Welcome back to our four-part series on having conversations about vaccines with residents, family members, and staff. In the first post, we explored the Transtheoretical Model of Change and its application to vaccine discussions. In this second part, we’ll go in-depth on using motivational interviewing—an evidence-based, culturally sensitive approach to discussing vaccines.
Motivational interviewing is a technique that helps individuals explore mixed feelings and move toward healthy behavior changes that align with their values and needs. The CDC recommends four steps for applying motivational interviewing to vaccine conversations:
Step 1: Embrace Empathy and Collaboration
Approach hesitant individuals with compassion, empathy, and curiosity.
- Avoid judgment — even if their statements contradict your views or current evidence. Their feelings are valid and reflect their personal experiences.
- Be mindful of cultural influences, family dynamics, and personal circumstances that may shape their vaccine views.
- Remember: Arguing is counterproductive. Taking a strong initial stand often backfires, especially with people who have concerns about vaccines.
Step 2: Ask Permission to Discuss Vaccines
Begin by asking if they’re open to discussing vaccines. For example, say, “If it’s okay, I’d like to hear your thoughts on vaccines for staff and residents at this facility.”
- If they decline, respect their choice:
- Option 1: Move on respectfully. Say, “I respect that, but vaccines are essential to our overall approach to infection control. Perhaps we could discuss it another time.”
- Option 2: If appropriate, spend a few minutes exploring why they don’t want to talk about it. The goal here is understanding, not persuasion.
- If they agree, proceed to Step 3.
- If they have questions about vaccine safety, risks, or personal health, go to Step 4.
Note: These conversations may require time and may span multiple visits.
Step 3: Engage in Motivational Interviewing
Use a scaled question to gauge their thoughts, such as, “On a scale of 1 to 10, how likely are you to get a vaccine?” Encourage them to vocalize both sides of their response.
- Example: If they say “4,” ask, “Why a 4 and not a lower number?” and follow up with, “What would help move you closer to a 5 or 6?” This approach allows them to reflect on their values, health, and community needs.
The goal is to help the individual become more open to moving toward higher numbers—in other words, becoming more receptive to vaccination. This process is often gradual and requires patience.
- Encourage them to vocalize the benefits of vaccination, as speaking aloud can help them process their choices and create forward momentum. Vaccine-hesitant individuals often have more practice explaining why they haven’t been vaccinated; reversing this by asking them to discuss potential benefits can be valuable.
- Be compassionate and curious about their mixed feelings, acknowledging both their desire to trust the vaccine's safety and their hesitation. It’s essential to show support, helping them incorporate personal values and the health needs of their family and community into their decision.
Step 4: Respond to Questions about Vaccines, Health, or Mental Health
If an individual asks about vaccine safety, risks, or their health or mental health, respond within the boundaries of your knowledge and ethics.
- If you feel prepared and knowledgeable, respond empathetically, providing scientific information as needed. You can refer them to resources on the CDC website, listed below.
- If the question is outside your expertise, suggest they consult their medical or mental health provider or a knowledgeable expert.
By tailoring messages and interventions to each individual’s stage, understanding, feelings, and concerns, you can help improve vaccine uptake and support staff and residents throughout their vaccination journey. Remember, each conversation is an opportunity to build trust and empower individuals to make informed health decisions.
In Part 3 of our series, we’ll take on misinformation—one of the most common obstacles to vaccine acceptance. Join us as we explore ways to address misleading or incorrect information that may cause hesitation and uncertainty around vaccines.
Visit the #GetVaccinated website for the latest resources and news on vaccines.