Vaccine Hesitancy: Can We Talk?
Difficult conversations require having respect, empathy, and patience.
Posted December 22, 2020
By Sue Kolod, Ph.D.
After months of isolation due to the Covid-19 pandemic, things are seeming a bit more "normal" as people get vaccines, with Public health officials stressing that COVID-19 vaccines are the best hope for achieving this new normal.
But, there's a "but."
Much is at stake. For life to return to anything approaching normal, 75% of the population must be immunized. If enough people avoid the vaccine, COVID-19 transmission will continue. Honest, fact-based conversations about the vaccine among family and close friends have an urgency that strikes close to the heart. Since some conversations are likely to be emotionally charged, it’s important to be able to communicate and listen actively. You’ll need to understand your own feelings about the issues, and also deal with someone else’s strong feelings — all while being able to think clearly and stay focused — basic psychoanalytic technique!
If a close relative or friend says they won’t take the vaccine, should you engage them in discussion? Is it possible to have a conversation about a deeply divisive and emotional issue? Should one try to persuade?
Those who believe the pandemic is a hoax and vaccination is foisted on us by the deep state are probably not open to either dialogue or persuasion. This could end in a bitter fight and it might be best to avoid the topic altogether.
However, many people are undecided and may be open to discussion.
What are some fact-based reasons people are refusing the vaccine?
- Concern about underlying conditions, such as seizure disorder, allergies, hypertension, HIV, diabetes
- Worries about unknown side effects
- Concern that methods used to develop the vaccines are unproven and testing may not have been sufficiently extensive
- Mistrust of government leading to mistrust in vaccine development
- Issues of consent: The history of abuse by the medical profession is particularly relevant among African-Americans. The infamous Tuskegee Study of “Untreated Syphilis in the Negro Male” is one example.
Even healthcare workers acknowledge ambivalence. In a New York Times article, Petrona Ennis-Welch, one of the first healthcare workers to receive the vaccine at Mount Sinai Hospital, stated, “Some of my colleagues feel they want to wait for the second wave [of vaccination]; they do not want to be a part of the first round. They want to see how people do — which is understandable.”
What doesn’t work
In most cases, vaccine hesitancy comes from a combination of rational and irrational factors. Starting a conversation about vaccine hesitancy requires a willingness to listen to both.
Shaming, calling people “stupid” or “crazy,” or laying guilt trips is not effective or useful in communicating.
Lisa, who is pregnant, told her sister she doesn’t think she would take the vaccine right now. Her sister, Jen, called her “selfish and ignorant—doesn’t Lisa realize how important it is for their parents to get together with them?” And their grandmother can’t see her at all until Lisa is vaccinated. Jen’s attitude made Lisa feel bad but didn’t convince her. Instead, she refused to talk about the vaccine with her sister at all.
Understanding the position of the other person
A more effective strategy is listening to the concerns of the hesitant person. Hear them out. Ask questions to better understand what facts or opinions they are basing their decisions on and the logic of their decision making. Treat them with respect and try to put yourself in their place.
For example, Alice, age 91, told her daughter, Emily, she wouldn’t take the vaccine if offered. Alice, who suffers from allergies and is concerned about her ability to withstand the vaccine at her age, decided she was unwilling to take the risk.
Emily was alarmed to hear this. She hadn’t seen her mom in person since March, and couldn’t wait for both to be vaccinated and finally get together. However, Emily, putting herself in her mom’s place, imagined how frightening it could be for her to take the vaccine, even though she knew her mom wanted to see her.
Emily researched the most up-to-date information about allergies, the vaccine, and older adults. She validated her mom’s concerns but, at the same time, provided her with data that put those concerns into context. After discussing risks and benefits, Alice agreed to reconsider but wants to wait until more people have been vaccinated, particularly people with allergies, to see how they react. While difficult for Emily to wait, she accepted that her mom can’t put aside worries until more data is available.
Suggestions for engaging in a conversation about vaccine hesitancy
- Try to maintain a neutral stance. It is not your job to convince the other person to take the vaccine but to open the dialogue for discussion.
- No interrupting or personal attacks.
- Tone down the rhetoric. This is critical to reaching people who are unlikely to agree with your message. Pay attention to questions you can’t answer and what you, yourself, don’t actually know.
- Strive to develop a greater understanding of the roots of others’ viewpoints; put yourself in the shoes of the other person.
- Provide the best, up-to-date scientifically approved information.
- Don’t give up right away. It may take several conversations to establish productive communication and discussion that is satisfying to both participants.
It is important to get information from reliable sources (CDC, AMDA, medical directors, providers) Social media is full of misinformation and opinions based on that misinformation.
Here are some links to information:
- CDC: About COVID-19 vaccines
- CDC: Provider Resources for COVID-19 Vaccine Conversations with Patients and Answering Patients’ Questions
Sue Kolod, Ph.D., is co-chair of the Committee on Public Information of the American Psychoanalytic Association and co-editor of the blog, Psychoanalysis Unplugged.