Motivational Interviewing Strategies for Addressing COVID-19 Vaccine Hesitancy

Cassandra L. Boness; Mackenzie Nelson; Antoine B. Douaihy

doi:10.3122/jabfm.2022.02.210327

Article Figures & Data

Tables

View popup

Table 1.

Summary of the Three Steps of Exploring Vaccine Hesitancy with Motivational Interviewing

Step	Description	Strategies	Examples
1. Practice a guiding style	Approach the discussion using a guiding and collaborative style characterized by neutrality, open-ended questions, affirmations, reflections, and summaries. It is especially important to emphasize an individual's autonomy in discussions related to vaccination behaviors.	Open-ended question Affirmation Reflection Autonomy support	How do you feel about getting the COVID-19 vaccine? You make a strong point that it's important to be informed about these types of decisions before deciding which course of action is best for you. You're feeling really stuck and aren't exactly sure how to sort through all the information about the vaccine that you've encountered. You're worried that the government might not have our best interests in mind. You get to decide what's best for you.
2. Evoke using the MI toolbox	Gather more information from the patient to better understand their perspective and values.	Elicit-Provide- Elicit Decisional balance	What is your understanding of the COVID-19 vaccine? [Elicit] Would it be all right if I shared some information about how the COVID-19 vaccine was developed? [Ask permission. If yes, provide information] What are your thoughts about that information? [Elicit] What makes you unsure about getting the vaccine? [exploring reasons against vaccination] What are some ways getting the vaccine would make your life easier? [exploring reasons for vaccination]
3. Respond mindfully and skillfully	Consider one's level of vaccine hesitancy at step 2 and proceed in the manner implicated by that person's position while still moving the patient forward in their decision making.	Summary Open-ended follow-up	You've thought a lot about whether you want to get the vaccine. You're concerned about some of the possible long-term side effects, such as infertility. At the same time, you really care about protecting older populations, such as your grandparents, from the serious consequences of the virus. On the one hand, you are worried about how you will react to the vaccine given your pre-existing conditions and the vaccine reactions you've experienced in the past [summarize reasons against vaccine]. On the other hand, you fear you could get far sicker if you were to contract COVID-19 and not be vaccinated [summarize reasons for vaccine]. What are you thinking might be the next step for you related to the vaccine? Where does that leave us now?

View popup

Table 2.

Five Useful Questions for Exploring and Evoking Vaccine Hesitancy with Motivational Interviewing

1.	What concerns do you have about taking the vaccine?
2.	What reasons do you see for taking the vaccine?
3.	How important is it for you to get vaccinated?
4.	How do you see the COVID-19 vaccination benefiting your community?
5.	What do you know about the safety of the vaccine?