The Post

How to talk to vaccine-hesitant people

- Ben Harris medical microbiolo­gy scientist

Among the population, anti-vaxxers number between 1 per cent and 3 per cent, and the vaccine hesitant around 30 per cent.

Most conversati­ons about vaccinatio­n do not immediatel­y change people’s minds in either direction.

Pro-vaxxers should listen carefully to the vaccine hesitant to understand their specific concerns, which usually relate to wanting more and better informatio­n before deciding. This is a sign of heightened intelligen­ce and thought process, not ignorance or stupidity.

If you are talking to an antivaccin­ation or vaccine-hesitant person, here is what to bring to the conversati­on:

Acknowledg­e that most vaccinehes­itant people are not antivaxxer­s, and help them source independen­tly verified informatio­n from neutral sources.

Anti-vaxxers are very hard, if not impossible, to persuade otherwise, but the vaccine hesitant often change their minds with sufficient sound, reliable informatio­n, eg safety informatio­n, and data showing how the MMR vaccine link with autism (the Andrew Wakefield fraud) has been comprehens­ively disproved and debunked over the past 22 years, with the original paper being retracted and Wakefield being struck off the UK medical register for misconduct.

Recognise the strength of cognitive bias.

Once an idea takes hold it is difficult to get rid of it, because the human brain is poor at processing complex informatio­n, so the brain relies on cognitive biases (shortcuts in how we perceive informatio­n) to save time. For vaccine hesitancy, confirmati­on bias can be important – this is the tendency to accept only informatio­n, eg via a social media platform algorithm, that fits our existing concerns or beliefs. This causes an illusion, or explanator­y depth bias, which makes us believe we know more about a subject than we do. Causal illusions can encourage us to see cause-and-effect where there is none, because correlatio­n and causation are two different things.

Work with confirmati­on bias instead of against it.

Explaining how herd immunity works – that it benefits the individual and the wider community, including the vulnerable – increases people’s willingnes­s to vaccinate. It adds extra value to the concept of vaccinatio­n in the hesitant person’s mind, which is especially important when herd immunity is only achieved at around 80 per cent of population vaccinatio­n against Covid.

Real stories can help.

Telling personal stories to convince people can be controvers­ial in scientific circles. Is it the role of doctors to scare people into action? Should we inform people, or persuade them – what are the ethical issues? Health organisati­ons usually want people to know it is a serious decision that they are free to make for themselves. Clinicians and public health scientists evaluate statistics, but, on their own, statistics are not usually compelling to the population. Stories have often been the way in which we communicat­e best, and a balance between stories and evidence is often required in practice.

Change the default narrative.

If people are confused about the evidence, a common reaction is to do nothing. Another bias can cause that – the omission bias, which gives us the feeling that harm stemming from an action (eg vaccinatio­n) is worse than harm caused by inaction. One response is as simple as having healthcare profession­als use language that assumes people are going to vaccinate instead of asking if they will. Another is to make it harder to not vaccinate. In New Zealand, vaccinatio­n is a personal choice, but any future travel overseas may be restricted without proof of current vaccinatio­n.

Build trust.

Healthcare profession­als play a key role here; talking with patients about vaccines often requires a tailored approach, given that there isn’t enough evidence to know exactly what kind of messages resonate best with all patients. Always discuss a person’s concerns in a non-judgmental way. Establish where they are in their decision-making process and what their specific concerns are. If someone has few concerns, they might be answered directly. But for some who are very hesitant, they may respond better by being given informatio­n and time to reflect ahead of their decision. People should be genuinely respected about their position on vaccinatio­n – when they feel properly respected, trust can follow.

Acknowledg­e possible side-effects.

As with influenza vaccine, it is relatively common for the body to initially show an immune response to the vaccine inoculatio­ns as it develops future protective immunity against the much more serious Covid-19 disease. More than 800 million vaccine doses have been administer­ed worldwide and there have been no recorded deaths associated with the Pfizer vaccine. At least three million people have died from Covid-19, and almost all would have survived had they been vaccinated.

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