Public Health

Access, not hesitancy, now biggest barrier to COVID-19 vaccination

Brendan Murphy , Senior News Writer

The biggest impediment to getting more people fully vaccinated for COVID-19 is access, not vaccine hesitancy, according to Thomas R. Frieden, MD, MPH, former director of the Centers for Disease Control and Prevention during the Obama administration.

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“There is kind of a narrative that isn't quite accurate in the media these days,” said Dr. Frieden during a recent episode of the “AMA COVID-19 Update” examining vaccine hesitancy and the role of politics. “Most of the people who are not yet vaccinated aren't strongly opposed to being vaccinated. They just haven't had the vaccine be as convenient as it should be.”

“We can make a lot of progress by making vaccination more convenient,” said Dr. Frieden, CEO of Resolve to Save Lives, an initiative to prevent epidemics and cardiovascular disease. “That's really important. That means walk-in hours. That means easy locations, easy hours, supporting transportation and setting up pop-up sites outside of everywhere, from ballgames to bars to bowling alleys to shopping centers. We need to make it the default choice, basically, to get a vaccine.”



Looking at the issue of vaccine hesitancy, whether it is within a political voting bloc or racial or ethnic group, Dr. Frieden offered the same playbook for success: Listen to patient concerns, validate those concerns even if you don’t agree with them, and address those concerns with facts and emotional anecdotes.

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“You know who's the very best person to do that? Is the person's doctor, the person's clinician,” he said. “That is, far and away, the spokesperson, the messenger, who is going to have the message best understood and, ideally, best understood just before saying: ‘And now, I'm going to give you your COVID vaccine.’”

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In trying to convince a fence-sitting patient to take the COVID-19 vaccine, one of the most powerful anecdotes a physician can offer is that they themselves have been vaccinated.

“It's really important that doctors share with patients that they've been vaccinated, their family has been vaccinated, their loved ones have been vaccinated,” Dr. Frieden said. “And they recommend that all of their patients get vaccinated. The vaccine is astonishingly effective, it's extremely safe and it could save your life. And I wouldn't get into a big argument. I would basically say, ‘And now we'll schedule it.’" 

Dr. Frieden said physicians should also be frank about the severity of contracting the virus.

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“I'm not saying we should be scaring—but we should be sharing with them the kind of tragedy and trauma that we see in patients struggling with COVID, or struggling to survive after a loved one has died from COVID,” he said. “It's a really serious problem. And it's a confusing one because the fact is about 199 out of 200 people who get it are not going to die from it. So, I think for many people who don't have a medical background, it seems like it's being overblown. But the fact is it's a bad infection.”

The AMA has developed frequently-asked-questions documents on COVID-19 vaccination covering safety, allocation and distribution, administration and more. There are two FAQs, one designed to answer patients’ questions, and another to address physicians’ COVID-19 vaccine questions.