About 27% of US adults haven't been vaccinated for COVID-19 because they have some combination of mistrust of healthcare/large organizations and a strong belief in their personal autonomy. That is why clinicians need to talk "with" their patients about vaccines rather than "to" them.
Although polls and surveys consistently show that doctors are the most trusted source of information about vaccines (about 80%, according to the Kaiser Family Foundation in June 2021), the percentages were lower among unvaccinated people.
Clinicians are an important community-level part of "retail messaging" about vaccines to complement the wholesale messaging that was used early in the pandemic to inform the general population about COVID and vaccines. However, for the vaccine-hesitant, -questioning, or -resistant patient, a clinician being authoritative and "talking to" an unvaccinated patient — with lots of fact-filled information — would be counterproductive because it could challenge their autonomy and reinforce their mistrust of authority figures and experts.
Since April 2020, I've been working with organizations and individuals to help them understand COVID and vaccine issues, including misinformation and reasons people might be hesitant to get vaccinated.
I've learned that there are many reasons why patients have some mistrust of healthcare providers and the healthcare "system." Those reasons range from historical mistreatment of demographic groups passed down from generation to generation (eg, the non-treatment of Black Americans with syphilis in Tuskegee), to first-hand or family experiences. This can also be compounded by perceptions of profit motives from pharmaceutical companies, healthcare providers, or institutions, and mistrust of government agencies or politicians.
