News & Views: First Do No Harm in the Context of COVID-19

"Until recently I thought that misinformation about vaccines was restricted to my medical profession."

Over the last month, we have been in communication with a colleague from Florida who operates an acupuncture practice. She and her colleagues offer yoga, pranayama and qigong classes — and they support vaccinations. This provider reached out because she has been so upset not only by the dire COVID-19 situation in Florida, but more specifically by the amount of misinformation she is hearing from healthcare providers. She wrote, “Until recently I thought that misinformation about vaccines was restricted to my medical profession,” going on to describe several specific instances of misinformation she has heard from physicians. These included telling pregnant women not to get the COVID-19 vaccine, failing to counsel families undergoing in vitro fertilization of the increased risk of COVID-19 during pregnancy, advising people who have had COVID-19 that they don’t require vaccination, and failing to specifically discuss the difference between the COVID-19 and pneumococcal vaccines, leaving some elderly patients to believe that they are protected against COVID-19 after getting a pneumococcal vaccination.

Likewise, over the past several weeks, we have heard several stories about healthcare workers suing their employers over COVID-19 vaccine mandates. While it is completely fair for healthcare workers to have questions about COVID-19 vaccines — the same as members of the public — these healthcare workers are also very likely to have colleagues who can answer their questions or can at least point them to reliable sources of information. Further, while not all healthcare workers took the “first do no harm” oath recited by new physicians, the fact of the matter is that by choosing to work in healthcare, everyone employed in a healthcare setting has implicitly agreed to that mantra. People trust that when they go for healthcare, they are not going to be harmed or further sickened. And, while they may sign informed consent agreements to acknowledge potential risks, simply walking into a healthcare setting should not increase their risk of being exposed to an infectious disease — not by sitting in an exam room, going for a test, talking with a nurse or receptionist, going to the cafeteria, or being in the same space while the room is cleaned. It is the duty of every single person who works in these settings to protect the people coming for care.

As our colleague from Florida said in her correspondence, “We are in a medical crisis, and we really need ‘all hands on deck’ to get everyone immunized against COVID-19.” With this in mind, we wanted to offer five things you — as healthcare providers — can do to help families, friends, and perhaps even some colleagues:

Tip 1: Get vaccinated

Hopefully, those of you reading this have already been vaccinated against COVID-19. We know these vaccines work and they are safe. We also know that every day people are losing their lives to this disease. People who have received the recommended number of doses of any COVID-19 vaccine are 5x less likely to be infected, more than 10x less likely to be hospitalized and more than 10x less likely to die. Please … get vaccinated.

Tip 2: Promote vaccination when you can

Even if you are not giving COVID-19 vaccines, if you are seeing patients, inquire as to whether they have been vaccinated. As a trusted healthcare provider, your words matter. And, even if a person can’t get the vaccine from you, they may benefit from hearing your point of view, be more comfortable asking you questions, or consider sources of information that you share valid. Likewise, hearing the same message from multiple healthcare providers can reinforce the notion that most are in favor of the vaccine. Unfortunately, media stories often highlight outliers, rather than mainstream ideas, so some people may incorrectly assume greater dissent among healthcare providers than actually exists.

Tip 3: Provide accurate information

It is not expected that everyone has all of the answers, but if you are not sure, say so. Just sending patients to a trusted source can be helpful. After all, it is better for them to get answers from a source that you know is reliable than from a random person on social media. Remember, a recent evaluation by the Center for Countering Digital Hate (CCDH) found that two-thirds of the misinformation related to COVID-19 vaccines could be traced back to just 12 people!

Tip 4: Share resources

Knowing that people are looking for information, consider proactively providing a list of COVID-19-related resources in places where your patients will see it. Such a list can be posted on a website, shared through social media, hung in waiting areas and exam rooms, or provided on an easily photocopied sheet by your sign-in or sign-out window.

The Immunization Action Coalition has been compiling resources related to COVID-19, so making a short list only requires a quick review of this comprehensive webpage to choose a handful of the resources that you think would be most helpful for your patients and families.

Tip 5: Practice empathy and patience

This one may be tough, especially so many months into this seemingly never-ending pandemic, but remember the old adage, “You’ll catch more flies with honey than vinegar.” If individuals are nervous about the COVID-19 vaccine, listening to and addressing their concerns is likely to be more effective than responding in a judgmental or condescending tone. The reality is that while we have been following this information closely and discussing it for months, most people are not as steeped in it as we have been. Even a brief open and honest conversation can make a difference for a lot of people.

Remember, “first do no harm” doesn’t only apply to treatments and procedures — providing a safe environment and ensuring that people have accurate and relevant information to make thoughtful and informed decisions counts too!