In doc we trust: Physicians moving the needle among vaccine-hesitant patients

After being shut out, by and large, of the country’s COVID-19 vaccination programs, Canadian physicians are now being hailed as critical players in the push to immunize vaccine-hesitant holdouts. On CBC.ca, a 73-year old resident of Peel region–one of the hardest hit areas in Ontario–named her family doctor among three people who changed her mind about getting a COVID-19 vaccine. "The educational information I received changed my mind completely," said Jennie Powell, who had attended a virtual information session on vaccines that her family physician had organized. Before that session, Powell said she had been telling everyone “I’m going to be the last one to take this vaccination. I’m not taking it, no.” In Toronto, Dr. Tara Kiran became the subject of a lengthy feature in the Toronto Star after she spent the better part of an hour convincing two patients–a mother and daughter–to book their COVID-19 vaccine appointments. The two women were among the roughly 20% of Canadians 12 years and older who, for various reasons, have not received their first dose. “I’m not getting it unless I can get it from Dr. Kiran,” the daughter, who is 39 years old, had told her husband, according to the Toronto Star story. The two women–who agreed to let the Star’s reporter observe their appointment but did not want their real names used–had been Dr. Kiran’s patients for almost 10 years. They lived in a part of the city considered a COVID-19 hotspot but held off on getting their shots weeks after they had both become eligible for vaccination. Dr. Kiran knew that mother and daughter worked together in their family’s convenience store, and was worried about their risk of infection. But she also knew that pushing them to get vaccinated could turn their reluctance to refusal. “If you try to rush it, you run the risk of not listening deeply,” Dr. Kiran told the Star. “You also run the risk of dismissing concerns.” So she took the time to listen and respond. The two wanted to know if they could choose the Pfizer BioNTech vaccine over Moderna. Dr. Kiran explained that, although a lot of people think Pfizer is better, the two mRNA vaccines are very similar and it would be like choosing between Colgate and Crest toothpaste. The mother, who had kidney-related problems in the past, said she had seen stories on YouTube that suggested COVID-19 vaccines were unsafe for people with kidney conditions. “One of the things that’s important to remember is that, unfortunately, there’s a lot of fake news,” Dr. Kiran reassured the woman. She cited stories from other patients about YouTube videos that made all sorts of unfounded claims about adverse reactions to vaccines, or that alleged the injections contained metals. Throughout the dialogue, the daughter translated for her mother, whose first language is Korean. “My mom’s still not 100% sure,” the daughter told Dr. Kiran. She and her mother knew fake news was a problem, but were uncertain which sources to trust. Dr. Kiran also addressed their concerns about allergies to latex and other substances. She listed the components of COVID-19 vaccines and told the women they were not at risk from these ingredients. She also told them that most allergic reactions occur right away and are treatable. “That’s why you’re asked to wait for 15 minutes,” she said, adding that they could even wait for 30 minutes after receiving the vaccine if that made them more comfortable. But the daughter was still worried. She had broken out into hives in the past after taking certain medications and was afraid it might happen again with the COVID-19 vaccine. “If that happens at home, then what happens?” she asked. “That’s the thing I’m most scared of.” Dr. Kiran offered a solution: she would give the daughter a prescription for an EpiPen, just in case. Then she moved to close the deal. She shifted the conversation to focus on the vaccine’s benefits, and on the risks of not getting immunized against COVID-19. She made it personal: The women's work at their convenience store exposed them daily to COVID. The mother had diabetes and, at 66 years of age, was in a high-risk category. The daughter had children too young to be vaccinated. “So that’s why it’s so important to get the vaccine,” Dr Kiran told them. “Especially your mom, but all of you really.” When the daughter acknowledged that she knew she really needed the vaccine, Dr. Kiran presented an idea. She was working the next day at a community vaccine clinic. How about mother and daughter go there so she could administer their vaccines? The mother nodded. That was enough for Dr. Karan to get on her computer to look for appointments for the next day’s vaccine clinic. “When you come tomorrow we can talk a little bit more,” she told the women. The next day, mother and daughter arrived together at the vaccination clinic. After getting their injection from Dr. Kiran, they stayed in the observation area for 40 minutes. A week after the vaccinations, the daughter said she felt hesitant about getting her second dose. She had experienced mild symptoms from the first shot, which made her wonder if she had made the right decision. She had booked another appointment with Dr. Kiran to discuss her concerns. “I want to see what she thinks,” she said.

In doc we trust: Physicians moving the needle among vaccine-hesitant patients

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