Changing the Conversation about COVID to Get More People Vaccinated

This article talks about the type of messaging that is most effective at changing minds about vaccination and how we can provide that messaging through discussion about long COVID-19. Nurses COVID Article

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

Specializes in burn ICU, SICU, ER, Trauma Rapid Response.
58 minutes ago, Sciencedude1 said:

The government mandating people being fired for not being vaccinated is a form of coercion. Coercion is not consent and takes the power of choice away from an individual. Autonomy is all about the patient choosing what medical treatment they will receive or not receive. 

Meh, we have been coerced and been deprived of choices and our autonomy for the last 10+ months by the anti vaxxers.  

    We have been bearing the brunt of the pandemic.  The days of accommodating the unvaxxed are (thankfully) coming to and end.

Specializes in Critical Care.
3 hours ago, Sciencedude1 said:

You missed the point. Myocarditis and Pericarditis is a risk and it appears that the CDC is attempting to quantify the risk. Regardless if it is a small or moderate risk, there is a risk.

"Cases of myocarditis reported to the Vaccine Adverse Event Reporting System (VAERS)external icon have occurred:

After mRNA COVID-19 vaccination (Pfizer-BioNTech or Moderna), especially in male adolescents and young adults,

More often after the second dose

Usually within several days after vaccination"-CDC

 

VAERS isn't a system for reporting confirmed or even suspected adverse reactions to a vaccine.  Your suggestion that this is what VAERS represents is irresponsible.

1 hour ago, Sciencedude1 said:

The government mandating people being fired for not being vaccinated is a form of coercion. Coercion is not consent and takes the power of choice away from an individual. Autonomy is all about the patient choosing what medical treatment they will receive or not receive. 

Then requiring that I wash my hands after using the bathroom is also a form of coercion.  And for that matter, the threat of jail for drinking and driving is a form of coercion.  

Specializes in burn ICU, SICU, ER, Trauma Rapid Response.
17 minutes ago, MunoRN said:

 

Then requiring that I wash my hands after using the bathroom is also a form of coercion.  And for that matter, the threat of jail for drinking and driving is a form of coercion.  

It gets worse than that. My employer forces me to send my own hard earned money to the state and says I'll be fired if I don't renew my nursing license.  Its absolutely coercion. I should be free to spend the money I earn however I want.  I'm being deprived of my freedom!

Specializes in Critical Care.
7 minutes ago, PMFB-RN said:

It gets worse than that. My employer forces me to send my own hard earned money to the state and says I'll be fired if I don't renew my nursing license.  Its absolutely coercion. I should be free to spend the money I earn however I want.  I'm being deprived of my freedom!

They've also coerced me into completing a degree in Registered Nursing, saying they wouldn't hire me if I didn't have such a degree.  

Specializes in Critical Thinking-Critical Care.

Well this conversation is starting to ...

4 hours ago, MunoRN said:

VAERS isn't a system for reporting confirmed or even suspected adverse reactions to a vaccine.  Your suggestion that this is what VAERS represents is irresponsible.

Then requiring that I wash my hands after using the bathroom is also a form of coercion.  And for that matter, the threat of jail for drinking and driving is a form of coercion.  

I never suggested anything about VAERS. The only thing I suggested is that we respect the patients autonomy. However I went ahead and searched what VAERS is and found this on the VAERS website "Established in 1990, the Vaccine Adverse Event Reporting System (VAERS) is a national early warning system to detect possible safety problems in U.S.-licensed vaccines". So it appears that VAERS is a system for reporting adverse vaccine reactions.

https://vaers.hhs.gov/about.html

 

 

Specializes in Critical Thinking-Critical Care.
5 hours ago, PMFB-RN said:

Meh, we have been coerced and been deprived of choices and our autonomy for the last 10+ months by the anti vaxxers.  

    We have been bearing the brunt of the pandemic.  The days of accommodating the unvaxxed are (thankfully) coming to and end.

Can you please expand on how you have been "coerced and been deprived of choices and our autonomy for the last 10+ months by the anti vaxxers"?

I'm not anti vaccine by the way. I myself have chosen to be vaccinated. I am however pro-choice. I strongly believe that all medical decisions should be made by the patient and doctor considering that all medical treatments including vaccines have risk. 

If the new mRNA vaccines did not present any risk for adverse reactions, than Pfizer and Moderna would not need total immunity from legal liability that they currently enjoy. 

https://www.cnbc.com/2020/12/16/covid-vaccine-side-effects-compensation-lawsuit.html

Specializes in Hospice.
34 minutes ago, Sciencedude1 said:

Well this conversation is starting to ...

I never suggested anything about VAERS. The only thing I suggested is that we respect the patients autonomy. However I went ahead and searched what VAERS is and found this on the VAERS website "Established in 1990, the Vaccine Adverse Event Reporting System (VAERS) is a national early warning system to detect possible safety problems in U.S.-licensed vaccines". So it appears that VAERS is a system for reporting adverse vaccine reactions.

https://vaers.hhs.gov/about.html

 

 

 No, it’s a system for reporting adverse events occurring in proximity to vaccination. There’s a difference. Finish reading your own citation.

Better yet, run a search here on AN. Several members have explained the error of using a VAERS listing as evidence of a side effect.

 

Specializes in Critical Thinking-Critical Care.

OK I see what you are saying. The system is utilized to detect patterns regarding adverse reactions around the time of vaccination. However, the CDC has recognized a pattern of adverse reactions associated with mRNA covid19 reactions which consists of incidents of myocarditis and pericarditis after the 2nd vaccination, and is commonly seen in young adults as per the webpage I referenced earlier. There most be a statistically significant signal from the data in order for them to encourage the public to be vigilant for symptoms indicating myocarditis/pericarditis. 

Specializes in Hospice.
2 minutes ago, Sciencedude1 said:

OK I see what you are saying. The system is utilized to detect patterns regarding adverse reactions around the time of vaccination. However, the CDC has recognized a pattern of adverse reactions associated with mRNA covid19 reactions which consists of incidents of myocarditis and pericarditis after the 2nd vaccination, and is commonly seen in young adults as per the webpage I referenced earlier. There most be a statistically significant signal from the data in order for them to encourage the public to be vigilant for symptoms indicating myocarditis/pericarditis. 

Have you compared the incidence of those reactions to the incidence of those problems as complications of active Covid infection? Is there a difference in relative severity between the two etiologies?

 

Specializes in Critical Thinking-Critical Care.

 

39 minutes ago, heron said:

Have you compared the incidence of those reactions to the incidence of those problems as complications of active Covid infection? Is there a difference in relative severity between the two etiologies?

 

No I will leave that statistical analysis to you. What I did happen to find is a publication on pubmed discussing myocarditis, pericarditis, and cardiomyopathy after covid19 vaccination. 

"The US Centers for Disease Control and Prevention (CDC) by mid-June 2021 had reported 1,226 cases of myocarditis after mRNA vaccination (Pfizer or Moderna, 29 December 2020–11 June 2021) from 296 million doses [37,38], an incidence of 4.1 per million doses" (Pepe et al., 2021).

Pepe et al., 2021 states that the median age of cardiac adverse events is 26, 75% of individuals with adverse events were males, and most incidents occured after the 2nd shot. 

This once again brings up the question as to what recourse do these young men have if they develop severe cardiomyopathy from a government mandated vaccine. Pfizer and moderna have legal immunity. These young men could be potentially disabled for life and have no legal recourse. Seems like a raw deal to me.

The original post was about how do we convince people to take on the risk of getting vaccinated. I think a good place to start is providing some kind of financial safety net for vaccine injured individuals. 

Reference

Pepe, S., Gregory, A. T., & Denniss, A. R. (2021). Myocarditis, pericarditis and cardiomyopathy after COVID-19 vaccination. Heart, Lung and Circulation, 30(10), 1425–1429. https://doi.org/10.1016/j.hlc.2021.07.011

 

 

Specializes in Hospice.
36 minutes ago, Sciencedude1 said:

 

No I will leave that statistical analysis to you. What I did happen to find is a publication on pubmed discussing myocarditis, pericarditis, and cardiomyopathy after covid19 vaccination. 

"The US Centers for Disease Control and Prevention (CDC) by mid-June 2021 had reported 1,226 cases of myocarditis after mRNA vaccination (Pfizer or Moderna, 29 December 2020–11 June 2021) from 296 million doses [37,38], an incidence of 4.1 per million doses" (Pepe et al., 2021).

Pepe et al., 2021 states that the median age of cardiac adverse events is 26, 75% of individuals with adverse events were males, and most incidents occured after the 2nd shot. 

This once again brings up the question as to what recourse do these young men have if they develop severe cardiomyopathy from a government mandated vaccine. Pfizer and moderna have legal immunity. These young men could be potentially disabled for life and have no legal recourse. Seems like a raw deal to me.

The original post was about how do we convince people to take on the risk of getting vaccinated. I think a good place to start is providing some kind of financial safety net for vaccine injured individuals. 

Reference

Pepe, S., Gregory, A. T., & Denniss, A. R. (2021). Myocarditis, pericarditis and cardiomyopathy after COVID-19 vaccination. Heart, Lung and Circulation, 30(10), 1425–1429. https://doi.org/10.1016/j.hlc.2021.07.011

 

 

I believe manufacturers of any vaccine, not just Covid, are shielded from lawsuits over adverse reactions. Nothing new there. There is also a mechanism for payment in the event of a vaccine injury.

Specializes in burn ICU, SICU, ER, Trauma Rapid Response.
8 hours ago, Sciencedude1 said:

Can you please expand on how you have been "coerced and been deprived of choices and our autonomy for the last 10+ months by the anti vaxxers"?

I'm not anti vaccine by the way. I myself have chosen to be vaccinated. I am however pro-choice. I strongly believe that all medical decisions should be made by the patient and doctor considering that all medical treatments including vaccines have risk. 

If the new mRNA vaccines did not present any risk for adverse reactions, than Pfizer and Moderna would not need total immunity from legal liability that they currently enjoy. 

https://www.cnbc.com/2020/12/16/covid-vaccine-side-effects-compensation-lawsuit.html

I was already preparing my reply in my head, until I got to the conspiracy theory at the end.

    Not interested in legitimatisizing scare tactics.