Changing the Conversation about COVID to Get More People Vaccinated

LeChele Mack, BSN, RN

How can we help stop the spread of COVID-19? The question isn’t so much about what we need to stop the spread, we know we need people to get vaccinated, wear masks, and practice social distance, but how do we convince people whose minds seem to be made up against doing any of these things?

The misinformation and political rhetoric have made this feel like an impossible task. We need our patients to listen to us, and we can feel defeated when they would rather believe a radio host than their health care providers. Giving up is not the answer. We need to change the way we speak about COVID-19 and the benefits of getting vaccinated.

The messaging everyone has heard over and over again has been about full hospitals and ICU’s. We have talked about overworked and exhausted healthcare providers and the danger for patients this creates. We have begged people to wear masks to stop the spread and protect their community. We have told the heartbreaking stories of people who are asking for the vaccine just before they are intubated, and of the COVID-19 deniers that reverse their stance when they become seriously ill. It baffles us that, with all this information, people continue to deny that COVID-19 is a problem, or refuse to follow public health guidelines. It’s not personal to them, it doesn’t affect them, and it’s not a problem until it becomes personal.

When we talk to our patients we need to make it personal. Research on messaging to increase COVID-19 vaccination rates found that emphasizing personal benefits of vaccination increased participants' intention to get vaccinated more than any other type of messaging¹. One way we can make the message personal is by talking about the long-term consequences of COVID-19 infection. There is more than ICU’s, and ventilators to talk about with our patients. How many times have you heard someone say they don’t have to worry about COVID because they are young, or healthy? In the context of severe illness and hospitalization, they are probably right. The majority of people infected with COVID-19 experience mild illness.

Of course anyone can experience severe illness, but for younger people, people without pre-existing conditions the threat of hospitalization or death is not personal. We need to educate our patients about the long-term effects of COVID-19 on their personal health. A study completed by the University of Arizona Health Sciences found that 68% of patients with mild or moderate covid experienced long COVID, only slightly less than those hospitalized with COVID². Long COVID or Post COVID is defined as experiencing one or more symptoms lasting four or more weeks³. The most commonly reported symptoms from the University of Arizona study were: fatigue, shortness of breath, brain fog, and stress or anxiety⁴.

The following is a list of the most common post-COVID symptoms⁵:

Difficulty breathing or shortness of breath
Tiredness or fatigue
Symptoms that get worse after physical or mental activities (also known as post-exertional malaise)
Difficulty thinking or concentrating (sometimes referred to as “brain fog”)
Cough
Chest or stomach pain
Headache
Fast-beating or pounding heart (also known as heart palpitations)
Joint or muscle pain
Pins-and-needles feeling
Diarrhea
Sleep problems
Fever
Dizziness on standing (lightheadedness)
Rash
Mood changes
Change in smell or taste
Changes in menstrual period cycles

While there are limitations to the data, it seems the prevalence of these symptoms is high and may affect a large number of people. It remains to be seen how long these symptoms may last and how COVID-19 infection may impact a person’s overall health. It is important for healthcare providers to relay this information to patients who may not know that COVID 19 may have a long-term impact on their health or cause disability. Perhaps then we can change some people’s minds about getting vaccinated to protect themselves from infection and the long-term consequences of that infection.

References

¹Emphasize personal health benefits to boost COVID-19 vaccination rates. Proceedings of the National Academy of Sciences of the United States of America

^2,4Post-acute sequelae of COVID-19 in a non-hospitalized cohort: Results from the Arizona CoVHORT

^3,5COVID-19 and Your Health. Centers for Disease Control and Prevention