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How to Talk About COVID-19 Vaccine Hesitancy: Addressing Four Common Types of Resistance

By Anuradha Rao-Patel | August 25, 2021 | Industry Perspectives, Coronavirus, Thought Leadership

Nurse gives vaccine to older woman

The most important conversations in life are often the most difficult to start.

At this moment in time, no conversation is more critical to our nation’s health than encouraging our family members, peers, neighbors and loved ones to get vaccinated against COVID-19. But how do we initiate dialogue that might trigger intense feelings?

Healthy conversation starts from a point of understanding. Many of us, including myself, feel very passionately that everyone should receive a COVID-19 vaccination, barring those with legitimate health or religious concerns. But passionate conviction likely won’t persuade anyone. Instead, we should try to convince from a position of empathy, not authority.

Empathy requires us to acknowledge and honor the concerns of others. It’s important to understand some of the factors driving resistance. Doing so opens the door to more meaningful exchange.

Fear of cost

Some avoid vaccinations for financial reasons. Many are afraid of hidden fees. In this case, take the time to explain that the COVID-19 vaccine is free everywhere. Congress passed legislation that prohibits providers and pharmacies from charging for doses during the public health emergency.

Many Americans don’t have access to transportation to vaccination clinics. Others can’t afford to take time off work.

It’s worth mentioning that many states, like North Carolina, are using funds from the American Rescue Plan to help those in need cover costs associated with transportation and lost work hours. In North Carolina, the United Way has collaborated with Blue Cross and Blue Shield of North Carolina (Blue Cross NC), Lyft and the NC Department of Transportation to remove transportation barriers statewide for low-income North Carolina residents who are eligible to receive the COVID-19 vaccine. There are likely similar resources available in your state.

If you have the time and resources, why not volunteer to drive your acquaintance to a clinic? This will provide both logistical and emotional support!

Complacency, or doubts about efficacy

In light of media attention spotlighting breakthrough cases and the unknowns related to the COVID-19 vaccines’ long-term potency, some might question whether the shots are worth the hassle.

Acknowledge that there have been breakthroughs, and explain that this is inevitable. Seatbelts can’t prevent car accidents, but they can minimize injuries and even prevent death. Similarly, no medicine is 100% effective. That’s precisely why vaccination rates need to be higher – when more people are immunized, we will minimize opportunities for the virus to spread (or transmit) from person to person. Although breakthrough infections are still possible among vaccinated individuals, they happen much less often because data suggest that those who have received COVID-19 vaccines are likely infectious for a shorter period of time compared to unvaccinated people.

Furthermore, you could point out that infections among unvaccinated people are driving the current spike in transmissions. Current data is even more convincing in another respect: the vaccines almost eliminate the risk of serious illness and hospitalization.

Finally, it might be worth stressing that wait lines, once so common during the initial rollout, have disappeared. Getting vaccinated is quick, easy and free.

Fear of risk

There’s hope that the Food and Drug Administration’s (FDA) formal approval of the Pfizer vaccine will help convince a lot of people that the vaccines are safe and effective. As the Centers for Disease Control and Prevention points out, “Millions of people in the United States have received COVID-19 vaccines under the most intense safety monitoring in U.S. history.” Undoubtedly, however, fear will still drive a lot of vaccine hesitancy.

Misinformation feeds much of the fear. Nevertheless, studies suggest that it’s more persuasive to empathize than to “correct.” Rather than dismiss these fears out of hand, acknowledge that medicine nearly always involves some degree of risk. Share your feelings that it can be scary to balance risk and reward, especially when health is at stake.

Studies show that people are more intimidated by risks that are unfamiliar. Even though the science of vaccines has been saving lives since the 1700s, many perceive the COVID-19 vaccines as “new and unknown.” The messenger RNA (mRNA) technologies that make them so effective are indeed cutting-edge. Meanwhile, a common over-the-counter drug like acetaminophen is so engrained in our daily lives that few of us pause to consider the risks of using it (for example, it is the most common cause of acute liver failure in the United States).

Instead of focusing on fears that might seem irrational to you, shift the discussion to the benefits of getting vaccinated. Experts suggest that sharing your own motivations might be particularly effective:

“I really missed hugging my mother. The vaccine has let me do that again, safely.”

“My daughter is too young to receive the vaccine, and I owed it to her to minimize the risk of transmitting the virus to her.”

“I’ve felt so sad not being able to experience live music, but I want to go to shows with confidence.”

“I’m much more petrified of having a tube stuck down my throat.”

As an example, it’s worth studying how 60 Black members of the prestigious National Academy of Medicine responded to vaccine hesitancy among people of color. Understanding the deep fear and mistrust of the medical community resulting from the historic neglect and overt mistreatment of Black and Native Americans, the members of the National Academy of Medicine issued a joint statement encouraging vaccination. Crucially, the statement does not trivialize these anxieties. Instead, it tries to establish empathy and trust.

Resistance stoked by cultural division

For some time now, deep cultural divisions have fueled fierce debate in our communities, and vaccines have become a flashpoint. Dialogue aimed at bridging this divide will be particularly challenging. It might seem inevitable that tensions will run high in these conversations, but keep in mind that heated emotions will do little to convince.

Instead, remain calm. Pinpoint the other person’s core values and build a rational appeal around the interests they hold dear.

If economics motivates a loved one, explain that putting COVID-19 behind us is the surest way for the American economy to operate at full throttle once again. It might be useful to reference New York State, where things are getting back to normal now that 70% of the population has gotten vaccinated.

For those who associate vaccines with government control, try framing the disease – not the treatment of the disease – as the real threat to individual liberties. If we let a deadly virus run rampant because we refuse the choice of a vaccine, the end result will be more tangible restrictions on how we live our lives: more social isolation and fewer opportunities to enjoy life outside the home, or, even worse, potentially more time tied to a bedside ventilator machine.

Recently, more celebrities and political figures from both sides of the aisle have been outspoken in their belief that constituents and fans should get vaccinated. Your loved one might be convinced when they learn that someone who shares their political beliefs has received their shots.

Map shows vaccine hesitancy by state, with North Carolina coming in at 15%-19.9% of adults hesitant to get a covid-19 vaccine

As of August 2021, the United States has suffered 37 million infections and 630,000 deaths related to COVID-19. As a point of comparison, that’s more lives than our nation lost in World War II – a catastrophic event that unfolded over the course of nearly four long years.

Talking about vaccine hesitancy won’t be easy. But it’s clear that the time for difficult conversation is now.