Category: Vaccines

Starbucks, DC Physicians, and COVID-19

As you all know, I have been carefully studying various approaches to convincing people to get vaccinated against COVID-19. My monthly conversations with physicians in my On Doctors’ MindsSM research project have been revealing that for many doctors, continuing to try to convince their unvaccinated patients to get the shot is now seen as a waste of their time and potentially offensive to some patients.  SO. They have stopped.

Conversations with clergy reveal that while some are willing to make a case from the pulpit for vaccination because they believe it is the moral thing to do, others want to stay clear of the political overtones that have unfortunately come to accompany this issue.

Joe Biden’s attempts, ranging from daily entreaties to controversial mandates, have at this point become old news, court cases, or both.

But here is a new one. Physicians offering to run discussion groups at coffee shops to present the efficacy and safety of the vaccines to groups of people who are not even their patients.  Interesting. Will the casual setting and the cup of Starbucks help to seal the deal? 

Bottom Line. Think about this one for a minute. If we have learned anything about the vaccine-hesitant over the last year, it is that simply talking “science” is unlikely to convince them to get their shots. And that’s true whether the people talking science are scientific experts or even their own physicians.  Why would these physicians, well-intentioned though they might be, be more successful using the same approach?

But wait! There actually is a possibility of a good outcome here. Think about it for another minute. Those people who would be willing to show up for such discussions must have at least a modicum of openness to getting vaccinated. AND. In good old “peer influence group” fashion, a skilled moderator might be able to facilitate these people talking each other into getting vaccinated by exploring and overcoming their shared objections. That might work.

As long as these doctors are smart enough not to just “talk science!!!” 

Winning the COVID Vaccine Lottery

Check this out. What you will see is a story from my local newspaper, here on Hilton Head Island, that I think has some fairly wide-reaching implications.

The young lady pictured above, Maddie Frank, is a very lucky Clemson student. More specifically, she is one of 16,000 Clemson students who uploaded their proof of COVID vaccination as part of a vaccine incentive program. A random drawing from that pool of students brought Maddie the grand prize, two semesters free tuition!!! Other prizes included computers, iPads, free meal plans, etc. Prizes were also offered to faculty members who submitted proof of vaccination.

Okay, this may be of interest at Clemson, and even on Hilton Head Island where Maddie went to prep school. But what are the “wide-reaching implications?” Best to answer that question with a question. When was the last time, pre-COVID, that we saw prizes being awarded to people just for taking an important step in protecting their own health? I’m probably missing something here, but I can’t think of any!

Two other related questions. First, what message does this incentive program communicate about the COVID vaccines? My snotty response is that if you have to rely on extrinsic motivators like lottery prizes to coerce people to get vaccinated, you are implicitly saying that the vaccines lack sufficient intrinsic motivators to make them worthwhile to receive. Do we really want to say that? 

Next question. Does the use of lottery prizes and other extrinsic motivators convince vaccine hesitant patients to go out and get the vaccine? I’m guessing that the Clemson student vaccination rate of 60%, pretty average at best, answers that question with an apparent “No”.

Bottom Line. Over the last year, we have seen lotteries, cash and even beer being used to motivate people to get vaccinated. I am thinking that such bribery has had little or no positive effect on the vaccine hesitant and, worse yet, may be setting a bad precedent by creating a situation where in the future, people will have to be extrinsically compensated for doing what is right for their health and the health of those around them. 

Not good!

“Connecting” With the Vaccine Hesitant Patient

Check this out. What you will see is a really well-written piece on how a physician can have a meaningful conversation with a patient who is hesitant to get vaccinated herself, and/or is hesitant about getting her children vaccinated. The message here is a simple one, but it is lost on many of the physicians with whom I have conversations in my On Doctors’ MindsSM project.

The punchline is, while most doctors try to convince such patients of the vaccines’ safety and efficacy by talking “science,” this doctor’s interaction with this patient, over several different occasions, is actually the right way to do it. Sure, the practitioner has to be patient (pun intended) enough to penetrate the diffuse “I’m just going to wait and see” objection that so many patients offer. BUT. This patient’s reason for eventually breaking down and following the doctor’s vaccine recommendation, “You saw me for me,” is genuinely profound. Understanding a patient’s psychological backstory here is essential to communicating at a meaningful level that often, as in this case, has nothing to do with the “science.”

Bottom Line. So what we actually have here is a special case of Salesmanship 101. Listen carefully before you start talking. Patients recognize the hackneyed, and to them irrelevant, science-based standard speech that many doctors have developed about the COVID-19 vaccines, and just tune it out.

There is a general principle here that merits some consideration!

Let’s Give “Breakthrough Infections” a Break

Check this out. A dollop of common sense here. Words are always important. We have sort of known all along that the specific words we choose to make a point can be our best friends or our worst enemies.  But the COVID-19 pandemic has given this concept new meaning. Think about the word “mandate.” As in “mask mandate” or “vaccine mandate.” In both phrases, the use of the word mandate is (has been made to be?) inflammatory, to put it mildly. Prior to the pandemic, the primary use that I recall of the term “mandate” was when a politician won an election by a large majority and declared that he had received a mandate from the electorate. In the good old days, a mandate was a good thing.

For those of you interested in getting a more erudite view of this topic, you might like to tap into this book. What you will see is a thoughtful review of how words can be crafted in such a way as to take advantage of such behavioral economics principles as biases and heuristics, and in turn can be used to influence desired healthcare attitudes and behaviors.

Now we focus on the point of the article referenced here. The use of the term “breakthrough infections” is unfortunately providing evidence for anti-vaxxers to use in making the point that the “vaccines don’t work.” Unfortunate since, as I have noted before, most people originally interpreted “90%” efficacy as “works for everybody,” responding to the behavioral economics principle of “rounding,” when in fact, it clearly means something very different. And then there are “little details” like the fact that most of the “breakthroughs” are milder cases, with very few hospitalizations or deaths. 

Bottom Line. Is it too late to undo the public health damage being done by these few words? Probably! As a wise teacher once taught me, “Until you say them, you are the master of your words. After you say them, they are the master of you.”

BUT. Hopefully going forward, we can avoid the setting of any more semantic traps which would likely contribute to even more lives being lost to the coronavirus.

AND. More generally, we hopefully will come to understand the emotional impact of words and how to work with them to society’s public health benefit rather than to its detriment.

Can Physicians Change Vaccine Hesitant Patients’ Minds??? Nah!!!

Check this out. What you will see is some mildly interesting stuff concerning telehealth. Skip over that and go to the section on VACCINE HESITANCY. 

There you will find some interesting numbers. More specifically, you will see that 52% of physicians believe that they need 2-3 conversations with patients to change their minds about vaccinations, BUT 67% of physicians believe that most patients’ minds can’t be changed. 

Put together, these numbers would support what I have been telling our On Doctors’ MindsSM subscribers based on my recent conversations with physicians, and that I also noted in a recent post.  That is, almost a year into vaccine availability, many doctors are largely giving up on evangelizing the COVID-19 vaccines with the unvaccinated. Why? In summary, they see time spent on these efforts as wasted, and they simply don’t have the time to waste. Put another way, doctors believe that anybody who hasn’t gotten vaccinated after a year is not likely to do so in the near future, no matter what their HCP says.

Bottom Line. The plot thickens. It should be noted that with the approval of new booster protocols and pediatric vaccinations, this whole dance is going to start up all over again. 

My bet? People that are already “fully vaccinated” should be ready to get their third shot. No problem.

On the other hand, how people will feel about getting their munchkins vaccinated will be interesting to watch. New objections? Same old? We shall see! 

Please Listen to Me!!!

In my most recent On Doctors’ MindsSM Executive Summary, I surprised some of our subscribers by reporting out that in the COVID-related conversations that I had with office-based physicians in September, most of them told me that while a majority of their patients had already been fully vaccinated for COVID, they had basically stopped trying to convince the remainder of their patients to get their shots. Why? Because, the doctors explained, after a year of preaching the gospel, they felt that continuing to try to convince holdouts was, quite simply, a waste of their time. 

But check this out. What you will see is a doctor’s recounting of a conversation in which he tries to convince an unvaccinated couple to get their shots. You will see that the doctor is not only wasting time here, but getting “hurt more than I care to admit.” How? By having the patients include this physician, by implication, as a perpetrator of the great COVID/VAX scam that they believe is being perpetrated in America.

Bottom Line. Read this doctor’s post carefully. Think about it. Digest it. If you were this physician, how many more traumatic encounters like this would it take to shut down your vaccine evangelizing?

I’m guessing not too many! 

The Covid Vaccination Struggle and “Market Forces”

In my most recent round of 10 On Doctors’ MindsSMmonthly conversations with physicians about the impact of the pandemic on their private practices in primary care, cardiology, oncology, etc., I have been asked by several clients to talk about the impact of “market forces” on vaccination acceptance among their patients.

As I predicted in a previous post, the Pfizer vaccine receiving “FULL FDA APPROVAL” didn’t matter in a single practice with which I conversed. Patients simply have no idea of the difference between “Emergency Clearance” and “FDA Approval.”

For practices with large numbers of working patients, the possibility of a “VACCINE MANDATE” was predicted by my discussants to have a significant impact, although not without a lot of rancor as the picture above, on the left, would suggest.

By far, the best conversation I had on the topic of convincing patients to get vaccinated was with a cardiologist in the Bronx, who actually was the first US physician to contract COVID himself at the beginning of the pandemic. He tells skeptical patients that they are right.  The vaccine is a hoax, as is the pandemic. The 600,000 people who have reportedly died of COVID were actually taken to Area 51 in Nevada, where they are being kept against their will. Etc., etc.  At the end of this riff, he asks patients if they believe all of that. Most, not surprisingly, say “No!” His retort? “Then your only choice is to get the vaccine.” One patient shot back that he was going to have to “Evaluate the science further.” To which the cardiologist, obviously no shrinking violet, responded, “You’re a truck driver. How are you going to do that?” Sort of the current situation in a nutshell! 

But check this out. An ICU nurse’s graphic reminder that when you show up at the ER gasping for air, there are no more choices. Everything available for treatment, including intubation, will basically be forced upon you. No volition. No more “bodily autonomy.” 

Bottom Line. One thing that my discussants are telling me this month is that the only “market force” they have seen motivate a recalcitrant patient to get the vaccine is actually seeing someone close to them die of the disease. 

Question. How can we synthesize the impact of that horrendous but impactful experience and get it into widespread public distribution???

Love Vs. Vaccine Mandates

May we live in interesting times. Check this out. What you will see is my friend Jane Sarasohn-Kahn’s blog post which further develops a theme I wrote about recently. In my post, I talked about the PSA offered by Pope Francis, in which he described getting the COVID vaccine as “An act of love.” Here, Jane notes that the Catholic Health Association has mounted an entire campaign wrapped around the notion of getting vaccinated being a way to “Love thy neighbor.”

AND. As I wrote this on September 9th, a clearly perturbed President Biden announced that he was “out of patience” with the unvaccinated, and proceeded to issue a mandate for almost 100 million people to get vaccinated. Federal employees, those doing business with the Government, employees of large corporations, etc.

Bottom Line. An interesting juxtaposition of events. A message based on love and a Presidential mandate. Will these forces combine to get the hardcore unvaccinated to take the plunge? What will the percentage of success be? How quickly will all of this unfold?

Stay tuned!

Does “Confidence” Cause “Action???”

Here’s an interesting one. A recent Harris Poll indicated that formal FDA approval of Comirnaty increased respondents’, both vaccinated and unvaccinated respondents, “confidence” in the vaccine. Interesting thought in and of itself. Reading this left me to ponder how many people could outline, even at the 20,000-foot level, the differences in the hurdles that a vaccine has to clear in order to obtain “emergency approval” versus “FDA approval.” I certainly couldn’t and look at what I do for a living!

The plot thickens. According to this same article, about 50% of those who are unvaccinated are moved enough by this increase in confidence that they “probably” or “definitely” will be vaccinated, and about 60% of parents are now willing to get their children vaccinated. Color me skeptical on that one. Talking with patients on the topic of vaccination, I have heard religious objections. I have had patients say that they are afraid that the vaccine since it is “Messenger RNA,” will alter their genetic makeup. Or have a negative impact on their fertility. Then there are those who believe that the vaccine will “magnetize” them or allow the government to track their movements. Does “FDA approval” relieve them of these objections?

Bottom Line. Just as I had finished reading this piece, I was scheduled to do one of my On Doctors’ MindsSM conversations to get an update for our hundreds of subscribers as to what is happening in office-based practices as a result of the pandemic. This doctor, a more senior primary care physician in a rural practice in Pennsylvania, offered that about 60% of his patients had been vaccinated and that he saw little likelihood of any more doing so. He has tried hard to get the balance to get vaccinated, but to no avail.

Survey research results versus the opinion of a physician with 50 years of experience under his belt. Which do we believe? Oh, and other factors, like major corporations, government agencies and academic institutions now feeling empowered to issue vaccine mandates given FDA approval might well have a significant impact on the outcome here.

What will Cominarty’s approval translate into in terms of new patients journeying out to get the “Fauci Ouchie?” 

Stay tuned!

What’s in a Name???

Here’s an interesting one, the likes of which we have never seen before. When the Pfizer vaccine received final FDA approval, the company quickly rolled out a brand name for the product. Comirnaty. You can see the “creatives’” minds at work coming up with this one.  “Co” for COVID. “mirna” for the first authorized messenger RNA. “ty” for community. 

The only question is whether any of this marketing fluff will matter. Likely “the Pfizer vaccine” is a term heard, around the world, more frequently than the name of any other pharmaceutical product prior to its FDA approval.  As we have often discussed, habits are strong forces, and I scratch my head wondering whether anyone will take the time to learn the new “brand name,” and to substitute it for the terminology now entered on hundreds of millions of vaccination cards. Will the result be clarification or confusion?

Bottom Line. While I see why Pfizer felt the need to promote this name, I wonder how many times someone will say “Comirnaty,” get a quizzical look from a listener, and respond, “You know! The Pfizer vaccine!!!” 

Will Pfizer spend a lot of money to drive the new name home? Will it matter? It will be interesting to watch and see!!!