MICNP Podcast S2 E4: Mastering Vaccine Conversations: Strategies for Healthcare Providers

In this episode, Drs. Justin Hooks and Rachel Hetzner interview Gianna Eagle, a registered nurse and DNP student, about effective vaccine communication techniques. They explore strategies to address patient concerns, misconceptions, and how to promote vaccination in clinical practice.

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Key  topics:

• Vaccine communication strategies
• Addressing patient concerns and myths
• Hepatitis A and B vaccination importance
• Shingles and pneumonia vaccine recommendations
• Building trust and rapport in healthcare discussions

Chapters:
00:00 Introduction to Vaccine Communication Techniques
02:05 Discussing Hepatitis A and Why It Matters
04:00 Hepatitis B: Immunity and Booster Shots
08:02 Shingles Vaccine: Who Needs It?
09:54 Addressing Patient Concerns and Myths
11:58 Building Trust and Effective Communication
14:06 Vaccine Recommendations for Special Populations
16:03 Final Thoughts and Future Outlook

Resources:
Hepatitis A Vaccine - CDC - https://www.cdc.gov/hepatitis/hav/index.htm
Hepatitis B Vaccine - CDC - https://www.cdc.gov/hepatitis/hbv/index.htm
Shingles Vaccine - CDC - https://www.cdc.gov/shingles/vaccination.html
Pneumococcal Vaccines - CDC - https://www.cdc.gov/vaccines/vpd/pneumo/index.html

Theme music

• Keyboard, Bass: Clementine Kanfom 
• Guitar: Tyler McDonald 
• Drums: Andrew Padfield 
• Mixed, Mastered: Andrew Padfield 

Michigan Council of Nurse Practitioners (MICNP): Website

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Transcript

Rachel Hetzner (01:38)
Welcome back to the MICNP podcast, where we once again have Gianna Eagle, a registered nurse and Wayne State University DNP FNP student, joining us again today. We're going to be flipping the script a little bit this time, where myself and my co-host, Dr. Justin Hooks, are the patients, and Gianna is going to go over different vaccine communication techniques with us.

Rachel Hetzner (02:04)
Hello, I'm Rachel Hetzner, president elect for Michigan Council Nurse Practitioners and co-host of the MICNP podcast.

Dr. Justin Hooks (02:10)
Hey everyone, welcome back to our third and final episode with our expert Gianna. I'm Dr. Justin Hooks, Chair of the Education Committee and the other co-host of the MICNP podcast.

Rachel Hetzner (02:22)
All right. So we're gonna switch things up a little bit today and talk about a couple different vaccines and how you might want to approach these with patients. So we've talked about HPV, we've we've talked about some some different vaccines. Let's talk today about maybe, you know, HEP A, HEP B. That's kind of a hot topic right now. And then some common ones, maybe shingles and pneumonia.

Rachel Hetzner (02:49)
And how we might want to approach these conversations with patients, answer questions when you meet a little resistance. So how how are we gonna do this? So what do you think, Gianna? You think that might be a good good thing to do?

Gianna Eagle (03:05)
Absolutely. Demonstrating the techniques and kind of giving our listeners a play-by-play of strategies to use, I think it would be really beneficial and hopefully you guys can take away from this some strategies to apply in your practice.

Rachel Hetzner (03:20)
And if nothing else, at least relate with some of the wild things that your patients say to you every day in practice. let's start

Rachel Hetzner (03:30)
with HEP A. Okay. NPGana, I don't live in a third world country. I don't eat bad food and drink bad water. Why would I need to get a HEP A vaccine?

Gianna Eagle (03:41)
Well, hepatitis A is a really serious liver disease that spread through close contact with infected people or when you unknowingly ingest the virus from objects, food or drinks that are contaminated by small amounts of stool from an infected person.

Gianna Eagle (03:56)
You don't necessarily have to live in a third world country to potentially be exposed to this disease. And the benefits of receiving the vaccine to prevent complications such as jaundice, fatigue, low appetite, stomach pain, you know, I would say that the benefits definitely outweigh the risks. And you can transmit the disease to and from other people even if you're not symptomatic.

Dr. Justin Hooks (04:18)
not to like jump in, but I push this for the men that have sex with men specifically because of the fecal oral route of transmission, which is a big thing. But I think Doctor Hetzner is gonna ask a silly question, so I cannot wait for this too.

Rachel Hetzner (04:35)
so I think I'm just gonna go ahead and trust my immune system. My immune system is superior to every other immune system out there. So that'll be fine, right? That'll work.

Gianna Eagle (04:46)
Well,

Gianna Eagle (04:47)
In order to build immunity to this disease specifically, you're risking a lot of sequelae or very negative consequences of becoming infected that can be very harmful to you. It's a lot safer to build your immunity in a risk-free way through immunization as opposed to actually becoming infected with it.

Rachel Hetzner (05:06)
All right, you sold me. I'm getting my hepe vaccine.

Dr. Justin Hooks (05:09)
So NPGna, my doctor did this crazy blood test to see if I was like immune for hepatitis. And my like provider said, I am not immune for hepatitis B, but when I went back and looked at my mixer, I've been vaccinated before. And I swear I had like the three shots. they said that I need to have

Dr. Justin Hooks (05:33)
Booster for hepatitis after three shots. Is that true? And like, why should I get it?

Gianna Eagle (05:40)
So if your titers were showing that you were not immune after the initial series, it could be the case that you did not respond to the primary series and that's why you need the booster. Hepatitis B is a very serious disease that affects your liver and...

Gianna Eagle (05:59)
So for that reason, I would recommend that you get the booster to ensure that you are immune to it.

Dr. Justin Hooks (06:07)
Yeah. So like it's not from eating food or anything. And I'm pretty healthy, like Dr. Hatzner too. So do I really need the hepatitis B? Like what does it protect me against?

Gianna Eagle (06:19)
So it's transmissible via infected blood or other bodily fluids and it can cause cirrhosis and liver failure if left untreated. So those are things that you definitely don't want to run the risk of becoming infected with.

Dr. Justin Hooks (06:35)
you said like the C word and I know it's not the cancer word, but it's like the cirrhosis word that I guess alcoholic people get. I don't wanna get that either, like through a virus if if if it's not from drinking. Okay. So I think I'll get the vaccine, but is it just like one shot today instead of like three?

Gianna Eagle (06:54)
Yes, it's just a booster today.

Dr. Justin Hooks (06:57)
Okay. You really sold me on that one. I I think I'll get it I'm gonna get it.

Rachel Hetzner (07:02)
Okay, this is off topic, but do you know what I just found out yesterday is that patients can look up their own mickers. So I did I was not aware of that. So I was in a meeting with my practice and we were talking about ways to save time and be more efficient. And we're like, have the patients that come in for their physicals bring their own mickers. Can

Rachel Hetzner (07:26)
yeah, so.

Gianna Eagle (07:26)
I like that the interface

Gianna Eagle (07:28)
is really user friendly too. Like all you, I do it all the time. All you need is your ID.

Rachel Hetzner (07:32)
Uh-huh.

Rachel Hetzner (07:33)
Yeah. Yeah. I didn't I didn't even realize that the patients could look up their own if I was like, all right, you're gonna have to come prepared with your maker. They'd be like, I don't know. But okay, so next up, shingles. I never had

Dr. Justin Hooks (07:46)
Mm.

Rachel Hetzner (07:47)
chicken pox when I was a child. So I don't need the shingles vaccine then, right?

Gianna Eagle (07:52)
Well...

Gianna Eagle (07:52)
that actually isn't the case.

Rachel Hetzner (07:54)
Dang it.

Dr. Justin Hooks (07:55)
Another poke.

Rachel Hetzner (07:57)
Another poke.

Gianna Eagle (07:59)
So the CDC actually does recommend the shingles vaccine for healthy adults that are 50 and over, regardless of your chicken pox history, because many people are exposed to the virus asymptomatically, meaning you've likely been around people who had it that didn't show symptoms. So you can carry it without knowing, and then it becomes reactivated later in life.

Rachel Hetzner (08:19)
Well it's just a rash, right? So I can handle a rash.

Gianna Eagle (08:23)
Well,

Dr. Justin Hooks (08:26)
Mm-hmm.

Rachel Hetzner (08:26)
Well.

Gianna Eagle (08:27)
it does

Gianna Eagle (08:27)
cause a rash, but it also causes other symptoms too.

Dr. Justin Hooks (08:31)
Like symptoms I have to be on a medication for.

Gianna Eagle (08:33)
Yes.

Gianna Eagle (08:35)
It can also cause fevers and severe shooting nerve pain. And there is no cure for it, but it can be treated with antiviral medications. So the best way to prevent that infection is through vaccination. That way you don't get sick and your body can develop resistance to it.

Rachel Hetzner (08:54)
Okay.

Dr. Justin Hooks (08:54)
That's very true.

Rachel Hetzner (08:57)
Well, you sold me again. I'm gonna get my shingles vaccine now. You

Gianna Eagle (08:59)
I'm just that good.

Rachel Hetzner (09:02)
are fantastic. So okay.

Dr. Justin Hooks (09:06)
Doctor Hatzer, like, she just cuts to the point. That's the good part about it. She just cuts to the point and

Rachel Hetzner (09:09)
Yeah, huh. Yeah.

Dr. Justin Hooks (09:12)
tells it like it is, which it's kinda like what we need though these days.

Rachel Hetzner (09:15)
Yeah. Yeah.

Rachel Hetzner (09:17)
It reflects kind of what she had said in the previous research in that you have to state the fact. this is what it is. Address the misinformation. A lot of these patients have no medical knowledge. They have no medical background. So they only hear what is

Rachel Hetzner (09:37)
Spread out there from their sources of information. So it's our responsibility to communicate that to them. And you still want to build that relationship though. So if someone is very serious about not wanting to get something, then okay, maybe revisit it at the next visit. your your

Gianna Eagle (09:56)
Okay.

Rachel Hetzner (09:57)
goal isn't to ruin that relationship.

Rachel Hetzner (09:59)
Your goal is to relay the information in the most effective way possible, address the myths, address what is recommended and the outcomes of not having that done. And if that is it, whatever their choice is, we have to respect it and just address it at the next

Gianna Eagle (10:18)
business.

Rachel Hetzner (10:19)
visit if needed. So I think you're you're really reflecting.

Rachel Hetzner (10:24)
what the evidence that you have presented in the previous two episodes has shown. So it's really good.

Gianna Eagle (10:31)
Yeah, and something that I forgot to throw into our scenarios that's also really helpful, even if the patient is sharing a concern and it's obvious that they're misinformed, you can lead by saying, you know, I really value that you're having these concerns about your health and that you're wanting to share them

Rachel Hetzner (10:45)
Mm-hmm.

Gianna Eagle (10:47)
with me so we can make the best choice for you together. Something that acknowledged was the fact that they do care, even if it's, you know.

Rachel Hetzner (10:53)
Right. Yeah.

Rachel Hetzner (10:54)
Yeah. No one wants to be in bad health, you know? It's just what the perspective of good health is. So

Gianna Eagle (11:03)
Yes.

Dr. Justin Hooks (11:05)
That's a really good point. a point. Yeah. Yeah. So I

Rachel Hetzner (11:07)
I'm wise. I'm like an owl. No, I'm just no, I'm just kidding. I've been doing this for a long time. I've had many of many a conversation like this. So

Dr. Justin Hooks (11:19)
so the last one is nurse practitioner Gianna. I

Dr. Justin Hooks (11:24)
I looked at my micker. I downloaded it from the state website now that Dr. Hetzner told me I had to bring it to my appointment. Yeah.

Rachel Hetzner (11:30)
Obvious play.

Dr. Justin Hooks (11:32)
And so I'm not seeing Dr. Hetzner today, but I'm seeing you. And it says I need a pneumonia vaccine. So what I did is I put it in Chat GPT and it really was really confusing to me. Can you like help explain do I need a pneumonia vaccine or not?

Gianna Eagle (11:49)
So it's currently recommended for adults ages 50 and older, especially if you have a chronic condition like asthma, diabetes, lung disease. Because especially when you're, if you have a history of chronic illness, catching pneumonia could be really detrimental to your respiratory health.

Dr. Justin Hooks (12:08)
Yeah, that's really important because I do have asthma and with it's July and everyone will revisit this once they hear the episode about the Canadian smoke, but it's been really bad.

Gianna Eagle (12:18)
Mm-hmm.

Dr. Justin Hooks (12:19)
It's like a bonfire outside. And so I

Gianna Eagle (12:22)
Yes.

Rachel Hetzner (12:22)
Yeah.

Dr. Justin Hooks (12:23)
I don't wanna have pneumonia if I already have breathing problems, right?

Gianna Eagle (12:27)
Absolutely not, nope. It will be the way that the pneumonia infection works and the sequelae or the negative outcomes that it causes. You definitely don't wanna compound that on top of already bad ear quality and history of asthma for sure.

Dr. Justin Hooks (12:45)
Well, that's a really good point. And the last question I have is I asked Chat GPT this and it didn't tell me any good answers, but I wondered if like if I get the pneumonia vaccine, does it cause pneumonia for me at all or not?

Gianna Eagle (13:00)
No,

Gianna Eagle (13:01)
it won't cause pneumonia. Yeah,

Dr. Justin Hooks (13:03)
Okay.

Gianna Eagle (13:04)
you seem very concerned about not wanting to get it and I'm glad that you came to me with your questions. It's a way for your body to build antibodies to the disease without becoming fully infected. So it's a safe and effective way to prevent yourself from getting it.

Dr. Justin Hooks (13:19)
Geez, okay. I'm gonna go back and tell my friends that you can't get pneumonia from the pneumonia vaccine. They told me I could get

Gianna Eagle (13:25)
That's it.

Dr. Justin Hooks (13:25)
the flu from the flu vaccine and I believed them, but I don't wanna get pneumonia now. So nurse

Gianna Eagle (13:31)
Yeah.

Dr. Justin Hooks (13:32)
practitioner Gianna, I think I'm gonna get the pneumonia vaccine. Do you think I can get it today? Like in the office, so I don't have to go to the pharmacy.

Gianna Eagle (13:40)
Yeah, we can absolutely do that for you. And all vaccines do have side effects. You might have some fatigue, might get a low grade temp or have local swelling or pain at the injection site, but that's just your immune system building antibodies to it. You'll feel a lot better in a couple days.

Dr. Justin Hooks (13:56)
Wow. Dr. Hudson, I I kinda enjoy this asking our expert here. Some testing as she's

Gianna Eagle (14:00)
That's me.

Rachel Hetzner (14:01)
Uh-huh, I know.

Dr. Justin Hooks (14:02)
finishing up her doctorate. And yeah, I think she's ready. I really do think she's ready to handle these crazy questions from all the patients and everything like that. Yes.

Rachel Hetzner (14:06)
I think she's ready. Yep. Spread the word. Tell your teachers. yeah. Yeah.

Gianna Eagle (14:12)
Thank you.

Dr. Justin Hooks (14:13)
Gianna, do you have like any final last thoughts to share with all of our listeners about just some things that we haven't talked about that you just want to share just as we're closing up here?

Gianna Eagle (14:25)
I think after having the discussion and sharing success stories and kind of practicing applying these techniques, I'm feeling really hopeful about the direction that our healthcare system is headed. Even during a time when things might seem bleak in some aspects and maybe not so bleak in others, I really do think that we can all, know, countrywide really make an impact with our patients and with health policy.

Dr. Justin Hooks (14:50)
Yeah. And like I said, Dr. Hetzner's health policy advocate for sure. I'm

Rachel Hetzner (14:56)
Yeah,

Dr. Justin Hooks (14:57)
a trainee as well, with her, but with all good things, unfortunately this has to come to an end, and I hate to say that, but please stay tuned for the latest and greatest in NP practice, expert conversations, and of course legislative updates because

Dr. Justin Hooks (15:14)
Our next episode, we're gonna have some legislative updates. I promise you that. You cannot wait for our next

Rachel Hetzner (15:19)
Mm-hmm.

Dr. Justin Hooks (15:20)
episode. Trust me, because it is coming soon. Subscribe today and follow along.