In this podcast, William Schaffner, MD, offers tips for clinicians on communicating information to their patients regarding COVID-19 and the COVID-19 vaccines, including dispelling misinformation about the COVID-19 vaccines.
Additional Resources:
- COVID-19 Vaccines Myths & Facts. National Foundation for Infectious Diseases. Updated April 2021. Accessed June 23, 2021. https://www.nfid.org/infectious-diseases/covid-19-social-media-graphics/#section-vaccines
- Frequently asked questions about COVID-19 vaccines. National Foundation for Infectious Diseases. Updated June 2021. Accessed July 6, 2021. https://www.nfid.org/infectious-diseases/frequently-asked-questions-about-covid-19-vaccines/
William Schaffner, MD, is the medical director of the National Foundation for Infectious Diseases (NFID), a professor of preventive medicine in the Department of Health Policy, and a professor of medicine in the Division of Infectious Diseases at Vanderbilt University School of Medicine in Nashville, Tennessee.
TRANSCRIPTION:
Jessica Bard: Hello everyone and welcome to another installment of "Podcast360," your go‑to resource for medical news and clinical updates. I'm your moderator, Jessica Bard, with Consultant360 Specialty Network.
The purpose of the podcast today is to help clinicians' communicate information to their patients regarding COVID‑19 and COVID‑19 vaccines. Dr William Schaffner is here to help us debunk some COVID‑19 myths and provide guidelines for how clinicians' can answer even the toughest questions from their patients.
Dr Schaffner is the medical director of the National Foundation for Infectious Diseases, a professor of preventative medicine in the Department of Public Policy, and a professor of medicine in the Division of Infectious Diseases at Vanderbilt University School of Medicine in Nashville, Tennessee.
Thank you for joining us today, Dr Schaffner. Firstly, what tips would you give clinicians for addressing concerns from their patients about COVID‑19 and the COVID‑19 vaccines?
Dr William Schaffner: Jessica, I think that that's very important. To my colleagues, please remember that no question is silly, and you must respect the patient and the question that they're asking you. You can't diss the patient.
Here's the drill that I go through when I get a question, "Mr. Jones, I see that you're hesitant about getting the COVID vaccine." Then I mirror back and say, "Your hesitancy is very common. It's a normal thing to be hesitant." That reassures the patient.
Then I say, "What specifically is your concern?" The patient will tell you, and then you mirror it back, "Oh, Mr. Jones, you're worried that the vaccine was developed too quickly. I've heard that a lot." Once again, you validate their concern and they relax, and they're much more interested in listening to what you have to say.
Very gently, provide your response. Sometimes at the end of these little lectures that I give to the patient I say, "I think this is so important. I've been vaccinated and so is my wife. Indeed, my grandchildren have been vaccinated."
I'll wave in the air and say, "When you go out and look around in the office, everybody in my office has been vaccinated. We think this is very important. We want to make sure that you're protected, and your family is protected also." You can personalize it, do it very gently, and recognize that you won't convince everybody instantaneously.
Jessica: Now, let's dive into some of these possible concerns. "The COVID‑19 vaccines can have effect on women's fertility." Maybe that's a question that somebody might have. Is that fact or fiction?
Dr Schaffner: [laughs] I'm going to mirror that right back to you, Jessica. I'm going to say that's something I have heard a great deal. I can say, categorically, that these vaccines will have no effect on a woman's fertility.
Indeed, the American College of Obstetricians and Gynecologists, those very doctors that take care of women during their pregnancy have convened a very large group of experts. At the conclusion of that meeting, they said any woman who is interested in becoming pregnant, any pregnant woman and women who are lactating, who are breastfeeding, they should all be offered the vaccine because it is safe.
It will not, in any way, interfere with their current or future reproductive capacity, and that's true. Let me add to that that women who are pregnant, who get COVID infection itself are more likely to have a more severe illness.
If the infection is contracted during the latter stages of their pregnancy, it can actually predispose to premature delivery of the baby. COVID, the infection itself, is not good for either the mom or the baby.
Those are additional reasons for a pregnant woman to get vaccinated. They respond very positively when they learn that, but they need to be reassured.
Our faculty in maternal and fetal medicine, all of whom are women, have gone out to our own staff right here in the medical center and have reassured them that there is no adverse effect to their reproductive system.
Jessica: How about this one? "COVID‑19 vaccines were developed too fast to be safe."
Dr Schaffner: That's also very common. In a sense, vaccines were developed very rapidly, but of course, the science behind the vaccine took 20 years to develop. Maybe we ought to count that in.
It is true that a very intensive effort was made to develop these vaccines. The new scientific technology allowed that and then not to go into all the details, but we did many things in the vaccine evaluation process simultaneously, that under normal circumstances, would have been done in sequence one after the other.
By doing them simultaneously, we cut down the time, and we did not spare safety. That's very important not only to the Food and Drug Administration but to their external Advisory Committee, which is always very tough and has safety top of mind.
We've now given this vaccine to over 160 million Americans alone. To be a bit facetious, we've discovered that people's arms don't fall off or their noses don't turn green. We've demonstrated that these are very, very safe vaccines.
Jessica: How about, "The vaccine will alter my DNA"?
Dr Schaffner: That's also very common. Fortunately, it's also not correct. The mRNA is a messenger. It is a blueprint. We inoculate it, it tells our immune system what the blueprint is, and then the mRNA dissolves. It breaks apart. It's a very fragile molecule, and we excrete it very, very carefully.
It does not persist in our system, and in our bodies, it doesn't go anywhere near our DNA in our cells. Speaking to the doctors, the DNA ,that's in the nucleus of the cell. The mRNA doesn't go anywhere near the nucleus. It works in the cytoplasm of the cell. It doesn't go anywhere near the DNA. It cannot affect your genetic composition.
Jessica: I've heard some people say, "Don't worry about the vaccine. We can achieve herd immunity by letting the virus to spread through the population." What would you say about that?
Dr Schaffner: Well, that's plan one, and that's the viruses' plan. It would like to infect everyone, and in the course of that, it would make everyone immune. Of course, along the way, it will make a huge number of people ill. It will send them to the hospital.
If we rely on Mother Nature in this scenario, we will pay an enormous price, and of course, we have paid already a very enormous price.
Isn't it gratifying that now that we have vaccinated a larger and larger proportion of our population, the cases are diminishing, the hospital admissions are going down, the admissions to intensive care unit are going down? We need to vaccinate more people to keep this COVID virus at the lowest possible level.
Jessica: What about, "The COVID‑19 mRNA vaccines could have a long‑term negative effect on my immune system"?
Dr Schaffner: All vaccines stimulate the immune system to make it an appropriate response, so that the immune system will recognize the pathogen, whether it's bacterial or viral ‑‑ and in this case, the COVID virus ‑‑ and be able to fend it off.
No vaccine that we use in childhood or adulthood as any long term deleterious effect on the immune system. It doesn't overexcite it, or it doesn't depress it. The immune system is created by nature in order to respond appropriately to these to these sorts of stimuli, so there is absolutely no anticipation at all that any adverse effect on the immune system will occur.
It will stimulate the immune system in a very specific way to make us protected against this particular COVID virus, and of course, that's what all vaccines do. They protect us against those bad germs [laughs] that are out there.
Jessica: "Vitamin D supplements prevent or even treat COVID‑19."
Dr Schaffner: A favorite concept, and that was brought up fairly early as people were combating COVID and looking for therapies and means of prevention. It was appealing because it was natural. It was a substance with which the body was already familiar, and people liked the idea of taking a simple natural vitamin supplement in order to get protection.
The studies have now been done. If there is any degree of protection, it's very, very small. It's a slice of Swiss cheese that's very thin with a lot of big holes. It does not play a major role in treatment or prevention today.
Jessica: As you said, we need to respect everybody's questions. This is another one that I've seen floating around the Internet. "COVID‑19 is an invented pandemic to cover up the effects of 5G radiation." What do you say about that?
Dr Schaffner: Jessica, I must admit I have to take a deep breath when I've heard that, and I must respect that question. I just can say that's not the case. There is no evidence that this virus was created maliciously.
Now, we know that there is a debate about the origin of the virus. Did it occur naturally, or did it come from a research laboratory in Wuhan, China? If it came from the research laboratory and that's a viable option needs further investigation, I support that.
But it came then as a laboratory accident. People were investigating these viruses, but nobody was creating a bio warfare agent. Anybody who wanted to create a bio warfare agent using a coronavirus, I would fire immediately, because it's such a dumb idea.
Think about this, if you want to use a bio warfare agent, if you're a bad guy, you want to be able to target your enemy. You don't want to imperil your own people, but you can't control COVID. It spread around the world.
It would blow back on your own people the same way it would affect your enemy, and so coronaviruses would make a disastrously bad bio warfare agent. I cannot imagine anybody creating a pandemic such as this for any really malicious reason. It would be a very foolish thing to do.
Jessica: My last question for you, are the COVID‑19 vaccines free? What if a patient receives a bill for the patient's vaccine in the mouth?
Dr Schaffner: This comes from the fact that some people have had not very good experiences with their healthcare system on the billing side. Indeed, in the COVID circumstance, people thought often testing was free or not very expensive, and then they got a surprise bill that was very large. That has made people wary of getting vaccinated because they think the same thing may happen.
You and I, all the taxpayers in this country have bought this vaccine. It's free. No one in any circumstance may charge you for the vaccine. The issue of providers giving a bill is supposed to be not permitted. I know the federal government has been after some people, who've tried to tack on a large administration fee, and that's gone down to almost nonexistent.
In any event, if you have any concern about that, go to your health department. Your health department never will give you a bill. If that's the barrier, please seek out a health department and be reassured that the vaccine you will receive will not be accompanied by any charge.
These vaccines are free and of course widely available. I just wanted to say that today. we vaccinated many, many people in the United States. Of course, there are people who, Jessica, as you say have many of these questions, hesitations, and concerns. We'll try to respond to their concerns.
In addition to providing them information, we'd like to make them comfortable. We'd like to reassure them because it's often how people feel that will motivate their behavior rather than just giving them facts.
The psychologists tell us that people's attitudes, "how they feel about stuff," is even more important than what they know about stuff that will motivate their behavior.
That's why I so often give my patients a smile, and at the end of these discussions, I say, "I've been vaccinated, so is my whole family. Everybody in the office has been vaccinated. Even my grandchildren have been vaccinated. That certainly wouldn't happen if I didn't think they were both safe and effective." You, Ms. Jones, I hope you come to that same conclusion also. I'm always here to answer your questions.
Jessica Bard: That's very well said. Are there any other questions that you've gotten from patients that you'd like to address?
Dr Schaffner: You have covered the waterfront, Jessica. I think that's most of the questions that I continue to hear.
Jessica: Thank you so much for your time today, Dr Schaffner. We always appreciate talking to you.
Dr Schaffner: This is a great pleasure. Let's get vaccinated, everyone.