I Think I'll Wait: Talking Through Vaccine Hesitancy
By Alan;Martha Howell Texas Medicine May 2021


Amid the excitement and hope the COVID-19 vaccine offered our health care colleagues, there are those friends and family in our communities asking questions and sharing information (evidence-based or not) raising concerns. It is our relationships with our patients that will help bridge that gap and invite them to consider another perspective.

Effective communication is at the core of that patient-physician relationship and can aid in assuaging concerns regarding the COVID-19 vaccine as well as other vaccines. 

Here are a few specific communication skills to help:

Address the emotion – yours and theirs

Yes, yours too. The pandemic has added stressors, and your emotional state will determine your bandwidth to properly engage in these conversations. Ask yourself:


  • What is your emotional state and preparedness for the conversation?
  • Are you feeling rushed, impatient, frustrated, or are you entering the conversation from a place of curiosity to learn more about the other person and establish trust? If the latter, are you aware of triggers/hot buttons that can change the conversation and can you reset your state of mind?
  • What prior experiences are influencing your expectations?
  • What assumptions are you making about this patient or their family members?  Being aware of our assumptions can heighten our awareness of any biases that can impede communication and the relationship.



Understand their perspective

Just like our emotional state can be a communication barrier, so can your patient’s. Responding with empathy and naming the emotions before offering information or evidence will help the other person feel heard and foster trust.



  • “A new vaccine can be scary.  I would have concerns, too, or want to ask questions.”
  • “With all the information in the news and social media, it is hard to know what is accurate, and I would also be worried.”
  • “With your health concerns I can completely understand why you would be fearful.”


Next, share information in small chunks, stopping to check for understanding from your patient’s perspective because offering a non-specific answer may not address their concerns or fears.

What do you know? What do you not know?

Eliciting our patient’s perspective will not only help eliminate assumptions, it also can provide insight into the reasons the patient may be hesitant to get the vaccine. This is important to gain understanding around what will resonate with them.



  • Ask: “What do you know about the clinical trials and vaccine safety monitoring?” Respond with empathy: “Yes, the amount of information on the internet can be overwhelming.” Then share relevant information: “The vaccine is ...”
  • Ask: “What are your concerns regarding the possible side effects?” Respond with empathy: “I am sorry your friend had such a reaction and can see why you are worried.”  Then share: “The side effects ...”


Make the relationship the goal

Health care is a fast-paced environment, and we are often drawn to focusing on accomplishing certain tasks versus focusing on the relationships with patients or family members. In this case, we are concerned about our patients, and our goal (our task at hand) is to get them vaccinated as soon as possible.  

It is the relationship, however, that most likely will determine when this task will take place.   

Verbalize your positive intent: We think this is a given in medicine. Of course, everyone cares about their patients and their well-being. However, this is an assumption we make that may or may not be shared by our patients and their families. Stating one’s positive intent can deescalate concerns and promote trust.



  • “I want to make sure you are safe, and my goal is to answer your questions so that you can make well-informed decisions.”
  • “You know your body best, and my intent is not to convince you but rather offer information to help you decide what is best for you.”
  • “You have done a lot of reading and have great questions. I’m happy to offer additional resources if you are interested.”


Verbalize your appreciation: This is sometimes an overlooked last item. Patients often think we will grow upset if they ask questions or have concerns about medical interventions. Being intentional about expressing appreciation goes a long way in relationship building.



  • “I appreciate you trusting me and sharing your concerns.”
  • “I appreciate your willingness to consider getting the vaccine.”


We may never see this patient again, but because of our interactions, he or she may continue to have a positive experience with the health care system in the future and be more willing to consider our recommendations at a later time and get vaccinated. 

The authors have no financial disclosures and would like to acknowledge the training tools provided by the Academy of Communication in Healthcare in this work.

Martha Howell EdD, is a quality improvement consultant for the Office of the Chief Quality Officer at Baylor Scott & White Health and leads the Relationship Centered Communication Program. She is a certified facilitator with the Academy of Communication in Healthcare and completing the faculty in training program. She is also a member of the TMA Alliance and TMA’s Council on Medical Education.

Alan C. Howell, MD, is an infectious disease specialist at Baylor Scott & White in Temple and a certified facilitator with the Academy of Communication in Healthcare. He is a member of TMA’s Committee on Infectious Diseases.

Tex Med. 2021;117(5):4-5
May 2021 Texas Medicine Contents 
Texas Medicine  Main Page  

Last Updated On

May 02, 2021

Originally Published On

May 02, 2021

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Communication | Coronavirus | Immunization