Drive for 75: Resources from Week 24

Workforce | August 13, 2021 | by Dee Pekruhn, Jill Schumann

LeadingAge Coronavirus Update Calls feature brief segments called “Drive for 75” to promote the successful vaccination of at least 75% of our aging services providers’ workforce, and as needed, residents. We will cover developments in the news, research, and innovative practices that support our members in attaining high vaccination rates.

Volume Fifty Eight: Air Date 8.9.21. “Coming Soon: Vaccine Passports”

New results are out from the Kaiser Family Foundation on what unvaccinated people think about the vaccines, and it raises again the question: how can we move the unmovable? As we continue to seek new answers to the vaccine hesitancy question, let’s shift our gaze to Pakistan, a country where vaccine hesitancy is not a new problem. Mistrust and disinformation are huge barriers to long-accepted vaccines for diseases such as polio – a disease that the country is still battling.

And yet, this country of 220 million people has figured out how to get one million people vaccinated a day – they estimate that the entire country will be fully vaccinated by the end of the year. They are convincing even people who say they don’t trust the vaccine and definitely do not want to get it. How are they doing this? With “cajoling and extraordinary measures,” according to the New York Times.

These measures include prohibitions on the unvaccinated, such as:

· Shutting off cell phone service

· Withholding salaries

· Prohibiting air travel

In addition, Pakistan requires proof of vaccination for school employees, hospitality and transport workers, and public-sector employees.

Is it working? Evidently, overcrowding at some vaccination sites is such that the government has said some centers will operate “around the clock” and send out mobile vaccination teams to some neighborhoods.

Back here in the States, the Kaiser Family Foundation survey results highlighted once again the great need for education and accurate information for the hesitant unvaccinated. Here are a few findings that add depth to our understanding of why some people still remain so entrenched in their hesitancy.

· Most (57%) unvaccinated adults say that the news has “generally exaggerated” the seriousness of the pandemic. And among those who say they will “definitely not” get a vaccine, 75% say the news is exaggerated.

· (53%) of unvaccinated adults believe the vaccine poses a bigger risk to their health than COVID-19 itself.

· Relatively small shares of the unvaccinated believe the vaccines are “extremely” or “very” effective at preventing death (23%), serious illness or hospitalization (21%), or getting infected after exposure (13%), despite substantial evidence and the conclusions of official scientific bodies that the vaccines work well at each of those things.

· Vaccinated adults are more likely than unvaccinated to say they wear masks in grocery stores and other indoor places (53% vs. 44%), at work (45% vs. 35%), or in crowded outdoor settings (45% vs. 35%).

· 3% of the unvaccinated say that they would only get a vaccine “if required” to do so for work, school or other activities, and 14% say they will “definitely not” get vaccinated. The size of the “definitely not” group has not changed significantly since KFF started tracking people’s intentions in December.

These results demonstrate that misinformation and mistrust continue to drive the “last hold outs” of the unvaccinated. As we are seeing from examples around the world – including Pakistan, today, and France, Italy and New York last week – a mixture of education and mandates may be what finally works.

See our links in today’s Handouts for more detail, and back to you, Ruth.

Volume Fifty Nine: Air Date 8.11.21. “The HEAR Technique”

As we work to get more people vaccinated, there is more and more being published about what is working and what is not in convincing people to get the shot. While training over 1,800 vaccine outreach workers, the UCSF Center for Excellence in Primary Care developed a practical guide for engaging people who are skeptical of the COVID-19 vaccine in meaningful conversations.

When we hear skepticism, our first instinct may be to end the conversation. Our second instinct may be to counter the person’s position without pausing to hear more about their perspective. Unfortunately, trying to force someone into getting the vaccine often results in defensiveness and anger.

They propose the HEAR technique, based on skills used in health coaching and motivational interviewing. The HEAR technique is an acronym that stands for:

Hear: Could you tell me more about your concerns about the vaccine?

Express gratitude: Thank you for sharing that concern. You have been thinking carefully about this!

Ask about pros and cons: What would be the bad things about getting a vaccine? How about the good things?

Respond: Would it be OK to share some information about your concern?

Here is an example of using the HEAR technique to defuse tension and respectfully offer information

relevant to the person’s concerns.

Thanks for taking the time to talk today. We’re reaching out because you are eligible for the COVID-19 vaccine. Are you interested in receiving the vaccine?

Yeah, I’ll pass.

Thanks for letting me know. Each person I talk to has a lot of things to consider when choosing to get vaccinated or not. Would it be OK to talk about what’s on your mind when you think about the COVID vaccine? [H for hear: Acknowledges the person’s opinion and asks permission to discuss concerns.]

Sure. But you’re not going to change my mind!

Fair enough! It’s ultimately up to you, right?

Yeah, it is. OK, well, I feel like the vaccine was developed way too fast. I don’t like the idea of putting something in my body without understanding the effects.

Thank you for sharing that concern. Understanding the safety of the vaccine is important to you. Is there anything else that makes you not want to get the vaccine? [E for express gratitude: Thank person for sharing. A for ask about pros and cons: Probes to understand the person’s “cons” to getting a vaccine.]

No. It really comes down to safety.

So, one reason that you don’t want to get the vaccine is your concern about safety. Are there any reasons that you might want to get it? [A for ask about pros and cons: Asks an open-ended question to understand a person’s “pros” for getting the vaccine.]

Well, sure. I mean, I miss singing in the choir at my church, and I miss my grandkids.

So, on the one hand, you want to be sure that the vaccine is safe before you get it. On the other hand, you want to get back to singing in the choir and seeing your grandkids.

That’s right.

Would it be helpful for me to share what we know so far about safety for this vaccine? Just so you can consider it while you think about what’s best for you? [R for respond: Asks permission to share additional information.]

Sure, I guess that would be OK.

If the person agrees to hear new information, that is a positive step. You could go on to share new information and assess the person’s reactions and motivations. This technique can be used to engage people you know in conversations about the vaccine.