UAB Pulmonologist: Conversations, access is key to overcoming vaccine hesitancy

“It’s not fair to sort of blame the entire pandemic on the unvaccinated, when the unvaccinated are not a monolith,” said Dr. Anand Iyer.
Published: Aug. 10, 2021 at 11:16 AM CDT
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BIRMINGHAM, Ala. (WBRC) – Sharing his computer screen in a Zoom meeting, Dr. Anand Iyer looks at the latest research on vaccine hesitancy from the Kaiser Family Foundation and lays out his plan.

“This is my group,” he says, moving his mouse to hover over the line that reads, “Uninsured under age 65.”

KFF COVID-19 Vaccine Monitor (June 8-21, 2021)
KFF COVID-19 Vaccine Monitor (June 8-21, 2021)(Kaiser Family Foundation)

“This little blue, this little lighter blue area, this is the group I am trying to move. That might be about 20 percent, that’s a huge group that’s moveable, all you have to do is talk.”

It isn’t incentives, or pressure, or fear that’s convincing Iyer’s patients to get a COVID-19 vaccine, but a conversation.

“Listening with grace, humility, honesty, trustworthiness, that is what we are trying to do.”

Iyer is the staff pulmonologist at Cooper Green Mercy Health Services, caring for mostly uninsured or underinsured people.

“They are the people who took the biggest hit during the pandemic, in terms of poor outcomes,” said Iyer. “And so, since the vaccines have rolled out, it’s been sort of my mission to help get the vaccine because of how bad their outcomes have been, and how much they’ve been overlooked, I think. So, it’s been a problem about access, not just hesitancy but having easily, readily available vaccines with your frontline clinicians.”

Iyer worked with leadership at Cooper Green to get the vaccine in his clinic, removing the access barrier and the chance that delay might allow hesitancy to set back in.

“So, open, honest conversations. No judging, answering all their questions, spending time to talk about side effects, I think it really works,” said Iyer. “And then lifting that barrier, they don’t have to go anywhere, [I say], ‘My nurse has it here, we’ll watch you, I’ll watch you myself for the next 15 minutes,’ and then, it really eases that concern and takes the level of anxiety down a huge notch.”

His clinic has been piloting this program for the past three weeks, and so far, 12 patients have gotten a vaccine.

“We call it point-of-care COVID vaccines.”

He said the most common questions he hears from patients are about possible side effects, and whether the vaccine might impact other medications they’re taking.

But mostly, he said, they want to talk.

“We have to get across the Delta variant is serious, vaccines are safe, they are effective, they are saving lives, and every single vaccine is a life saved from COVID. It’s not fair to sort of blame the entire pandemic on the unvaccinated, when the unvaccinated are not a monolith. We’ve got our children who are under 12 who can’t get vaccinated, or who are not eligible. We’ve got billions around the world who still don’t have access. We’ve got millions in the US, like underserved, rural, homebound elders, we still don’t have the vaccine readily available.”

“And then you’ve got this population that are waiting and seeing, they are convincible, they just need to talk to somebody, and maybe they don’t have a healthcare physician to talk to because they are uninsured, and they don’t have access, or they just haven’t been able to get, or schedule an appointment, or they’re afraid to go back into clinics or something like that. Sure there are people who are outright refusing, but I think that there is still that 15-20 percent of the people who are remaining unvaccinated, who are convincible with just some simple discussions one-to-one, and I think we have to take every single vaccine as a success.”

He adds, “Because I have seen the devastating effects on the other end, in the ICU.”

When Iyer’s not at Cooper Green, he’s working as a critical-care pulmonologist at UAB Hospital.

“My team of pulmonary physicians, nurses, nurse practitioners, respiratory therapists have worked on the front lines in every surge for the past year and a half now.”

He added, “It’s devastating because they’re so short of breath, they can’t breathe and we end up having to put them on ventilators and on advanced life support measures to help them survive, and if they get really sick, they spend weeks to months in the hospital with devastating long-COVID symptoms.”

His positions gives him a unique perspective to be on the prevention and treatment side of COVID, and an urgency to protect his patients from the worst this virus has to offer.

“Now on the upfront, ahead of the hospital, if I can have a tool that can help me and it’s this, I have to use it,” said Iyer.

More than 1,400 providers in Alabama are eligible to receive COVID-19 vaccine, but it’s estimated 50-60 percent of those current have vaccine, according to the Alabama Department of Public Health.

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