The Vaccination Conversation
How can those working in the social service sector hold conversations about the COVID-19 vaccination with clients or service users, and people they work with?
Vaccination has been identified as one of our country’s key public health tools to offer some protection in our fight against COVID-19. The COVID-19 vaccination campaign is well underway in Aotearoa. There are several groups who are vulnerable to getting COVID-19, including those under 12 who are not currently able to be vaccinated in New Zealand. There are also those who are at a higher risk of serious illness if they do get COVID-19, such as elderly or those who are immunocompromised.
We spoke to several people working within our sector here in the Waikato for their views.
Mike Holloway from Male Support Services Waikato says that our sector most definitely has a role to play in having conversations with people in the communities we work with about the COVID-19 vaccination because our sector is the most connected with these communities.
“The caution needs to be around how far you take these conversations and how they are put across, as trust can be quickly lost if you push too hard. Some you will never change, and this must be accepted but you need strategies to work with them still” says Mike.
Lady Tureiti Moxon, Managing Director of Te Kōhao Health agrees and says we must work together.
“Everyone has a role to play to ensure people know how important vaccination is to keep each other safe” she says.
Ruth Harlow, Senior practitioner at Single Parent Services Waikato says that their guiding values of Kaitiakitanga, Manaakitanga, Mana and Whakaute provide useful touchstones in dealing with the conversations about the Pfizer vaccine roll out.
“We support our community to make informed choices. The principle of kaitiakitanga indicates the importance of ensuring people are well informed about the risks and benefits to health, for the good of the individual and society alike” Ruth says.
Josie Rapana, CE at Te Hauora o Ngati Haua says that it’s important that those who work on the ground in amongst our communities, are involved.
“While the vaccination process is health related, the importance of understanding the effect inequalities can have on a community requires our sector to continue to upskill our communities as well as remind the powers that be of their accountability and doing what’s right” says Josie.
What are some key tips for how to have these conversations?
Don’t be judgmental
“Consider their situations and history if known. Do they have mental health or trust issues? Are they scared?” says Mike.
Ruth says there is a real skill in having these conversations in a way that embodies whakaute and upholds the mana of all.
“Gentle curiosity and open-ended questions help establish a level of comfort when having a discussion about vaccination” says Ruth.
Listen to their reasoning
Most people who remain unvaccinated are hesitant for a variety of reasons, but not completely against the vaccination, according to Doctor Renee Liang. It is OK for people to have questions and concerns.
“Respect begins by listening to the other persons point of view. If you then have a chance to share your thoughts, do so using ‘I’ statements and owning your own view fully – ‘My understanding is…’ or ‘The reason I chose to be vaccinated is…’ (not ‘the truth is…’),” says Ruth.
Focus on the benefits of vaccination and direct people to credible sources of information
Don’t get into a data war with people, instead of focusing on arguing about information they may have come across, focus on the benefits of vaccination. Vaccination is a core public health tool that people use to stay healthy, and it is part of what we do to look out for each other.
“It’s about protecting whaanau and keeping them safe” says Mike.
“If they are into the misinformation they will be continually concentrating and sourcing information to support their reasoning and there is a heap of it out there. Benefits are more easily put and hard to counteract” says Mike.
Ruth agrees that rather than getting into an argument about what is true or untrue, encouraging people to access trust-worthy information sources may be more productive.
“Social media exploits our natural tendency towards cognitive bias – it can be useful to encourage people to access a range of sources” says Ruth.
“Our concentration is to ensure we stick to the facts and promote validated information where possible. Our focus on the benefit of vaccination is premised on protecting our whaanau, our whakapapa and our future generations” says Josie.
Lady Tureiti Moxon says that a lot of people say they have done their own research and decided against vaccination. It’s one thing to make their own decision, but it’s another to share misinformation. So, she is working very hard to ensure people understand the disease and know where to find good information.
“I think it’s a matter of both, counteracting misinformation by ensuring people have access to good information. And talking about the benefits of being vaccinated. We talk about the importance of whakapapa, of protecting those you love, and knowing and understanding what this disease can do. People are dying of Covid. And for others, there are long-term effects of the disease that are still being realized. People need to be made aware of this” says Tureiti.
Find out if there are ways you can reduce barriers for vaccination access
Some of the reasons people may not yet be vaccinated could be a lack of transport, lack of options for vaccination in their part of the country, a fear of needles, or a lack of information in their own language.
“Check if they need support to get them there” says Mike.
Connect people to the right people to have these conversations
Trusted contacts are more likely to be able to have open, constructive vaccination conversations.
“A beneficial influence can be someone that is a trusted confidante” says Ruth.
“We connect people with the right people, such as having doctors available, so that people are able to have their questions answered” says Tureiti.
“At the end of the day, the key to working with our communities is fostering honest, trusting relationships. If the relationship is on point, then that will ensure safe, supportive conversations irrespective of the topic” says Josie.
What are some of the internal conversations we need to have with staff?
We need to keep team members and our service users safe. Particularly if someone is at higher risk of complications should they get ill.
Workplaces could look to develop a Covid Vaccination Policy or amend other work policies that consider things such as supporting people to get vaccinated, Health and Safety workplace risk assessment, whether the vaccination is required for your workplace, privacy, employment rights, how to provide services to unvaccinated people, and more.
“Involve staff in these policies to get the buy in and ownership” says Mike.
“I don’t think we will have a ‘no vaccination no support’ policy but we will have to make sure we have a safe room and PPE available. When triaging clients, we will have this as a question but will make sure they know first that if they are not vaccinated, we can still work with them which hopefully will stop them withholding this information” says Mike.
Lady Tureiti Moxon says Maaori have been devastated as a people throughout history, and the best medicine is to vaccinate.
“Our staff are aware that we must walk the talk. Because we are all front-line staff, we are all exposed. It just takes one person to infect all of us. We have an obligation to protect ourselves, our whaanau, our community” says Tureiti.
Ruth says that staff are trusted first and foremost to make good decisions.
“Remaining open to questions and general discussion about the issue of vaccination can avoid conversations becoming personalized, preserving the mana of all” says Ruth.
Josie Rapana talks about how COVID has changed her teams thinking.
“Our practice has changed. We’ve learned new ways of working; we’ve become more flexible in our practice without losing quality; we’ve found new ways of engaging. Our team discussions have raised our consciousness and awareness about our own safety; the safety of team members, and whaanau safety” says Josie.
What information should we be giving to our service users about our organisation’s vaccination status?
A person’s vaccination status is personal information and so falls under the protections laid out in the Privacy Act 2020. But there are some circumstances where an employer has a legitimate need to know an employee’s vaccine details.
The Community Waikato team collectively decided to let service users know that 100% of our team are vaccinated. We realise that some of the people we work with have a higher risk of being affected by COVID-19. So, we wanted to communicate our staff vaccination status so that people we work with feel some level of protection when working with us.
Many staff in this sector have been mandated to receive the vaccination. This may mean that amended employment contracts need to be drawn up and you will let your service users know that you are following Government health requirements.
“It is an expression of manaakitanga to let our clients know that our organisation provides a safe and healthy space for clients and staff. A staff member who lets clients know they are fully vaccinated extends manaakitanga by promoting feelings of safety for the client. It is important for clients to be informed about the environment of which they are a part” says Ruth.
How do we engage constructively with team members or service users who are fiercely opposed to vaccination?
Look for ways you can help to reduce their anxiety. Also allow that for some people who are fiercely opposed to vaccination, there may be no use in pushing the issue further. Internal work policies, and Government health regulations and mandates will help provide a framework for you to engage constructively with team members and service users and to manage risk appropriately for your workplace.
“Talk to people you have connections with about your own experiences with vaccination or with the COVID-19 virus. Reality is quite distant for people and the lack of urgency can come from COVID not being in their back yard. We will see it spreading soon. Those who refuse to be vaccinated will find it harder to participate in many areas” says Tureiti.
Ruth says there is another kind of safety to remember here too. It is important to be kind to a staff member who does not intend to be vaccinated. People all reach their viewpoints honestly and with best intentions.
“It remains true that the decisions of today will have long term lasting effects for each person’s future both personally and professionally. The messaging around vaccination is that it protects the health and safety of our community, and it seems likely that people working in public facing roles will be required to provide evidence of vaccination. Until legally mandated, there is an opportunity to support colleagues and clients wherever possible” says Ruth.
Josie Rapana says their strategy is to rely on factual data, and through their newly formed Haua Tahi which is a collaboration of their 5 Marae, they are encouraging whaanau to be vaccinated.
“Each Marae are identifying key whaanau champions who have the ability to influence their younger members and those fiercely opposed to vaccination. Whether that is going to be enough to effect a change, I’m unsure at this stage, but at least we will give it a go. Again, the focus is premised on protecting our whaanau, our whakapapa and our future generations” says Josie.
And Finally…
Remember that most people are choosing to get vaccinated. We can forget this when our focus is on those who are not. Most people will get vaccinated when the right conditions are created for them. We all have a role to play when it comes to protecting our communities and we as a sector have already stepped up in many ways to respond to this pandemic.
“I think the sector needs to continue to build community capability and capacity, increasing a community’s ability to adapt to constant change – hopefully this will assist to ease the impact that COVID brings” says Josie Rapana.
So, we keep on doing what we can to support each other, and we continue looking for ways we can best serve our communities. We’re in it together!
Thank you to all those who contributed toward the writing of this article.