The Vaccination Gap: Leading with Empathy

The COVID-19 vaccination divide requires a new type of Nursing Leader; one who leads with empathy and understanding.

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The Vaccination Gap: Leading with Empathy

The year 2021 began with such promise. New COVID-19 vaccines had not only gained Federal Drug Administration Emergency Use Authorization, but those at highest risk were eagerly snapping up every available dose. As more vaccines rolled out, millions of American adults—and then teenagers—rolled up their sleeves.

But a large minority of Americans expressed lack of confidence in vaccination from the start. According to a rolling survey fielded by the Kaiser Family Foundation, many were taking a “wait and see” attitude because of the newness of the vaccine. Others said they would only get the shot if it was required, and some said they would “definitely not” get vaccinated, even if it was required.

Today, for reasons that predate the COVID-19 pandemic—including concern about side effects and a lack of trust in the government or the scientific community—three out of four of those who lacked vaccine confidence in January have not changed their minds. As we near the end of August, just over half of American adults are fully vaccinated.

The Vaccination Divide

The vaccination divide in our country is an important conversation for case managers and certified disability management specialists. It has been identified that this is a clear public health risk with mitigating factors that can include vaccination, herd immunity, masking, and social distancing. Voluntary efforts have not yet achieved this goal. For employers, the need to protect employee health and to mitigate lost productivity drives some to push for vaccination and other safety measures; perhaps without full consideration of individual beliefs and barriers. As professionals in the field know, there is enormous potential for differences in opinion about vaccination to cause stress and increase tensions among peers at the workplace and with clients who may not share their vaccination viewpoint. Being aware of the differences of opinion, as well as the science related to vaccination, can help case managers and disability management specialists navigate the client’s journey.

COVID-19 vaccination has been presented as a personal choice. And, as former Surgeon General Jerome Adams said in a July 25, 2021, interview, choices have consequences. (It may be recalled that Adams was a keynote speaker at the 2018 CCMC New World Symposium.)

Today, with just over half of American adults fully vaccinated, the deadly and highly
contagious Delta variant of COVID-19 has taken hold. Virus case rates jumped in just a month to pre-vaccine levels, according to information from the Centers for Disease Control and Prevention. In July, Adams warned: “This pandemic is spiraling out of control yet again, and it’s spiraling out of control because we don’t have enough people vaccinated. So, get vaccinated because it helps your neighbors, but get vaccinated because it’s going to help every single American enjoy the freedoms that we want to return to.” Surgeon General Dr. Vivek Murthy, agrees, stating, “That is ultimately how we are going to save lives and overcome the [Delta] variant.”

We all agree that we want the freedom to gather without social distancing and go out without a mask, whether it be for work, school, or entertainment. Yet just two days after this interview, the CDC updated its guidance for the fully vaccinated, recommending they wear masks in public indoor places once again. Although there’s no indication of a future federal mandate for vaccination, there are daily reminders that decision-makers in business and local governments are willing to up the stakes in favor of vaccination. New York City announced the first week in August that diners and theater-goers would be required to show proof of vaccination before entering venues. A growing list of employers—from health care plans to big-box stores, airlines, high-tech innovators, and entertainment giants—announced vaccination requirements for on-site workers. And, some companies that had been planning to have their employees return to the office have now extended their remote work schedules through the end of the year.

Listen with Empathy and Understanding

For case managers and certified disability management specialists, it’s critical to remember that our Codes of Professional Conduct require us to respect the rights and dignity of our clients. Our own vaccination viewpoint may be in complete opposition to theirs, but our professional role is to listen with empathy and understanding.

Several real barriers to vaccination have been identified. The recent final approval of the Pfizer vaccine by the FDA may help to eliminate some of these concerns, but some are still available reluctant due to the rapid development of the current vaccines. Others may have a strongly held religious objection. Or perhaps an individual fears side effects from vaccination that could impact their ability to work and, in turn, affect their financial well-being.

Respond with Empathy

By responding with empathy, case managers may have an opportunity to offer information that could help clients make an informed decision. Listening will also contribute to your understanding of the individual’s readiness to consider their options. It’s critical that you remain non-judgmental in your client relationships. Assess their willingness to receive information about vaccination and be supportive in providing information when desired so clients can consider choices and make an informed decision.

Build Trust and Support

Both board-certified case managers and disability management specialists have an ethical responsibility to the principles of beneficence (to do good to others) and non-maleficence (to do no harm). We are charged with honoring the client’s desires and their right to make their own decisions (the principle of autonomy). By listening rather than judging, we have the opportunity to build trust and support our clients in their decisions, even if we disagree.

MBK-MaryBethKurland2020-tiny.jpg.9e70f606c259ff8bf22af9735638cba5.jpg Article written by...
 MaryBeth Kurland, CAE, 
 Chief Executive Officer,
 Commission for Case Manager Certification


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The Commission for Case Manager Certification is the first and largest nationally accredited organization that certifies more than 48,000 professional case managers and disability management specialists. The Commission is a nonprofit, volunteer organization that oversees the process of case manager certification with its CCM® credential. The Commission is positioned as the most active and prestigious certification organization supporting the practice of case management. The Commission also oversees the process of disability management specialist certification with its CDMS® credential. For more information, visit, connect with the Commission on Facebook or follow us on Twitter @CCM_Cert.

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jive turkey

677 Posts

Specializes in A variety. Has 11 years experience.

These are great suggestions for EVERYONE in the medical field.  Not only for the patients' benefit but also for fellow medical professionals with concerns and hesitancy. 


20,964 Posts

Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis. Has 26 years experience.

Great article. However empathy is running in short supply for the front line who are weary and exhausted from all this. People who willfully refuse to take a step to protect themselves and others are being met with as much empathy as such staff can render. But it's going to wane fast. Seeing so much needless death and illness, and denying others (non-COVID) patients space in the hospital is going to have a backlash effect that is hard to conceal.

The ones I have the most empathy for are these health care providers and those made ill through no fault of their own.

2BS Nurse, BSN

699 Posts

Has 10 years experience.

In the beginning, I understood the hesitancy. Now that we have more evidence (vaccine safety, unvaccinated being admitted to our hospitals), it's getting harder to muster the empathy. It's heartbreaking to see stories of pregnant women and young nurses with children dying when we have a vaccine to prevent death. Also, how many of our health care tribe died before the vaccine was even available?

Our unvaccinated "medical professional" coworkers should know better. I have no empathy for them.