You may mention the new vaccines were subjected to all the typical steps in vaccine development and evaluation, including phase 1, 2 and 3 clinical trials. Don’t assume your patient knows what that means. Provide an explanation:
“That means studies were conducted in people, not just animals, beginning with tests in a few healthy volunteers (under a hundred) and moving up to large-scale tests in people with the disease (hundreds to thousands) to ensure the vaccine is safe and works as intended. The vaccines are safe. More than 302 million people in the U.S. have now been vaccinated, with rare serious side effects and very few deaths—about 7 per 1 million vaccinated women between 18 and 49 years old—positively linked to vaccination.”1
Dr. Phillips
“I think that when we start really respecting our patients [and giving them] the science,” says Dr. Manning, “you’ll be surprised at how many people will respond and say, ‘That makes sense.’”
Counter Patient Concerns
For some patients, statistics may be a helpful tool, noted co-moderator Chris Phillips, MD, of Paducah Rheumatology, Kentucky. For example, Dr. Philips said he might contrast the small risks of thrombosis from the Johnson & Johnson vaccine with the much greater risks of mortality from COVID-19, using specific numbers. “Sometimes I think our patients … misvalue how likely those things are to happen, so trying to recenter that is sometimes helpful,” he said.
Dr. Karp
Another co-moderator, ACR President David R. Karp, MD, PhD, chief of the Rheumatic Diseases Division at UT Southwestern Medical Center, Dallas, remarked on a particular concern that many rheumatology patients have: the risk the vaccine may trigger a flare. “I tell patients that if you have a flare [after a vaccine], we can treat you, but in the meantime, you are protected from a disease that is deadly. Thus far, thousands of patients with rheumatic and autoimmune diseases have been vaccinated and have done well,” Dr. Karp said.
Sometimes, clinicians feel an urgency to get their patients vaccinated as quickly as possible, Dr. Manning noted. But by trying to understand patients’ specific concerns and gently and repeatedly bringing up the subject, clinicians may gradually make an impact. “Yes, there is urgency when it comes to being vaccinated for COVID, but if you don’t keep trying to plant the seed and keep the trust open, we definitely aren’t going to get there,” she said.
