How to discuss vaccines so that people will listen.

At this miserable point in the pandemic, vaccines offer welcome good news: So far results from the big Phase 3 trials have been stronger than vaccine experts had dared to hope.

Now the question is: Will enough Americans get the vaccine to stop the virus?

Scientists worry that a large minority of Americans say they’re unlikely to get vaccinated. In a Gallup survey released last month, 58 percent said they would get a COVID-19 vaccine — but 42 percent said they would not. To varying degrees, reluctance shows up in every demographic category — men and women, Republicans and Democrats, people of all ages and racial and ethnic backgrounds.

What’s behind those numbers? Can that distrust be changed?

And how can we talk about vaccines so that people will listen?

Lu Tang,a Texas A&M University health communications researcher who even before the coronavirus outbreak had been studying the ways that vaccine misinformation spreads on social media, has answers.

This interview has been edited for length and clarity.

Question: The U.S. and Texas are so fragmented now, with such deeply entrenched opinions about COVID-19 and masks and vaccines, that it’s hard for regular people to talk with each other about those things — much less for scientists or government officials to change people’s minds. As someone who’s studied this, what are your general recommendations?

Answer: Well, I don’t know the best way to talk to a general group of people. But I do know the way not to do it: The thing that we shouldn’t do is just to talk science. Even if you’re communicating legitimate scientific findings, people might be very resistant to it; they wouldn’t listen. This has been found again and again in research where scholars are trying to promote vaccines — different types of vaccines among different groups of people.

Of course, we will communicate some scientific facts, like the efficacy rates of the vaccine and the safety of the vaccine. However, this is just the first step.

The best way to move forward at this point is to really narrowcast our messages. As you said, people are so different these days. So it is absolutely necessary to understand different groups of the population and create messages that target the different groups.

Q: So what’s the best way to tailor COVID-19 messages for different sorts of people? What works?

A: That’s a very good question. Whether people are going to get vaccinated is determined by a number of factors. So of course, the perceived effectiveness of the vaccine and the safety of the vaccine are important.

At the same time, there are other things — for instance, people’s perceived barriers, like not thinking that they can get the vaccine. They might think, “I don’t have the money” or “I don’t have the access” or “I don’t have the time because I have a lot of work to do.” These are more practical barriers to vaccination. Even for those people who say they might get the vaccine, there are still real challenges.

So for people who are not strongly against vaccines, but who are more ambivalent, providing

practical resources is good. Money is an important factor, and convenience. For instance, you can make the vaccine free. Research in early surveys has shown that if you make the vaccine free of charge, 21 percent of the people who said that they’re not going to get the vaccines say they’re going to seriously reconsider. If you make this available at the local pharmacy, then 15 percent of the people who said they won’t get it said they’re going to to seriously reconsider.

Doctors’ recommendations make a difference. People might be suspicious of the government, but we usually trust our own personal physicians very much.

Q: What about people who are firmly against vaccines?

A: There are a number of things that public agencies could try. One is social norms. We are social animals. Sometimes whether I do something isn’t determined by whether I like it, or I want to do it, but by what other people around me are doing and whether they approve of it. Smoking, for instance: The United States has a low smoking rate now because of the social norm that generally disapproves of smoking.

We could potentially create this environment, this social norm, that says, everybody needs to get vaccinated. If you don’t do that, then you’re irresponsible. Your friends are doing it. They want you to do it. Your grandmother has done it and she wants to do it. Or your children who can’t get the vaccine at first, they want to go back to school; so they want you to get vaccinated.

If we can create this pressure, then people are probably more likely to change their behavior. That doesn’t necessarily mean that they will suddenly be converted to vaccine believers, but many will be vaccinated nevertheless so that they fit in.

We have this very strong desire to be part of a group we want to fit in.

Some survey studies have shown that in the U.S., men are more likely to want the vaccine than women. And older people are more likely to want to get vaccinated than younger people. Asian Americans are more likely to want to get a vaccine than other racial groups. And African Americans have a lower rate … of willing to get vaccine than white.

Q: What accounts for those differences?

A: In the case of African Americans, there’s this historical distrust of the doctor sent by the government. We’ve all heard of the unethical medical experiments, like the Tuskegee syphilis study, carried out without permission on Black men. So in general, African Americans have lower trust in government and government health policies. And also, African Americans are generally a bit more marginalized.

However, my student Felicia Nicole York and I just did an ethnographic study among African American people living in the greater Houston area. It shows they might not trust government that much, but they do trust their doctors. ... Some researchers have argued that African Americans don’t trust their doctors, but what we found was this is not true.

So for this group, who are less likely to trust government but more likely to trust their doctors, it is very, very important for the doctors to talk to their patients — to encourage them and to answer their questions about the COVID vaccine.

Q: What about other groups?

A: Asian Americans are more willing to take the vaccine: 80 percent of

Asian Americans are willing to get it, compared to 58 percent of Americans in general. I think part of the reason is that even for Asian Americans who grew up in the United States, Asian culture generally pays a lot of respect to authority. So we’re more likely to trust doctors or government. We’re more likely to give people in authoritative positions the benefit of the doubt.

Young people are less likely to want to get the vaccine because they’re less likely to take the virus seriously. If Instagram influencers and TikTok stars create this narrative that getting the vaccine is the cool thing to do, then young adults who otherwise might not bother might get it.

It’s really difficult to come up with a single unified strategy. My opinion is that we need to look at different groups of people — what they think, what they believe, what they like — and then come up with tailored messages.