By Patricia Mukhim
We all have friends and acquaintances who are either vaccine hesitant or anti-vaxxers. With the latter it is pointless to argue for they will always be one up on information culled from the internet. As medical experts universally say, it is best to address the vaccine hesitant group for they are open to changing their attitudes towards the vaccine if they understand the implications and if they get that information from sources they trust.
Dr Tom Aechtner of Uppsala University, Sweden says, “Vaccine hesitancy is much broader than the classification of anti-vaccine, hence understanding the difference between anti-vaccination beliefs and vaccine hesitancy is key to creating public health communication strategies. At present, there are many who are pro-vaccine but have concerns that the Covid vaccines were developed too quickly or relied on untested technologies. These are fears that come from the half-informed or ill-informed and are therefore understandable Aechtner says. There are others with different concerns. They feel that the perceived benefits of the vaccine are outweighed by its ability to create adverse impacts, especially, if they are immuno-compromised.
Research by several agencies across the world found that the percentage of people who might be truly anti-vaccine is only around 2 to 3%. It is the vaccine-hesitant groups that is much larger and is anywhere from 20 to 40%. Hence it is important to tailor health communication strategies to meet the specific needs of these two distinct groups. Each set of people have to be dealt with differently. Aechtner says that it is unfortunate that even the scientifically minded tend to make the mistake of confronting the anti-vaxxers head on and to dismantle their arguments with facts. He says this approach is wrong and unlikely to yield results. It is more effective to communicate to the vaccine hesitant group that is confused by misinformation than to attack the vaccine deniers who send these messages around. Hence health workers and communicators should invest their energies in reaching out to vaccine hesitant people. They are more likely to be convinced that vaccination can protect them from a severe form of Covid which might not require hospitalisation.
The misinformation about vaccination is that (a) it will kill people in two years (b) there is a magnet ticker in the vaccine (c) it might affect the arms and people may not be able to work as they used to do (d) It could cause loss of fertility. These fear reactors might have caused the consternation. Vaccine hesitant people may have strong opinions, but they have not yet taken the final leap to the anti-vaccination camp. Between 2020 and 2021 much research has gone into how to reach fence-sitters. Studies suggest that success comes, not from lecturing them or telling them they are wrong, but rather finding their desires, identifying their values, and leading them to a solution that works for what they want, which is, in most cases, the safety of their children” or some other rational goal.
Researchers have also concluded that health communicators should actually avoid trying to convert anti-vaxxers or ardent vaccine deniers. That’s because fervent anti-vaccinators are least open to impartial argumentation, scientific evidence, and discussion.
In an article in the New York Times, “What if the unvaccinated can’t be persuaded,” Ezra Klein narrates a heart-breaking story from a Facebook post by Brytney Cobia, a doctor in Alabama who wrote the following:
“I’ve made a LOT of progress encouraging people to get vaccinated lately!!! Do you want to know how? I’m admitting young healthy people to the hospital with very serious Covid infections. One of the last things they do before they’re intubated is beg me for the vaccine. I hold their hand and tell them that I’m sorry, but it’s too late. A few days later when I call time of death, I hug their family members and I tell them the best way to honour their loved one is to go get vaccinated and encourage everyone they know to do the same. They cry. And they tell me they didn’t know. They thought it was a hoax. They thought it was political. They thought because they had a certain blood type or a certain skin colour they wouldn’t get as sick. They thought it was “just the flu.” But they were wrong. And they wish they could go back. But they can’t. So, they thank me and they go get the vaccine.”
It is sad indeed that the young are infected and dying because they refuse to be vaccinated. The Delta strain we are told is highly infectious but by rejecting the vaccination we are giving free rein to the virus to infect the defenceless. This, health experts say will give birth to a strain that evades vaccines while retaining lethality, or that attacks children with more force. Throughout this pandemic, the same pattern has played out. Countries had not done enough to suppress the virus when they still could, so they had to impose more draconian lockdowns and see more deaths. For this reason alone, those who object to vaccination saying, “My body, My Choice,” should perhaps widen their tragic imagination.
The vaccine does not promise 100% efficacy, we are told and breakthrough COVID infections are possible. Some vaccinated people will get infected, some will get sick, and in rare cases, some may even be hospitalized. The only claims that scientists have made for the vaccine is that it prevents severe illness, which is a proven fact, rather than on preventing any infection. Health experts says the Delta variant is not a major threat to everyone but is largely a threat to the unvaccinated. It’s more infectious, it’s spreading more quickly, is causing the unvaccinated to get sick, and unfortunately, to die.
Dr Arnaud Gagneur neo-natologist and a professor of pediatrics at the University of Sherbrooke and Karin Tamerius a former psychiatrist and the founder of Smart Politics, an organization that teaches people to communicate more persuasively, agree that most vaccine hold-outs are not anti-vaxxers or conspiracy theorists. They suggest that the common persuasive styles — commanding, advising, lecturing and shaming don’t work; on the contrary they backfire.
Hence the main task of governments is to create a pool of advocates who are recognized as the ’voice of authority’. People generally know which sources to trust in their immediate circles. Messaging too must be nuanced and take the form of a discussion rather than a lecture from a ‘know it all’ position. That usually puts people off. The vaccine hesitant group needs more understanding and clearing of doubts than a lecture. Since distrust about Covid-19 vaccination is the main driver of hesitancy, who the message comes from is just as important as what the message entails. Trusted messengers and communicators whose messages resonate with the community are much needed here. They include doctors, nurses, pharmacists, national medical experts, teachers, faith-based and community influencers, athletes, musicians, actors et al.
At this point Government needs to invest in good research and identify the most harmful misinformation and then combat it head-on with the most powerful and approachable truths. Research from credible institutions like WHO have found that trust is at the root of hesitancy. It is important to build that public trust but that’s a challenge since people are so used to being let down by the system (read government), especially when it comes to health care. Those who build communications capsules need to work in different ways to reach their audiences with education and information that will resonate and help build trust. However, communities are by nature heterogenous. The communication therefore cannot be homogenous. Health workers should not push a, “one-size-fits-all,” message. This will not work. What also doesn’t work is pointing fingers, blaming and shaming those hesitating to take the vaccine.
As for the anti-vaxxers, one only wishes they would stop converting others to their viewpoint. But that’s what they do best. I guess we have to learn to live with such sceptics too.