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.

 

2 hours ago, Sciencedude1 said:

 

God I feel sorry for the patients you deal with. God forbid any of your patients disagree with your point of view, or are not vaccinated.

I feel sorry for them too. I freely admit that, thanks to the four 12 and two 16 hour shifts I've worked in the last seven days, I'm not at the top of my game. 

      Of course the reason I've worked so much is to take  care of the unvaccinated people choosing to tax our ICU staff beyond the breaking point. 

    

Specializes in Adult Internal Medicine.
3 hours ago, Sciencedude1 said:

What else should we mandate in the future because it is in the best interest of public health? I don't understand why that is so difficult to understand. 

Did not have a clue that there already exists a mechanism for compensating those who experience a “vaccine injury” that does not require a lawsuit.

OK so because I don't know something that automatically discredits me.

I'm going to respond to this as I would respond to a nursing student: there will be lots of things in your future that you don't know, and in the end, what differentiates a safe nurse and a dangerous nurse, is their understanding of their own limitations. You can not be a safe nurse if you do not clearly know what you don't know. Not knowing something doesn't discredit you but speaking with authority on a topic without having even the most basic understanding of it does discredit you. 

In the midst of the small pox crisis, more than a century ago, a pastor named Henning Jacobson (who himself was injured by a vaccine), refused the forced vaccination mandate by the State of Massachusetts (and I mean forced, they fined people and even handcuffed them and forcibly vaccinated them). The case was taken all the way to the Supreme Court of the United States, and in 1905, the SC ruled that: "in every well ordered society charged with the duty of conserving the safety of its members the rights of the individual in respect of his liberty may at times, under the pressure of great dangers, be subjected to such restraint, to be enforced by reasonable regulations, as the safety of the general public may demand....[r]eal liberty for all could not exist under the operation of a principle which recognizes the right of each individual person to use his own [liberty], whether in respect of his person or his property, regardless of the injury that may be done to others." Vaccine mandates began in 1905 and we have yet to spiral out of control. 

Specializes in NICU, PICU, Transport, L&D, Hospice.
2 hours ago, Sciencedude1 said:

LOL an opinion? The article has references to peer reviewed publications with imperical data discussing incident rates of myocarditis and pericarditis. Hardly an opinion. 

Yeah, an opinion. The incidence of myocarditis and pericarditis following acute viral infection is higher than following vaccination.  

Specializes in Trauma ED.
On 11/1/2021 at 10:23 PM, PMFB-RN said:

What has proven to increase vaccination rates are vaccine mandates. I hope we have more of them.

   A side benefit it that the mandates prevent the anti vax bullies from depriving us of our freedom and body autonomy as they have for the last 10+ months.

   I fully understand that its uncomfortable for the bullies when we, their victims, start to hit back. But I don't care about their discomfort any more than they have cared about ours for the last year. 

I disagree with anti-vaxxers who argue about efficacy and safety of vaccines including the COVID vaccines. I am currently waiting for my booster. That said, I am curious as to how they deprive anyone of their freedom and body autonomy? Can you elaborate on that as I am apparently missing something.

Specializes in burn ICU, SICU, ER, Trauma Rapid Response.
9 hours ago, RETNAVYTHENMEDIC2RN said:

I disagree with anti-vaxxers who argue about efficacy and safety of vaccines including the COVID vaccines. I am currently waiting for my booster. That said, I am curious as to how they deprive anyone of their freedom and body autonomy? Can you elaborate on that as I am apparently missing something.

You haven't heard of travel restrictions? My wife has been unable to vist her father who is in ilhealth thanks to the unvaxxed.  How about the people who have died because the unvaxxed have chosen to get very sick and clog up the ICUs?

     Suggest you go to the COVID forum and read my post "I'm Done"

    No sence in my typing it all out again.

  Off topic but,  I see by your user name you were a corpsman.  I was an army medic. Here in Wisconsin medics and corpsmen can challenge the pandemic license exam without further training. We can also become RNs in only two semesters (9 months including one off for the holidays) for around $4k in a fully accredited (NLN) associate's degree program at any one of our 16 technical colleges. 

    I just mention it in case you have any service buddies.

22 hours ago, RETNAVYTHENMEDIC2RN said:

I disagree with anti-vaxxers who argue about efficacy and safety of vaccines including the COVID vaccines. I am currently waiting for my booster. That said, I am curious as to how they deprive anyone of their freedom and body autonomy? Can you elaborate on that as I am apparently missing something.

I also feel that my freedom has been curtailed.  I cannot travel where I want, or do some of the acctivities I love.

And while my body autonomy seems currently intact, it will be a hell of a lot less autonomous if I get truly sick from Covid.  The chances of which are much higher due to a politically motivated resistance to vaccination.

FWIW- I do not blame the victims of the propaganda- I blame the purveyors.  That is every single politician and cable tv talking head who:

A- understands vaccine efficacy as evidenced by getting vaccinated.
B- supports vaccine mandates.  Schools, military, new Americans, etc.  Except for the craziest of the crazy, not one of these folks has suggested we reintroduce polio and measles to schools, risk our defensive capability, or allow preventable disease to enter this country.

 

Specializes in Trauma ED.
On 11/19/2021 at 8:34 AM, hherrn said:

I also feel that my freedom has been curtailed.  I cannot travel where I want, or do some of the acctivities I love.

And while my body autonomy seems currently intact, it will be a hell of a lot less autonomous if I get truly sick from Covid.  The chances of which are much higher due to a politically motivated resistance to vaccination.

FWIW- I do not blame the victims of the propaganda- I blame the purveyors.  That is every single politician and cable tv talking head who:

A- understands vaccine efficacy as evidenced by getting vaccinated.
B- supports vaccine mandates.  Schools, military, new Americans, etc.  Except for the craziest of the crazy, not one of these folks has suggested we reintroduce polio and measles to schools, risk our defensive capability, or allow preventable disease to enter this country.

 

I am assuming you are vaccinated. If that is the case, the chances are very low that you will get truly sick from COVID. That is what the CDC, the medical experts at leading health institutions, and the manufacturers of the vaccines tell us. That is what the data from the hospitals purport to show when they say that 95-99% of those hospitalized due to COVID are unvaccinated. I know the health system where I work provides the data from our ICU's that show that to be the case. While we are not overwhelmed by COVID patients, the vast majority who are hospitalized are unvaxxed.

I am somewhat surprised by the number of medically trained vaccinated people who seem disproportionately worried about the impact the virus will have on them. I have worked in the ED since the start of this mess. Been vaxxed since 12/20 (got it the second day it was available to me.) I have never tested positive for COVID. I now rely on the vaccine to provide an additional level of protection along with what I did pre-vaccine: follow basic hygiene and universal precautions during each patient contact, and increase that level of protection accordingly when the patient has sx which indicate potential for COVID/Flu e.g. fever, cough, N/V. etc. To be blunt, as a medical professional, I need to show confidence in the vaccine, or why bother to support it? I tell patients it's important to be vaccinated as it prevents severe illness in the majority of patients who are subsequently exposed to COVID. I tell them how long I have been working around it and that I feel the vaccine is part of the reason I have never been infected or infected to the point I was symptomatic.

I also don't make a huge deal about unvaxxed people, as I have been asked several times by patients: If the vaccine is so good why are you worried about them. They have a valid point. I do explain that just because I get a flu vaccine, I don't get near a patient with a positive flu test w/o a mask. We always masked up for them pre-COVID. Why? We can still catch the flu even if we are vaccinated. The catch, a vaccinated positive flu patient, like a positive vaccinated COVID patient will likely be in laymen's terms "less infective" than someone who is vaccinated. At the end of the day though, I explain to the patient that an individual can only control themselves and that is what they should focus on, hence, get the vaccine. Not sure if it makes a difference with them, but that's my take. 

Specializes in OB, OB surgical tech, nursing education.

Congratulations on winning the contest! Your article has definitely stirred up some conversations amongst ourselves. I agree we need to figure out a way to reframe why vaccinations are important, outside the context of mandates and scare tactics. Certainly it is the choice of the individual to vaccinate or not, just like it is the choice of the institution to require the vaccination as terms of employment. It goes both ways. In the midst of a critical nursing shortage I would hope most nurses could accept the COVID vaccination as a part of their job (Like Hepatitis and flu vaccinations), but we all must have the freedom to make that choice. Unfortunately the choice of others can have a negative impact on our communities and those we love. That’s been happening for a long time now with childhood vaccinations, it’s only now the stakes have risen considerably higher. 

Specializes in burn ICU, SICU, ER, Trauma Rapid Response.
On 11/22/2021 at 12:51 PM, RETNAVYTHENMEDIC2RN said:
Quote

I am somewhat surprised by the number of medically trained vaccinated people who seem disproportionately worried about the impact the virus will have on them.

I'm not concerned about the impact the VIRUS will have on me. I've been bathed in COVID since the start. I take precautions but I'm not afraid of it.

   It's kinda like a rattlesnake. I have no problem with them but recognize they are too dangerous to be allowed to live in my yard so I relocate all those I find in my yard. Just taking common sense precautions. It's not fear. 

     I'm legitimately concerns about the impact the unvaccinated have had and continue to have on me, my family, friends and coworkers. 

 

Quote

I also don't make a huge deal about unvaxxed people, as I have been asked several times by patients: If the vaccine is so

good why are you worried about them.

Because the vaccine provides zero protection against car accidents, active shooters, or any other kind of trauma. I very much hope you or your loved ones are not denied critical care after being injured because the unvaccinated' s choice to get very sick and clog up the ICUs, as has already happened with some deaths as a result. 

 

 

Specializes in Critical Thinking-Critical Care.
On 11/13/2021 at 2:44 PM, MunoRN said:

"But myocarditis caused by Covid infection is generally more severe and often permanent, and occurs far more commonly" 

No a new publication in Nature by Oxford University studied the rates of myocarditis vs COVID19 infections. There was a clear signal in the data that one commonly used vaccine has higher rates of myocarditis compared to actual infection. So in other words not all vaccines against covid19 have the same risk.This information may be useful in determining which vaccine to get if you suffer from heart issues. Dr. Vinay Prasad MD MPH an associate professor from the University of California San Francisco does a pretty good job of explaining the study. He makes a good point in the video where we should strive to find a vaccine regimen which poses the lowest risk with the highest amount of protection against the virus.

Patone, M., Mei, X.W., Handunnetthi, L. et al. Risks of myocarditis, pericarditis, and cardiac arrhythmias associated with COVID-19 vaccination or SARS-CoV-2 infection. Nat Med (2021). https://doi.org/10.1038/s41591-021-01630-0

 

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

No a new publication in Nature by Oxford University studied the rates of myocarditis vs COVID19 infections. There was a clear signal in the data that one commonly used vaccine has higher rates of myocarditis compared to actual infection. So in other words not all vaccines against covid19 have the same risk.This information may be useful in determining which vaccine to get if you suffer from heart issues. Dr. Vinay Prasad MD MPH an associate professor from the University of California San Francisco does a pretty good job of explaining the study. He makes a good point in the video where we should strive to find a vaccine regimen which poses the lowest risk with the highest amount of protection against the virus.

Patone, M., Mei, X.W., Handunnetthi, L. et al. Risks of myocarditis, pericarditis, and cardiac arrhythmias associated with COVID-19 vaccination or SARS-CoV-2 infection. Nat Med (2021). https://doi.org/10.1038/s41591-021-01630-0

 

I'm not sure what you're saying "no" to.  

It seems to be the idea that myocarditis is more common with Covid infections than with vaccines.  Yet your reference only confirms that.

Specializes in Critical Thinking-Critical Care.
12 hours ago, MunoRN said:

I'm not sure what you're saying "no" to.  

It seems to be the idea that myocarditis is more common with Covid infections than with vaccines.  Yet your reference only confirms that.

Really then you haven't  taken the time to read the publication or watch the video of the doctor presenting the study. Moderna has higher rates of myocarditis after the 2nd vaccination compared to COVID19 infections. Pfizer on the other hand has lower rates of myocarditis compared to covid19 infection. So it seems that the vaccination with better safety profile between the two is Pfizer. Especially for males under 40 years of age. In other words different vaccines have different safety profiles so which vaccine a patient gets or does not get should be decided between the patient and the doctor after a benefit risk analysis.