gms | German Medical Science

Background and status of (inter)national research: COVID-19 vaccination is recognized as a key component in addressing the COVID-19 pandemic. In Germany, outpatient practitioners play a leading role in the dissemination of vaccines. Communication on vaccination by physicians plays a crucial role in informing patients about the benefits and risks of vaccination.

Research question and objective: How do physicians' personal attitudes toward COVID-19 vaccination affect their behavior in communication with patient on COVID-19 vaccination?

Method or hypothesis: Within the scope of an online survey (09–11/2021), German outpatient physicians of different specialties were asked about their attitude towards COVID-19 vaccination. Physician's behavior in vaccination consultation was assessed with a five-point Likert scale on the acceptance of the patient's refusal of vaccination without further discussion, the willingness for a detailed interview with the aim of convincing the patient, empathy for patient's concerns, and the explanation of individual risks in case of vaccination omission.

Results: Of 1,122 physicians who participated in the survey, 1,073 physicians responded to the question regarding their attitude toward COVID-19 vaccination (four-point Likert scale: 1=“very positive” to 4=“very negative”). While 12 physicians rated vaccinations in general as negative/very negative (1.12%), 84 physicians (7.83%) did so for the COVID-19 vaccination. Especially, East German physicians were significantly more likely to state a negative attitude (mean=1.68 to mean=1.31; p<.001). Four multiple linear regression models were performed to examine the behavior of family physicians (n=444), pediatricians (n=132), and gynecologists (n=166) in more detail. In addition to specialty, attitudes toward vaccination in general and COVID-19 vaccination, own COVID-19 vaccination status, gender, age, and size of practice location were included in the models. Negative attitudes toward COVID-19 vaccination are significantly associated with increased acceptance of patient refusal of COVID-19 vaccination and empathic behavior for patient concerns. In contrast, willingness to engage in a detailed persuasion interview was significantly lower. Physician attitudes toward vaccination is not associated with educating patients about individual risks of vaccination omission. Pediatricians show significantly higher empathy for patient-side concerns compared to family physicians, whereas gynecologists show less empathy than family physicians. Physicians not fully vaccinated also show significantly more empathy for patient-side concerns.

Discussion: Physicians have a distinct responsibility in counseling their patients. In an effort to keep the patient's best interests in mind, tensions may arise between the patient's decisions and the physician's perspective.

Practical implications: The personal attitude of the physician influences his behavior in the COVID-19 vaccination consultation.

Appeal for practice (science and/or care) in one sentence: In addition to medical evidence, physicians should respect the needs and concerns of their patients and take them into account in their communication.

Funding: Einzelförderung (BMG, DRV, BMBF, DFG, etc); 01KI2099