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Researchers to study health care providers’ influence on COVID-19 vaccine acceptance

Follow-up survey aims to alleviate widespread vaccine hesitancy found in earlier research

Now that two COVID-19 vaccines have received Food and Drug Administration emergency authorization, with more on the way, how do we encourage widespread acceptance among the public?

Two UMass Medical School researchers who surveyed Americans about their attitudes toward a COVID-19 vaccine last spring are preparing another study to evaluate ways for health care providers to talk with patients about COVID-19 vaccination.

Kimberly Fisher, MD, and Kathleen Mazor, EdD

“A strong recommendation from a health care provider is one of the most influential factors in somebody deciding to be vaccinated,” said Kimberly Fisher, MD, associate professor of medicine and co-author of the survey on attitudes toward a COVID-19 vaccine published in the Annals of Internal Medicine Sept. 7 as well as principal investigator in the new study.

A recent Massachusetts survey found that an individual’s personal doctor was the most often cited source of trusted information across all racial groups. Similarly, the Kaiser Family Foundation reported that 85 percent of Americans said they trusted their own health care provider as a source of reliable information on the vaccines.

“Health care providers should be prepared to talk about vaccination with their patients and should recognize that they have an important role to play in promoting vaccination,” Dr. Fisher said.

Kathleen Mazor, EdD, professor of medicine and associate director of the Meyers Primary Care Institute, Fisher’s co-author and a co-investigator on the new study, said views are changing as more is learned about the vaccines.

Last spring, as many as four in 10 adults said they would refuse to get a COVID-19 vaccine. Nearly a third of the total sample said they were “not sure” because of concerns about safety, efficacy and the newness of a vaccine, which had yet to be authorized by regulators. Approximately one in 10 said they did not intend to be vaccinated.

Some of those who said they would not take the vaccine were unlikely to change their opinion. For them, Dr. Mazor suggests, “It’s more of an emotional response, not one they necessarily arrived at through a review of information.”

But now that clinical trial data for the Pfizer/BioNTech and Moderna vaccines show around 95 percent efficacy and a high level of safety, those who were on the fence last spring when a vaccine was merely hypothetical may think more positively about it. They may not want to be first in line but are more open to getting vaccinated after seeing other people’s reactions, Mazor said.

Fisher said polls between September and December showed the percentage of people who were willing to be vaccinated had increased.

And the fact that the FDA reviewed and authorized the vaccines after, rather than before, the U.S. presidential election may have removed some perceived politicization.

Still, a sizeable proportion (35 percent according to a Kaiser Family Foundation tracking poll) of Black adults, who as a population have been disproportionately affected by the worst impacts of COVID-19, say they definitely or likely won’t get vaccinated. Overall, about a quarter of the population remains vaccine hesitant, the report found.

“Transparency is key to trust,” said Fisher. “Officials need to be transparent about any potential adverse reactions. So much of vaccine acceptance really hinges on trust.”

Fisher said it was reassuring that vaccination protocols call for people to be observed for at least 15 minutes following injection in case a person has an anaphylactic allergic reaction, a rare but potentially serious effect.

The researchers hoped people would have the ability to weigh minor reported vaccine reactions such as temporary headache or muscle pain against much worse potential symptoms of COVID-19.

Leadership from public officials, community leaders and especially health care providers is key to explaining why vaccination—as well as the need to continue masking and social distancing until most are vaccinated—are necessary to get through the pandemic, Mazor and Fisher said. And they must lead by example.

Fisher and Mazor’s research study will test different messages for patients about the vaccine and gather concrete data on what people understand and are influenced by. Pilot funds have been provided through the Network of the National Library of Medicine New England Region, based at the Lamar Soutter Library at the Medical School.

The online survey is expected to start in January.

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