Ritom Bhuyan wasn’t going to get the coronavirus vaccine. But three months ago, the 28-year-old rolled up his sleeve and got immunized.
What changed his mind? The health of his 65-year-old father, who struggled with COVID-19 for a month after the family all caught the virus. Bhuyan realized he wanted to protect his dad by getting vaccinated.
“My mom passed at a young age, so my dad’s all I have,” said Bhuyan, of Plymouth Meeting, “so when I saw him get sick with something potentially deadly, that kind of changed my mind.”
These deeply personal reasons are often why people who are initially reluctant decide to get vaccinated, said several physicians and vaccine providers, and finding those connections may be key to increasing vaccination.
With the delta variant sparking outbreaks in the country’s undervaccinated communities, causing case counts to rise across the Philadelphia region and prompting renewed masking rules, changing minds — and getting people to finally walk into a clinic and get their shot — has new urgency, they said.
Doctors recommend patience. Six months into the vaccine rollout, they say, people who haven’t been vaccinated may require some convincing, and open, fact-based, nonjudgmental conversations with those they trust can help.
While the duration of the pandemic has increased the urgency, it also has provided real-world data that doctors say they can use persuasively: The vaccines are safe; they keep people from getting severely ill, even if the vaccinated occasionally get a rare breakthrough infection; and the people ending up in hospitals are usually unvaccinated.
“You can have a conversation with anyone about the impact of COVID on their life,” said Marisa Rogers, a physician and executive medical director at Oak Street Health, which has 10 clinics in the Philadelphia area for patients on Medicare. “Connecting people to how COVID has impacted their life and tying vaccines to a return to normalcy, whatever that means to that individual, really gets them to buy in on the value.”
Instead, they said, people seemed more swayed by emotional and lifestyle reasons — a relative or loved one’s hospitalization with the virus; the desire to travel again; or an impending return to in-person work or school.
“We are seeing a resurgence in interest in getting vaccinated,” said Ronan W. Gannon, CEO of La Comunidad Hispana Health & Community Services, which offers free vaccination at its three Chester County sites. “We think it’s likely a combination of the delta variant concerning people, some employers mandating vaccinations, and the prospect of schools reopening in the fall in person.”
While the daily number of vaccinations in Pennsylvania and New Jersey remains far less than it was during the spring rush, the counts have risen modestly over the last month, with both states on track to give more people first doses in August than they did in July, according to an Inquirer data analysis.
Vaccine uptake is increasing nationwide, too, especially in places where delta is hitting the hardest. Louisiana, Arkansas, Missouri, Mississippi, Oklahoma, and Alabama have recently been inoculating as many people as they did during the April peak, White House coronavirus response coordinator Jeff Zients said last week at a news briefing.
However, the majority of people in the United States who were strongly against getting the vaccine at the beginning of the year had not changed their minds as of last month, according to ongoing research by the Kaiser Family Foundation. Still, roughly a quarter of those who said in January that they would “only get vaccinated if required” or would “definitely not” be immunized, had since received at least one dose.
At Adam Rom’s practice in South Philadelphia ― where the majority of patients are people of color, 40% don’t speak English, and many live in poverty — the family physician views vaccine persuasion as an incremental battle, one he’s motivated to keep fighting.
“We’ve convinced people over time that wearing a seat belt is a very effective way to prevent injury and death. Unfortunately with the COVID vaccine, we don’t have years. We have months,” said Rom, who leads the coronavirus vaccine and testing program for Greater Philadelphia Health Action, Inc.. “We have to realize even if a patient said no 10 times in the last year, something could’ve happened, some lightbulb could’ve gone off, and they could be ready to make a change.”
The power of ‘pause’
Doctors said they often are able to have the biggest impact on longtime patients, ones with whom they’ve established trust over years and whose family members the physician may also treat.
Rogers employs this strategy with her patients, most of whom are people of color and many of whom don’t trust the health-care system due to its long history of abuse and mistreatment of Black people. Sometimes they’ve experienced inequity firsthand. So Rogers said she and her colleagues try to focus on the patients’ trust of them and their practice: “We’re not asking them to trust the health-care system.”
Rom said he has explained to his patients that they may be particularly vulnerable to the virus due to health-care disparities, health conditions, age, or a combination of factors. Then he asks them: Do they know of anyone who has died or gotten seriously ill from COVID-19?
“At that point, I usually say: ‘I’m really sorry to hear that. That’s such a tragedy,’” Rom said. “And then I kind of pause, and let them make their own connection in their own minds.”
By tapping into personal motivators and listening to the unique concerns of each patient, Genevieve Minick, a Crozer Health primary-care physician, said she has been successful in persuading about three-quarters of vaccine-reluctant patients she’s seen at her Drexel Hill office in recent weeks. With young people, among the hardest to reach and the most undervaccinated, she tells them that there are fewer elderly patients in the hospital now because most have been vaccinated.
“They haven’t heard the information about how it’s young, healthy people that are in the hospitals,” she said. “And that really gives people something to pause, something to think about.”
Some patients are difficult to persuade, and might not ever change their minds, a fact with which doctors say they’ve had to make peace. But for those who are still reluctant, the influence of loved ones may be able to help.
“I have had some patients, as well as some friends, who I know specifically got vaccinated because of a relative, particularly an older relative who they know is at risk,” said Rogers. “Another option for younger people is to think not about themselves, but think about who they’re protecting in terms of loved ones.”
Rom said he isn’t sure whether enough people can be persuaded to get the vaccine in time to ward off delta or future variants. And every time he reads a news story about someone who died of the virus, his heart breaks, he said, knowing more vaccinations could have prevented it.
That means each vaccination is a victory.
“Every time I have one person who comes in and says, ‘I got vaccinated,’ I just say to them: ‘I’m so proud of you. You made such a good choice for you and your family,’” Rom said. “And I go home feeling good about the day.”
Staff writer Justine McDaniel and graphics artist Chris A. Williams contributed to this article.