Using Motivational Interviewing to Vaccinate for Influenza During a Pandemic

How can we portray the importance of getting vaccinated for the flu amidst a pandemic?

If you work in a retail pharmacy setting, then I’m sure you’ve heard stories from patients about the “horrors” of the flu vaccine. A chunk of your patients have probably told you that they never got sick from the flu until they got their first flu vaccine, or that the flu vaccine will cause autism, and even worse, the government uses it as a tracking mechanism. What about your iPhone that sends you a notification of how long it will take you to get to your home or work as soon as you turn on your car? How did it even know where I was going? Or those ads that pop up on Instagram about something you’ve never searched for before but may have been talking about to a friend a day prior? Point blank, the government in no means is putting tracking devices in flu vaccines (or any other vaccines for that matter).

As health care professionals, we are are taught early on about the importance of getting vaccinated throughout our lifetime. We understand how vaccines work and that if vaccination rates drop below 85–95%, vaccine preventable diseases can become a huge threat. This was evident by the pertussis and measles outbreaks in the US in recent years. We also know that the flu is in fact the most common vaccine preventable illness in the US. But how do we get our patients to understand this, especially during a dangerous pandemic?

We need to evaluate how we have been portraying the message. Recently, there is more and more growing evidence about the effectiveness of motivational interviewing. What is motivational interviewing exactly? It is simply an approach towards resolving ambivalence by providing a patient-centered counseling style to elicit behavior change. While motivational interviewing is most often used in the psychiatric side of medicine, it can also be an effective method of communication for other populations.

There is something called the Ask-Tell-Ask method which I will explain in detail.

Ask: If a patient denies wanting to get a flu vaccine, ask them to tell you why they do not want one. Actively listen to what they are saying instead of immediately having a response built up without hearing their concerns. Most times, at least in my case, they will tell me they came down with the flu after receiving the vaccine. After listening to their concern(s) and before proceeding to resolve the misconception, ask them if it is ok that you share information with them. Asking them to proceed demonstrates respect for the patient and will help strengthen the relationship throughout the conversation (if they agree to hear what you have to say).

Tell: A response to a concern such as coming down with the flu after getting vaccinated should be centered around the facts such as saying: “It is possible to experience some side effects from the vaccine such as a fever and body aches, but this is because your body is making an immune response to the virus. Unless it was diagnosed, it should not be confused with the actual flu. The vaccine does not contain a live virus and could physically not cause the flu itself.” You can also mention that if they were indeed diagnosed with the flu, that the vaccine is not 100% effective every year but can only benefit them instead of harm them. Remember to watch the patient’s body language and answer questions if they come up while you are talking.

Ask: Once you feel you have provided enough information for the patient, and that they understood what you were saying, ask them about their thoughts now about receiving the flu vaccine. If they still say no, you need to respect that, but remind them that they can always come to you with more questions and that if they decide to change their mind in the future, that you encourage them to do so.

If you work in the healthcare setting, try motivational interviewing for yourself. You might be surprised at the responses you receive. Even with the pandemic, it is still important to get vaccinated for the flu. While it may not prevent you from getting COVID-19, it has been effective for preventing the flu which will always be around every year.

Stay safe & healthy everyone.