Strategies for Talking with Patients about Vaccinations for Mpox

As a healthcare provider, you are a trusted source of health information. The way you speak with patients who have questions or concerns about receiving a vaccine for mpox can influence their willingness to consider vaccination.

Motivational interviewing is an evidence-based and culturally sensitive way to speak with patients about making a behavior change. In the case of mpox vaccination, motivational interviewing can be used to speak with unvaccinated patients about getting vaccinated. The goal of motivational interviewing is to help people manage mixed feelings and move toward healthy behavior change that is consistent with their values and needs.

Here are five strategies you can rapidly implement (1–5 minutes) during a patient visit.

Strategy 1: Embrace an attitude of empathy and collaboration

  • Demonstrate curiosity about wanting to know the patients’ thoughts and beliefs about vaccination.
  • Be compassionate by asking the patient about their beliefs regarding vaccination without judgement on those beliefs. Indicate understanding of how these issues can often be confusing or stressful.
  • Be sensitive to culture, family dynamics, and circumstances that may influence how patients view vaccines.
  • Remember—arguing and debating do not work. Taking a strong initial stand may also backfire, especially with people who have concerns about vaccines.

Strategy 2: Ask permission to discuss vaccines

Start by asking permission to discuss vaccines. Say something like, “If it is okay with you, I would like to spend a few minutes talking about vaccinations for mpox.

  • If the patient says no, respect that.
    • Option 1: Move on and say, “I respect that, and because I care about your overall health, maybe we could talk about the vaccines at a future time.”
    • Option 2: Based on the patient’s demonstrated emotions and your assessment of the patient’s worldview and values, you could spend several minutes curiously exploring why the patient may not want to talk about it. The goal is to understand, not to change their mind.

Remember—these conversations may take time, and they may continue over multiple visits.

  • If the patient says yes to talking about the vaccines, move to Step 3.
  • If the patient asks a question about the safety of vaccines for mpox, vaccine risks, or their health or mental health, potential responses are suggested in Step 4.

Strategy 3: Motivational interviewing

Ask the patient a scaled question. For example, “On a scale of 1 to 10, how likely are you to get a vaccine for mpox?” (1 = never; 10 = already have an appointment to get vaccinated).  Then explore both sides of whatever number is given.

  • Example: Let’s assume someone says 4. This is where curiosity comes in. You can say, “Can you tell me more about why you picked 4?” Let them answer, and ask a follow-up question like, “What would help you move to a 5 or 6?”

The goal is to help the patient become more open to moving toward higher numbers—in other words, getting vaccinated for mpox.

  • You want them to talk about this out loud because talking actually changes how they process their choices and can develop forward momentum.
  • People hesitant about vaccines usually have more practice explaining why they haven’t gotten vaccinated, so it’s good to reverse that. Ask them to express the benefits of vaccination out loud.
  • Be compassionate and curious about the patient’s mixed feelings, both the part of them that wants to trust that getting a vaccine is important and safe and the other part that feels hesitant. It is important to show support for the patient to incorporate their personal values and the health needs of their family and community as they make their decision.
  • Note: This approach may have limited effectiveness with low literate and low emotionally intelligent patients. This exercise should not get stuck if the differences along the scale are not meaningful for the patient. Move on to step 4 if the scale if it is not immediately intuitive.

Strategy 4: Respond to questions about vaccines, health, or mental health

If a patient asks a question about vaccine safety, vaccine risks, or their health or mental health, respond within the boundaries of your knowledge, ethics, and scope of practice.

  • If you feel able to answer the patient’s question, respond with empathy and provide scientific information as needed. Refer the patient to resources on the CDC website, which are listed below.
  • If the patient’s question is outside of your knowledge base or clinical scope, recommend that they speak with an appropriate medical or mental health provider or a knowledgeable expert, as needed.

Strategy 5: Discuss vaccine options that may alleviate concerns about side-effects

Some patients may have seen or heard of side effects associated with intradermal administration of the JYNNEOS vaccine in the forearm. These side effects can include swelling, redness, thickening of the skin, and skin discoloration at the spot where the vaccine was given. This may last for several weeks. These visible side effects may be stigmatizing and could be a reason some are hesitant to get the JYNNEOS vaccine or complete the two-dose series.

  • Let patients know the vaccine can also be administered intradermally in the skin of the upper back (just below the shoulder blade) or the skin of the shoulder (the area above the deltoid muscle).
  • If vaccine supply allows, the vaccine is also approved to be administered “subcutaneously” in the fat layer underneath the skin on the back of the upper arm (triceps).