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Vaccine engagement: the importance of speaking out

Engaging with the public about COVID-19 vaccination is a crucial focus of our work in the coming months. As part of this, we ran a webinar for researchers on Friday 18 December on how to have constructive conversations with the public on COVID-19 vaccination. Ahead of this, we interviewed one of our speakers, Dr Matt Morgan, on his thoughts around why it is so important for us all to contribute to the public dialogue on vaccination. Having previously completed a PhD in immunology, Dr Morgan is an ICU doctor at University Hospital of Wales and regularly spoken out in the media throughout the pandemic.


As an ICU doctor, you were one of the first people in the country to have the COVID-19 vaccine when it became available last Tuesday.  What led to you getting the vaccine on the first day it was available?

I was very lucky to do so.  The way it was structured for healthcare professionals where I work was by professional groups. They decided to offer it first to staff working in the emergency department and on wards that look after COVID-19 patients. I was very grateful and lucky to offered the vaccine so soon and the process was pretty simple.  I was given the Pfizer vaccine, which is the mRNA vaccine where you need two doses, 21 days apart.  I made one phone call and booked in the two time slots for having the vaccination then and there.

 

You’ve spoken out a lot about getting the COVID-19 vaccine both in the press and on social media. What are your motivations in speaking out publicly about this?

Since the beginning of the COVID-19 pandemic, I’ve decided to speak out about certain topics and that really came from various public engagement activities that I’d done in the past. I wrote a book called ‘Critical. Science and stories from the brink of human life’ that illustrates how science history and stories can be bound together in my place of work, intensive care.  During this pandemic, it became obvious to me that yes, we need science, we need nurses, we need doctors, but much like the founder of the NHS, Aneurin Bevan, said “The purpose of getting power is to be able to give it away.” Throughout the pandemic, we have seen that the material interventions that help in stopping the spread of the virus are the actions that the public take. We need to engage with people to make sure they have the correct information on which to base those decisions.

When it comes to vaccination, I find it very difficult when I see people making decisions on the basis of myths or disinformation. You can make any decision you want, but everyone should have access to the evidence to allow them to accurately assess the risks. To give you an example, I have a friend who jumps out of a plane every weekend. To me, that’s a crazy decision, but it’s his decision to make. But that’s fine as long as he makes it on the basis of fact. If someone told him, there’s never ever been a problem with anyone jumping out of a plane, that would not be ok because he’s not making the decision on the basis of the evidence. So that’s the reason I decided to speak out – to make sure that people had evidence to the facts about COVID-19 vaccination.

 

What response have you received, both from the public and other healthcare professionals and researchers, to speaking out about getting the vaccine?

Like everything in life there is a range of responses and social media sadly often thrives on conflict. I’ve had a lot of positive responses, thanking me for talking about a particular aspect of vaccination or for framing risk in a certain way.  But there have also been responses that perpetuate some of the disinformation out there.  I take the approach that there are very few bad people in the world but there are bad ideas and bad incentives.  I think what you have to remember is to fight the bad ideas and incentives rather than the people involved because you never know what is going on in someone’s life.

 

What role do you think healthcare professionals and researchers have in building vaccine confidence?

I think we all have a role to play and it’s not just healthcare professionals, but it’s scientists, it’s advocates of science and reason, it’s teachers, it’s politicians.  That’s why engaging on the topic of vaccination is really hard – because you can’t just rely on people getting their information from one source. People are influenced by a huge number of different factors and social networks, including professional groups, peer groups, friendship or family groups. We all have a responsibility to base the things that we say on truth and fact as much as we can.

 

You currently work in the ICU in Cardiff but previously you completed a PhD in immunology.  Has your immunology background helped you in engaging on conversations about vaccines?

Yes, in particular it’s encouraged me to embrace uncertainty. It made me realise more than ever that in life there are two options when you consider difficult questions. There is either the answer that is simple and normally false, or the answer that is normally complex and true.  Science as a discipline thrives on uncertainties. If there were no uncertainties, there would be no point in science. Throughout the pandemic, people have sometimes struggled with changing narratives – one day we need to do this, the next we need to do that.  These changes are often referred to as backtracks or U-turns or seen as a sign that science is broken. But for me, it’s the opposite. It’s a sign that science works. It’s only dogma that maintains its position despite evidence to the contrary.  It can be hard to have these conversations about science where there is an element of uncertainty.  Going into my PhD, I thought I would do some experiments to get one clear answer, but of course that’s not what happens and the real situation is a lot more complex.  So, my immunology background has helped with being honest about scientific uncertainty when engaging in conversations around the pandemic and vaccination.

 

Do you have any final tips for our members who would like to be positive role-models for speaking out about COVID-19 vaccination?

Firstly, you forget how much your language changes as you do more science and healthcare, so really try to make your language as simple and as clear as possible. Secondly, analogies are really useful. For example, I’ve discussed about the drive to the vaccination centre being the riskiest part of my decision to get vaccinated. There are lots of things we do in life without thinking about the risk they entail – for example, driving or drinking alcohol.  Using analogies that people can identify with from their everyday lives is really helpful. Thirdly, try not to rally against people, but rally against bad ideas or bad incentives because that is what motivates a lot of disinformation out there.


Dr Matt Morgan is an honorary senior research fellow at Cardiff University, consultant in intensive care medicine, and research and development lead in critical care at University Hospital of Wales. He regularly writes for the British Medical Journal and other publications. His book ‘Critical: Stories from the front line of intensive care medicine’ was published in paperback earlier this year.

Follow him on Twitter at @dr_mattmorgan

He spoke in the BSI webinar 'COVID-19 vaccine conversations: effective ways of engaging with the public' which took place on Friday 18 December. The live recording is free for all to watch.