COVID-19 vaccine hesitancy: The role of mental health experts

• Mental health professionals may be uniquely positioned to address a wide range of concerns, including vaccine hesitancy.
• This hesitancy must be overcome to boost vaccination rates and recover from the ongoing COVID-19 pandemic.
• Without adequate vaccination, it is not possible to achieve herd immunity.

Given that uptake of vaccines is low among young adults — and young adulthood is the age of onset for many mental health problems, mental health experts are uniquely suited to help overcome resistance to COVID-19 vaccination. This is the message of an opinion column that appeared in September in JAMA Psychiatry.

As we approach the second anniversary of the emergence of the pandemic illness now known as COVID-19, it has become clear that available vaccines confer significant protection against the worst ravages of the disease. Of course, COVID-19 is a potentially life-threatening, multisystem illness caused by the coronavirus known as SARS-CoV-2.

The authors, Dr. Noel T. Brewer and Dr. Neetu Abad, of the column note: “Mental health professionals and teams are trained to use empathy, reflective listening, and cooperative goal setting to help patients address challenges. […] Engaging new approaches for increasing adult vaccination is a national priority.”

Dr. Brewer is the Gillings Distinguished Professor in Public Health at the University of North Carolina.

In an email interview with Medical News Today, Dr. Brewer wrote: “COVID-19 vaccination is our passport to greater personal freedom. It allows us to safely go to stores, hang out with friends, and visit loved ones who are ill. It may even be required by airlines soon. We have seen COVID-19 cases overwhelm hospitals in several states.”

The stakes are high, Dr. Brewer notes, adding: “To avoid a national meltdown in emergency care this winter, the nation needs to get its COVID-19 vaccine coverage up higher. Mental health professionals can work with their clients to work through concerns and help them navigate getting a COVID-19 vaccine.”

Available vaccines have proved highly effective at preventing the worst symptoms of SARS-CoV-2 infection.

The Pfizer-BioNTech and Moderna shots are mRNA vaccines. This means that they contain instructions for our cells to make just one small segment of a key component of the SARS-CoV-2 virus: the spike protein. The “m” stands for “messenger.”

By itself, this snippet of protein is harmless. But it supplies enough “information” to the immune system for the body to identify and neutralize the living virus if it encounters it.

Unlike older, inactivated virus-based vaccines, mRNA vaccines do not contain any potentially infectious material. Whether these vaccines actually prevent infection is less clear. But they can help prevent hospitalizations and deaths.

In fact, emerging data from the United States and elsewhere indicate that the vast majority of COVID-19 deaths and hospitalizations are now occurring among unvaccinated people.

Clearly, vaccinating as many people as possible is of paramount importance to public health.

Old alarm, new urgency

Back in 2017, well before the present pandemic, health experts in the U.S. and Australia wrote in the journal Psychological Science in the Public Interest, “Psychology offers three general propositions for understanding and intervening to increase uptake where vaccines are available and affordable.”

Perhaps anticipating our current situation to some extent, the authors offered several tools that healthcare professionals may leverage to boost public health through greater use of available vaccines.

Dr. Neetu Abad, the co-author of the JAMA Psychiatry opinion piece, is a behavioral scientist in the Global Immunization Division of the Centers for Disease Control and Prevention (CDC). Her work there focuses on “assessing and intervening on the behavioral drivers of vaccine hesitancy globally.”

In an email interview with MNT, Dr. Abad commented on the significance of the call for mental health professionals to help overcome vaccination hesitancy.

Untapped resources

“The potential of mental health professionals and agencies to address barriers to COVID-19 vaccination has received inadequate attention,” Dr. Abad told MNT.

“Mental health professionals and teams are trained to use empathy, reflective listening, and cooperative goal setting to help patients address challenges. These professionals actively support patients’ well-being, including their adoption of health behaviors, such as receiving COVID-19 vaccination. Around 18% of U.S. adults see a mental health professional in a 12-month period, providing an important opportunity.”

– Dr. Neetu Abad

“Such care may be particularly important in the context of greater mental health problems during the pandemic,” she continued. “A better understanding of how mental health affects receipt of COVID-19 vaccines and better defining how mental health professionals can help, particularly for disproportionately affected communities, is fundamentally important now and could strengthen vaccination efforts.”

Dr. Juveria Zaheer is an assistant professor in the Department of Psychiatry at the University of Toronto. In an interview with MNT, she reflected on the role of mental health professionals in combatting the pandemic. “One thing that has been striking to us [working in the mental health arena] is that we know it’s a really important demographic. […] We can absolutely play an important role.”

Dr. Zaheer noted that virology and epidemiology are not her areas of expertise, but said: “As a parent myself, I recognize there’s a huge benefit to [encouraging vaccination] so we can provide herd immunity.”

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