVID-19 vaccine late in pregnancy — or for their babies.

We’re also finding that vaccination during pregnancy builds and passes along antibodies that might protect the baby. And vaccinated parents who breastfeed pass along protective antibodies to their baby.

Dr. Flynn’s antidote to misinformation is to lean on her relationship with patient families. They trust her as a source, so she “jumps into the mud” with every single person. If the person worries about myocarditis, she talks it through with them. “I say, ‘I care about you and want you to stay safe and healthy.’”

CDC studies show parents are more inclined to receive counseling from pediatricians because they trust that pediatricians have the child’s best interest at heart.

Dr. Diasio may sum it up best: “For many people, the pediatrician is the primary care physician. Adults might let primary care visits lapse or not have a close relationship with a doctor, but they won’t let that happen for their kids. So, pediatricians ought to use the trusted relationship they have with the family.”

“If you were ever going to use that power, my God, let’s use it to end COVID.”