Addressing Vaccine Hesitancy on the Front Lines:
Information about COVID-19 Vaccines for Social Service Providers Working with
People Experiencing Homelessness in the West Kootenay Region
In March 2021, the Nelson Committee on Homelessness and Selkirk
College offered a 1-hour virtual session on COVID-19 vaccines, led
by Nurse Practitioner, James Kitch, and Selkirk College Nursing
Instructor, Rob Tanner. The session was targeted at social service
providers, and had the objectives of 1) providing basic information
on vaccine theory and the COVID-19 vaccines that were available at
the time; and 2) sharing tips on how to communicate with service
users about COVID-19 vaccines. The overall goal of the session was
to combat misinformation about COVID-19 vaccines by providing
a common knowledge base for front-line social service staff. A full
recording of the session is available here. This document provides a
brief summary of topics discussed during the session.
HOW COVID-19 VACCINES WORK
Vaccination is one of the most successful health interventions in
history. Vaccines work in two main ways. First, vaccines function
on a personal level by introducing a very small amount of protein
from a virus. This protein primes an individual’s immune system to
be able to better identify and fight a virus if it enters the body. At
the time of writing this, there are four COVID-19 vaccines approved
for use by Health Canada, including two mRNA-based vaccines
(Pfizer-BioNTech and Moderna) and two adenovirus-based vaccines
(AstraZeneca and Johnson & Johnson).

The second way vaccines limit the spread of disease occurs on a
societal level. As the number of people with immunity to a virus
increases, the number of susceptible individuals decreases which
minimizes the potential for the virus to spread. Another common
term used to describe this principal is herd immunity. With
reference to COVID-19 the percentage of immune population that is
necessary to reach herd immunity is speculated to be approximately
85% of people; however, this value is variable depending on the
virulence of particular strains. Vaccination acts as the most effective
and viable way to rapidly reach these levels of immunity and to
prevent new variants from emerging.
VACCINE EFFECTIVENESS
When viewing the effectiveness of the available vaccines it is
important to note how the vaccine trials were designed. In the trials
for the Pfizer and Moderna vaccines, the focus was on the reduction
of moderate to severe symptomatic infections. This outcome was
met approximately 95% of the time in individuals aged 16-64.
The focus for the AstraZeneca and Johnson & Johnson trials was
reduction of asymptomatic and symptomatic COVID infections
which occurred at lower percentages than the Pfizer and Moderna
vaccines. Due to data not being collected on asymptomatic

infections in the Pfizer and Moderna trials, efficacy rates cannot
be directly compared between available vaccines. Despite this
difference it is accepted that all available vaccines reduce the
spread of moderate and severe cases by 85-95%. Even with the
high efficacy rates of these vaccines a small percentage of
vaccinated individuals remain susceptible to infection. Further,
vaccinated individuals can continue to act as hosts spreading the
virus which is why it is essential that guidelines and precautions
must still be followed after vaccination so that vaccinated
individuals do not act as vectors for the disease.
Though the long-term effectiveness of these vaccines is not
currently known given uncertainty in how the disease will evolve,
it is possible that vaccinated individuals will need booster shots to
maintain immunity over time.
WHO SHOULD GET VACCINATED?
The short answer to this question is everyone who can. The
route to herd immunity will be shorter if more people become
vaccinated. The government has developed a rigorous vaccination
rollout plan taking many factors into account in order to protect
the most vulnerable people in the population. However, to
continue protecting these people and provide the best outcome
for all of society, vaccinations must be administered to the
remainder of the population. This includes pregnant women,
previously infected individuals, immunocompromised people, and
possibly children as more information is acquired.
VACCINE SAFETY
All vaccines have undergone very thorough testing to be approved.
A common misconception is that vaccine development and trials
were rushed however this is not the case. What took place was the
rapid development of vaccines funded by enormous amounts of
money backing the research and large scale collaboration within
the scientific community using the most advanced resources
available.

COMMUNICATING WITH SERVICE USERS
ABOUT COVID-19 VACCINES
The Nelson CARES Society gathered information on how service
providers can effectively communicate about vaccines with
service users who may be hesitant to become vaccinated. This
effort concluded that foremost, the goal of vaccination-related
conversations should be to help individuals make their own
informed decisions and opinions regarding vaccination.
Some individuals will be uncertain about vaccination or simply
unaware of the facts. Discussions with this group will be most
effective if the service provider takes an honest, compassionate,
and relatable approach that doesn’t attempt to convince anyone
to be vaccinated, but rather focuses on personal experience (“I’m
not an expert but I can tell you what I know…”) and points to
established facts. It is important to be empathetic and recognize
that a service user may have had negative past experiences with
the health care system.
The use of self disclosure (“This is what I’m doing and why…”)
may be helpful as decision making can be an emotional process
and service providers are often seen as a trusted and dependable
source of information. Another recommended approach focuses
on the community aspect of vaccination. Emphasizing benefits
such as herd immunity can help people understand how getting
vaccinated can protect the people around them while helping the
pandemic end sooner.
One or more of these strategies can be used to limit the spread of
misinformation and support vaccine-hesitant individuals to make
an informed choice.
LEARN MORE
ImmunizeBC’s website is a trusted resource for information on
COVID-19 vaccines: https://immunizebc.ca/covid-19

The COVID-19 vaccines have been held to the same standard as
previous vaccines and function using similar principles. Trials
included thousands of participants and millions of people around
the world have now been vaccinated. Very few adverse effects
have been reported. With regard to the novel mRNA vaccines,
long term adverse effects are scientifically unlikely as the
components of the vaccine begin to degrade soon after injection.
Short term effects do occur from the vaccination which includes
fatigue and soreness at the site of injection. These effects are
minor relative to the potential consequences of being infected.
Allergic reactions to vaccines are rare, occuring in less than 10
people per million vaccinated.

Disclaimer: The information provided in this document and the associated recording is not meant to be comprehensive or absolute. The information
shared by the presenters does not necessarily represent views held by Selkirk College or regulatory agencies.