How to broach the sensitive question of COVID vaccination status

Over the next couple of months, there will be a need to navigate conversations and questions that we have probably never thought about before – about someone’s COVID vaccination status.

While the numbers of those fully vaccinated continue to rise around Australia, a sizeable proportion of the population still remain unvaccinated. Children 12 and over can now get the jab, but kids under 12 remain unvaccinated for now.

It’s reassuring to know that children appear to be less likely to be hospitalised with COVID compared to adults, but children are getting COVID – often due to transmission in the household, from an infected adult.

Researchers say the best way to protect younger kids, and adults, from COVID is to ensure as many adults as possible are fully vaccinated.

Dr Ashneeta Prasad, a clinical psychology registrar from UNSW’s School of Psychology, says for many families, knowing the parents of their child’s friends are vaccinated may provide them with some sense of peace. But the choice to ask another person about their vaccination status is ultimately up to the parent/adult. “Over the last few months, it appears we as a country have been shifting our approach from eliminating cases to learning to live with COVID-19 as vaccination rates increase,” Dr Prasad says. “During this transition, some families may view asking about vaccination status as a useful way to manage their residual concerns about COVID-19 circulating within the community as we learn to navigate the post-lockdown world.”

Infectious disease social scientist from UNSW’s School of Population Health, Associate Professor Holly Seale is a parent of two children under the age of 10 years. She says it’s important to have these discussions with adults before catching up with them, or parents prior to having a playdate. “I have never previously asked a parent about whether their children are vaccinated prior to playdates,” she says. “I do make some assumptions that those within my close network have vaccinated their children. Sometimes this is easy to work out due to the child’s attendance at childcare which requires vaccination. I have also been in situations where parents have told me their children are unvaccinated unprompted, to allow me the opportunity to navigate whether I want our children to play together.”

Dr Prasad says before approaching conversations about vaccination status with other parents/caregivers or adults, it’s helpful to first consider what boundaries you are wanting to uphold. She says some things to
consider would be: whether you require one or both (if applicable) parents/caregivers to be vaccinated;; and whether your boundaries vary depending on the setting, duration, or type of activity.
A/Prof Seale agrees with this approach. “If the family has a child over the age of 12 that has not received their vaccine, will you proceed with catching up?,” she says. “Perhaps you may be more comfortable sticking to outdoor activities.”

Dr Prasad says when initiating a conversation about vaccination status, it can be useful to frame the question within the broader context of why it is being asked. “This could begin with expressing relief that some gatherings are now possible and mentioning how you have been looking forward to socialising in person,” she says. “Then you could disclose that you may still have lingering concerns about COVID-19 circulating within the community and to keep yourself and your loved ones healthy, you are trying to ensure that the people you are meeting up with in person are vaccinated. Providing this bigger picture before explicitly asking someone if they are vaccinated can help ease them into the conversation and promote more open and respectful communication.”

A/Prof. Seale points to a recent piece in The Conversation which highlights that offering your own vaccine status first may help break the ice. “This is a logical step as it supports setting the social norm,” she says. “As part of this process, you can acknowledge that it is a strange or difficult time. It’s important to be clear and transparent about why you are asking and be open to finding alternative options or delaying the catch up until later in the year.”

But what if some people decline to answer? “It is important that we don’t assume that they are vaccine refusers but instead may have a health condition that means they are unable to get vaccinated or they are still trying to navigate their decision around the vaccine,” A/Prof Seale says.

If the answer is no, it is helpful to be honest and transparent about your views while remaining respectful, Dr Prasad says. “You could begin with describing the situation and respectfully acknowledging that there appears to be a difference in both parties are managing their approaches to COVID-19,” she says. “You could then follow up by calmly reinforcing your preferences in this situation. Try your best to use ‘I’ statements that frame your decision to delay or abstain from in person meetings as a personal choice made for yourself, rather than a consequence of the other person’s vaccination status”.

It is possible that these conversations could elicit feelings of rejection or embarrassment, so it can be helpful to remain sensitive to their feelings, she says. “If possible, acknowledge and validate their feelings: for example, “I understand if this is upsetting or frustrating for you”, and avoid using blaming or accusatory language which can cause tensions to escalate further.”