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West Virginia Doctor Makes Her Office A Vaccine Judgement-Free Zone


Back in February, West Virginia had one of the highest COVID vaccination rates in the world. It was competing with Israel for the top spot. But now the state is giving only a few hundred doses a day. It's fallen behind 44 other states. General James Hoyer, the head of West Virginia's vaccine task force, told me it used to be a problem of logistics, but not anymore.

JAMES HOYER: You're now fighting a different threat. So now we've got to figure out how to do a better job of educating citizens through all the maze of the misinformation that's out there about vaccination across the spectrum.

KING: The education part often falls to primary care doctors. Elizabeth Brown is a physician in South Charleston. She told me the most important thing is to have the vaccine in the office so people who make a snap decision to get it don't change their minds. But not as many minds are changing as she'd like.

ELIZABETH BROWN: Sometimes it does take convincing to get people in the right frame of mind and to give them the right information to make that decision. Sometimes they've been on the fence. And if you can talk to someone and get them ready to take the vaccine, you want to jump on it right then. Because if they leave, they may or may not come back.

KING: When people are in your office and they're telling you, I will not get this vaccine, what are you hearing mostly?

BROWN: Oh, there are a lot of different reasons. Some people say it hasn't been around long enough. We don't know what the long-term side effects are. I'm not taking anything that doesn't have full FDA approval. Some people say, well, I just don't take vaccines. I never get sick, so why should I? Some people say it's a religious issue. There's a lot of misinformation out there. There are a lot of less than solid scientific reasons for it. And, you know, we explore those. And I always do it in a very nonjudgmental way.

You know, my job is not to shame anybody. It's to provide accurate scientific information and encouragement so that people can ultimately make the best decision for them. If their decision is based on something that's just plain wrong - like people will say, oh, I hear it makes you infertile - I'll say, you know what? Let's stop right there (laughter). There is no data to suggest that. In fact, all of my OB colleagues are recommending it for their patients who are pregnant or plan to become pregnant. So let's just put that to rest right there. And sometimes that's enough to make them say, oh, OK, well, in that case, maybe I'll take it.

KING: When people say they don't want to take it for religious reasons, what are the religious reasons?

BROWN: You know, you hear things like, oh, I hear it's the mark of the beast. That's a big common one. You know, in biblical terms, that's heralding the end of the world. And they think that that makes them less of a Christian. You know, a friend of mine is a minister. And he actually, on Facebook, made a whole post based on the Bible as to why this is not the mark of the beast. He actually went through step-by-step, from the biblical terminology, things that have not happened that would, you know, make this the mark of the beast. And I had that discussion with a patient once. And I told her, you know, all the things that have not yet happened that he had said. And she was like, oh, I feel so much better. And I was like, whoa, you know, I didn't tell you anything about the data and the science and the statistics, but you already feel better because that was her main concern.

KING: Did she end up getting the vaccine?

BROWN: You know, I can't remember. But at least we opened the door for her to consider it. You know, with anything, whether it's quitting smoking or trying to adopt a healthier lifestyle, at least getting someone to contemplate change - that's a step in the right direction. And I think the more times you can build on that, the more likely you are to get someone to actually take that step.

KING: Is there someone you remember specifically who did change their mind, and you thought, what I did there - it worked, and I'm going to do it the next time, too?

BROWN: There's one guy in particular who I distinctly remember. He was very against it. And after a number of times discussing it with him and how masks are good, but they're not as good as the level of protection given by the vaccine and also caring for elderly family members - it's also a responsibility because I think he cares for an elderly aunt in a nursing home. And next thing I knew, he was on our schedule to get a Pfizer vaccine. And I was super surprised. So, you know, I wish I could say the same strategy works for everybody. But it's very specific to, you know, what is this person going to respond to? And I think that's where knowing your patient really comes in handy. Because I can tailor my counseling in a very different way for different people.

KING: Do you chalk up your ability to change people's minds about the vaccine to the fact that you are a doctor, and therefore people trust you? Because, you know, a lot of us have people in our lives whose minds we'd like to change about getting vaccinated. And I wonder if you think your experience applies more broadly, or if it only really applies because they are there in a physician's office and they know that you have medical training.

BROWN: I mean, I think my patients have trust in me because we have a history together. I think it's not just being in a doctor's office. A lot of these patients - we've gone through some tough times together, and we have that level of trust. And we can have conversations and really open up about things that they might not feel comfortable talking about with a stranger. I call this the judgment-free zone because this is where people need to be able to talk about anything. I find that a gentle approach of persuasion and encouragement backed up with scientific fact and reassurance from myself with my own personal experiences often does better than hammering it home. So I think taking a soft approach is more likely to achieve the desired outcome.

KING: Dr. Brown, thank you for your time this morning.

BROWN: Absolutely. You're so welcome.

(SOUNDBITE OF MUSIC) Transcript provided by NPR, Copyright NPR.