Vaccine Confidence Insights: Interview with Dr. Simon Mittal

Regulation | March 18, 2021

Dr. Simon Mittal, Chief Medical Officer with Convenire Healthand a leader with the MN Association of Geriatrics Inspired Clinicians (MAGIC), joined LeadingAge for the March 18, 2021 Coronavirus Update Call. He responded to questions from Ruth Katz and from callers.

Dr. Simon Mittal, Chief Medical Officer with Convenire Healthand a leader with the MN Association of Geriatrics Inspired Clinicians (MAGIC), joined LeadingAge for the March 18, 2021 Coronavirus Update Call. He responded to questions from Ruth Katz and from callers.

Q:​Please tell us more about MAGIC. 

A:​MAGIC is the Minnesota Association of Geriatrics Inspired Clinicians. It was formerly the MN Medical Directors Association. We have expanded our group to include other clinicians such as Nurse Practitioners and Physicians Assistants. We have engaged people from the major health systems and also independent geriatricians. We educate and develop resources on issues related to older adults. This past year we have produced toolkits and have focused on operational issues related to COVID-19.

Q:​We’d like to hear more about what you are experiencing with regard to vaccine confidence among staff and residents.

A:​It is a complex issue. There are many variables that influence a person’s hesitancy including: their previous experience; their sources of information; who their support systems are and whether those support systems favor vaccinations. We must be honest and address what we do know, but also speak to the longer -term questions for which we don’t yet have answers. People are uneasy about how quickly the vaccines were developed, even though no shortcuts were taken in development and testing. People may have deep personal belief systems that may include not wanting to be vaccinated at all – not just for COVID-19. 

Q:​Given the real and current dangers of COVID-19, it can be hard to understand why people are so concerned about vague possible long-term effects. 

A:​We have to be careful that we are not over-riding people’s deeply held belief systems and values. The conversation is not, “why aren’t you willing to be vaccinated”, but rather, “tell me a little more about how you are thinking about this – help me understand.”

Q:​In our recent town hall with the Black Coalition Against Covid, a participant asked a question about how the vaccine might affect a woman’s fertility. One of the physicians answered and admitted that we don’tknow everything yet, but what we know now suggests that it will not harm you. That honesty seems to build trust. Is that your experience?

A:​Yes, we need to move away from right/ wrong thinking and acknowledge that we don’t know all the answers. And yet we can still reflect on what we do know. We need to maintain communication lines so we can continue the conversation as we all learn more.

Q:​You have been working with people born outside the US related to the COVID vaccines. Please tell us more about that. 

A:​People born outside the country often have different cultural and spiritual concerns that we should be aware of. For example, in MN we partnered with Somali leadership for a roundtable session about COVID vaccination. The panel included an Imam to be sure to address how the vaccine fits with religious belief and doctrine. Participants wanted to know whether receiving the vaccine would be against their faith. So, it was very helpful to have the religious leader’s perspective. Spiritual leaders are important in these conversations as they can deliver culturally sensitive information. We found that travel is an area of interest to so many people with family and friends living in other countries as they think about vaccination. It is also the case that many cultures in West Africa, for example, have a very tight sense of community identity rather than individual identity, which makes having the support of leadership within the community very important. 

Q:​How did the medical experts equip the Imam and the community leaders? What was your role?

A:​We made sure to have community and spiritual leaders on the panel and only one clinician. So, we needed to work with those leaders in advance and provide them with information and answers to their questions. We were also able to provide practical support such as information in appropriate languages. We also helped to work through concrete logistical barriers to vaccine access. 

Q:​And, thinking about travel and about family members back home, are there staff worries about family situations in areas where COVID is rampant,and vaccines and healthcare generally may be less readily available?

A:​Yes, we need to empathize with our staff members and their concerns about their families and friend.s This builds caring relationships and helps not only with vaccines, but also with fatigue and burnout. Demonstrating caring and concern person-to-person makes a difference.

Q:​As we listen to concerns and objections about the vaccine, how might one change a mind or a heart?

A:​People who have strong belief systems are not going to change in one conversation. They need to feel that they are heard and that their beliefs aren’t being dismissed. Open and curious questions rather than bringing answersencourages understanding. Then over time, I ask if I may share my own perspectives – “here are some things that I know and here are things that are important to me about this vaccine”. Once the perspectives are explored, we can ask, “what would you like to do next?”

Q:​May we use the video referenced in the handout with our organizations?

A:​Yes – please use it. Some of our organizations have it on continuous play in their lobbies. The video addresses wider issues rather than granular information so it should be up- to- date for a while.

Q:​You mentioned that you needed to make sure to have materials in different languages. Where did you find resources for translation?

A:​We relied on community groups and their leaders to assist. Many of our health systems were already used to providing language and culturally- oriented resources, so that was a plus.