“I listened:” A nurse case manager on addressing vaccine hesitancy

Published May 10, 2021

Ericka Newman’s job is to make sure patients don’t fall through the cracks after they come home from the hospital. Newman, a former ER nurse, is a nurse case manager for Blue Cross & Blue Shield of Rhode Island (BCBSRI). If a member has been to the emergency room or discharged from a longer hospital stay, she calls to check in, to see if the member has everything they need to keep healing. These days, that conversation includes asking whether a member has received a COVID-19 vaccine.

Why a patient declined to get the vaccine
A retired police officer had just come home from the hospital after being treated for a pulmonary embolism (a blood clot in the lungs). He had other health issues that made it difficult to leave the house, so Newman called to arrange medication home delivery, ensure his physical therapy and pain management plans were in place and that he had access to healthy food.

When the patient told Newman a visiting nurse offered him the vaccine but he declined, she asked why.

Your questions about the COVID-19 vaccines, answered


“He said that he believed that if he hadn’t contracted the virus in the hospital, there was little chance of catching it in the community,” says Newman. “He believed he could survive COVID if he did get it, which outweighed the risks of an unknown vaccine. And he’d been following some social media accounts that were spreading false information about the vaccine.”

At that point, Newman could have launched into a lecture about the benefits of the vaccine and false assumptions about the disease. But she didn’t.

Just listening, and providing the right facts, made the difference
“I let him talk,” she says. “He said no one had taken the time to sit down and discuss it with him, to let him ask questions, without judgment.”

Next, Newman used a technique called motivational interviewing, which essentially means listening with empathy, asking questions and asking for permission to offer insights. “I provide evidence-based information and ask what they think.”

Newman shared the facts, but she made sure those facts would appeal to someone who had served his community for so long:

  • Getting vaccinated is your personal contribution to improving public health.
  • Improved public health means the economy can gets healthier.
  • The vaccine may help prevent a severe COVID infection.
  • Preventing a severe COVID infection may not only prevent death, but also the long term effects of COVID, which scientists are still studying.

Familiar faces arrived to administer the vaccine
Those facts made sense to the patient. He agreed to get the vaccine. Since he couldn’t leave the house, members of an ambulance crew came by to administer it. And in a small state like Rhode Island, where police and firefighters and EMTs often know each other or each other’s families, that made this retired police officer feel more comfortable. And in the end, he was relieved to have gotten the shot.

At a time when vaccination uptake is falling, in part because of hesitancy or mistrust, Newman and other case managers may be in one of the best positions to help: they can listen to a patient’s concerns, offer the facts, building trust one patient at a time.

Blue Cross & Blue Shield of Rhode Island is an independent licensee of the Blue Cross Blue Shield Association, an association of independent, locally operated Blue Cross and Blue Shield companies.

The Blue Cross Blue Shield Association is an association of 35 independent, locally operated Blue Cross and/or Blue Shield companies.