Many Americans, me included, are patiently awaiting the opportunity for our families to be vaccinated against COVID-19. As a family physician focused on health promotion and disease prevention, I have long advocated for the benefits of vaccines in keeping my family, patients and community safe from infections like chicken pox, measles, polio and influenza. Similarly, vaccination against COVID-19 offers another significant line of defense in the fight against the pandemic, which has taken such a horrible toll on people and communities across the globe. Based on my education, training and experience, I have confidence in the safety and effectiveness of vaccines and specifically the COVID-19 vaccines that are currently available in the United States.

What is vaccine hesitancy?

Although the majority of people in the U.S. have confidence in vaccines, there remains a smaller percentage of people who are vaccine hesitant. As defined by the World Health Organization (WHO), vaccine hesitancy refers to a “delay in acceptance or refusal of vaccines despite availability of vaccination services.” Importantly, vaccine confidence and hesitancy are not dichotomous and represent a spectrum of attitudes about the safety, effectiveness and necessity of vaccines. An article in the American Journal of Health Behavior identified five types of vaccination attitudes with relative proportions of the surveyed group:

• Strongly agree vaccines are necessary and safe (33%)
• Agree vaccines are necessary and safe (26%)
• Agree vaccines are necessary but are less sure about their safety (25%)
• Slightly agree that vaccines are necessary and safe (13%)
• Slightly disagree that vaccines are necessary and strongly disagree that vaccines are safe (3%)

What influences vaccine hesitancy?

In addition to the diversity in vaccination attitudes, there is a spectrum of reasons why people may be hesitant about vaccines:

• Concerns about vaccine safety
• Questions about vaccine necessity
• Mistrust in the healthcare system
• Mistrust in the government
• Misinformation
• Cost
• Lack of access

Overcoming Vaccine Hesitancy

By understanding people’s questions or concerns about vaccination, vaccine advocates can better understand the nuances behind why people might be hesitant and partner with patients to address their concerns thoughtfully and directly.

For example, a patient may express concern about the safety and efficacy of COVID-19 vaccines given the speed with which they were developed, tested and manufactured. With this understanding, vaccine advocates can directly address this concern by describing the rigorous FDA process (both during and after approval) to ensure the safety and effectiveness of COVID vaccines, the additional tools in place to monitor safety (e.g., Vaccine Adverse Event Reporting System (VAERS), V-Safe), and the millions of people who have already been safely vaccinated against COVID-19.

For others, hesitancy may stem from a historical mistrust of the healthcare establishment created by events such as the unethical treatment of Black Americans in the Tuskegee Study. This barrier to vaccination is even more pressing during the COVID-19 pandemic given data that reveals communities of color have been disproportionately affected and are more hesitant to get the COVID-19 vaccine. To overcome these reservations, it is essential for vaccine advocates to address the issue directly. Advocates must engage and work with community leaders for communication and outreach strategies, articulating the importance of COVID-19 vaccination, and conveying the tangible benefits.

Doing our part

Since the beginning of the pandemic, Allscripts has redoubled its commitment to both our associates and our clients. Allscripts took aggressive steps early in the pandemic to protect the health and safety of our team members to ensure support for our clients when they needed it most. Allscripts has also created COVID-19 resources to help our associates stay informed about COVID-19 and vaccine availability in their areas. Building on this commitment, Allscripts has joined other employers across the nation as part of the U.S. Chamber of Commerce Rally for Recovery Movement committed to protecting workers in our fight to defeat the pandemic.

For our clients, Allscripts continues to leverage its platform of health to support their mission-critical activities. Whether using our clinical solutions to help healthcare systems manage patients with COVID-19 or our industry-leading Veradigm ambulatory EHR dataset to support COVID-19 research and safety surveillance, Allscripts remains committed to leading efforts to improve healthcare now and into the future.

Resources

• COVID-19 Vaccine Facts (CDC)
• COVID-19 Vaccine Frequently Asked Questions (CDC)
• COVID-19 Vaccine Facts and FAQs for Business Leaders (U.S. Chamber)
• COVID Vaccines Digital Resources Center (U.S. Chamber)
• State by State Vaccine Guidance (U.S. Chamber)
• Vaccine Testing and the Approval Process (CDC)
• Vaccine Adverse Event Reporting System (VAERS) (CDC & FDA)
• V-Safe (CDC)
• Allscripts COVID-19 Response
• Veradigm COVID-19 Response