Despite the ongoing health consequences of COVID-19, 18% of American adults remain unvaccinated, and these individuals are more likely to contract and die from this disease. Vaccine hesitancy may arise from distrust in the development or safety of the vaccine or misinformation about its efficacy or side effects. Common interventions to increase vaccine uptake include public health initiatives, myth-busting, and expert encouragement, such as from a trusted clinician. Psychotherapists are well-positioned to advocate for vaccination – being trained in both communication and scientific understanding.

This study explored therapists’ own decision-making about the COVID vaccine and techniques used to discuss the COVID vaccine with patients. Using convenience sampling, we recruited 15 psychotherapists who completed a 30 to 45-minute qualitative interview assessing their decision-making process around COVID vaccination, their experiences discussing vaccination with patients, and how they decide if and when to broach this topic with patients. Using the 5C psychological antecedents of vaccination as the conceptual model, we employed a combination of deductive and inductive coding to analyze interview data.

Confidence (“I trusted the science…”), calculations (“And you know we’ll wait to see longitudinal data…”), and collective responsibility (“We have an obligation to society…”) emerged as major themes of therapists’ decision making for their own vaccination. Sub-themes included exploring patient views about vaccination, discussing science and data around the vaccine, encouraging patients to consider pros and cons, countering misinformation, and discussing COVID vaccine as a health choice rather than a political issue.

Our findings showed that therapists are having these discussions with patients and using their own vaccine experience as a method of facilitating these conversations. Therapists however expressed the challenges of maintaining boundaries and avoiding providing suggestions outside of their scope of competency. Our results emphasize the need for therapists and other healthcare providers to be actively involved in discussing patients' concerns, assisting them with understanding medical information, and participating in shared decision-making around health. More research is needed to clarify the acceptability and efficacy of therapist-led interventions for vaccine decision-making and to examine how self-disclosure may facilitate these conversations.