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Marcie Hopkins, University of Utah Health
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Breaking Through Fear to Build Vaccine Confidence with Immigrants and Refugees
Redwood Health Center physician Eli Moreno shares a simple exercise to cut through vaccine misinformation and empower patients to make educated decisions.
W

hen the Covid vaccine became widely available, Catholic Community Services (CCS) asked if a Spanish-speaking clinician would talk about the Covid-19 vaccine. CCS offers resources and support for refugees, immigrants, and people experiencing homelessness and food insecurity. They also provide classes and resources on how to access health care, food, and other services to help ease integration into their new communities.  

As a Spanish-speaking clinician, I decided to address vaccine misinformation. This particular talk was for a group of Venezuelan refugees. I could have lectured about the vaccine, but instead I approached the discussion as more of a neighbor or a friend. Sure, I’m a doctor, but what I really want to do is help people decipher this information. The choice is ultimately theirs to make. I mean, we shop at the same store, we eat the same food, and we use the same public transportation. We’re all part of the same community. If I just talk about my own experience, hopefully they’ll make a decision not just for themselves, but for our children, our families, and our community.

Teach (not tell) how to cut through misinformation  

Instead of simply instructing the refugees on how to get the vaccine, I wanted to teach them how to find trustworthy resources so they could make their own decisions. Since guidelines can change as new information becomes available, I encouraged them to become familiar with up-to-date websites like the CDC and the Utah Department of Health.  

The most powerful tool we have is word of mouth, or in our case—the internet. I want to empower people to look for resources that will share accurate information. To best prepare to speak to this group of refugees, I turned to Facebook. I asked a Facebook group that I’m a part of called “Mexicanos in Utah,” what questions do you have? Some of the main questions were, "If I had Covid, should I get a vaccine?" Or "When should I get the vaccine after Covid?" and “Why don’t we have to pay anything?” 

My goal was not to convince them to get the shot, but to have an open dialogue with them. I wanted to approach them as a professional, as a human being, and as a mom. At the end of the day, their decisions should be based on true facts, not unfounded stories they’ve heard from friends.  

Overall, I wanted to set the stage with a sense of togetherness. This is a virus that everyone is facing together, after all. Just learning some basic facts about viruses can help us invite an honest discussion about the vaccine.  

"We’re all part of the same community. If I just talk about my own experience, hopefully they’ll make a decision not just for themselves, but for our children, our families, and our community."

Demonstrating the power of information 

I began with a simple exercise—the game of telephone. 

  • I broke the larger group into four smaller groups. Each group was given a four-word phrase. The first person would write it down and draw out what they thought it meant. Then they would hand the drawing to the next person. That person would guess what the drawing meant, and then draw that message themselves. And surprise—each group got a different message based on the same thing.

The exercise makes us realize, “Wow, in less than 10 minutes, the context and content completely changed.”  

  • For the next exercise, I asked them common questions like, “What vaccines are there? How many doses, and how long are they good for? How effective are they?” Instead of providing answers through a slide, I divided them into groups and had them look up the answers. Since everyone has smartphones now, they had the power to search for that information in their own language. 

We then shared what we had learned. At the end, I said that all of us have the responsibility and the skills to tell the truth and guide people towards the resources. 

How I build confidence with patients 

Here are some ways we can help empower patients to make educated decisions:   

  • Listen as a peer: You need to truly listen and try to read between the lines. If someone says, "I don't want the vaccine," realize that it might not be just a simple no and try to understand why they’re hesitating. Be prepared to plant the seed and come back to the discussion during future visits. If you come from a casual place and build that initial trust, patients may be more willing to share their reasoning.  

  • Be transparent: Always be truthful. Tell them what you know and don’t know. Tell them that things do change with time, and that there are resources for everybody. Be clear that what might be true now may change in the future, but we’re in this together. 

  • Plant a seed: Patience is key. If people don’t want the vaccine, it’s okay to say, “That’s fine. If you have any questions, we can talk about them next time.” Cultural changes take time, so don’t give up. Vaccine or no vaccine, I say, “I’ll give you my opinion if you want it, but you are the owner of your own body. Only you know what’s good for you.” That way, they can see, “Oh, she’s actually telling the truth. She’s really not trying to confuse me.” 

  • Remind them how far we’ve come: If they still don’t want the vaccine, or they say they just want to see what happens with other people, remind them to wear their mask and social distance. We’re still in a pandemic and people are still getting sick. I tell them, “I’ll feel like I did a terrible job as your doctor if you get sick with something I could’ve helped prevent, so please stay safe. I just want what’s best for you.” 

Contributor

Eli Moreno

Assistant Professor, Family and Preventive Medicine, University of Utah Health