I read a word of advice once: "Our job isn't to change local culture." I've been thinking about this recently with an influx of unvaccinated ICU COVID admissions. In several of these cases, the hospitalized patient comes from an entire household that is unvaccinated, where everyone contracted COVID. What strikes me most in this all-too-common situation is talking with the family and finding that they remain adamant against vaccination. Now, it is true that infection generates immunity and someone who had COVID must wait some time before they can get the vaccine. But vaccination (at least one dose) is still recommended because it generates even stronger protection. Nevertheless, many of these family members (and even patients who recover) refuse the vaccine. Some of it is misinformation still circulating on social media, talk shows, and the internet. Some of it is stubbornness without good justification. I spend a lot of time talking to families about this, because I think it could be an opportunity to show how serious COVID is and how beneficial vaccination could be.

But our job isn't to change local culture. We do our best to present the strongest case for vaccination, to justify science, and to protect our community, but at the end of the day, people will make their own decisions based on their beliefs. This is a really hard realization as someone who has seen the worst of COVID in the past year and a half. Sometimes the most difficult parts of my job don't relate to diagnosis or treatment decisions, but rather to the emotional challenges we may not have anticipated.