It’s been a year since all of our lives took a hard-left turn, with offices, schools, restaurants, gyms, and many other parts of our daily lives shutting down, going remote, or trying to find some other way to adapt to the dangerous realities of a global pandemic. At first, many of us hunkered down with the expectation that once the lockdowns were lifted, life would return to normal and we would all be able to buy toilet paper once again. While the second part proved to be true (thankfully), a reality gradually set in that life would not return to anything resembling normal until a COVID-19 vaccine was developed.
And here we are with not one, but three FDA-approved vaccines, and a completely different kind of challenge: convincing people to take them.
On the one hand, it’s a nice problem to have when compared to the alternative of having no vaccine at all. On the other, it’s deeply frustrating to have a path forward in the effort to end this pandemic, but still face a significant struggle convincing enough people to take it.
Succeeding in that struggle is only possible if we understand why people are uncertain or unwilling, acknowledge valid concerns, and address them with an effective strategy.
What are the barriers to choosing to get a vaccine?
There are several prevalent reasons people give for hesitation or opposition to taking a COVID-19 vaccine and it’s important to remember that for many people, it’s often not just one, but a combination that can push them over the threshold.
Top concerns include:
- Potential side effects
- Lack of trust in the government to ensure the vaccines’ safety and effectiveness
- The “newness” of the vaccine
- The role of politics in the development process
It’s important to keep in mind how widespread these barriers are – a recent survey by health-nonprofit Surgo found that 15% of the 2,500 healthcare workers they spoke to had turned down the vaccine. That’s right, 15% of the people who are at the highest risk of exposure and have seen the devastating effects of the disease turned down a vaccine
Confidence in the evaluation and review process.
Throughout 2020, we conducted regular polling with our Health Stories Project digital community to understand how the pandemic was affecting people’s lives and how they felt about the government’s response to it. Our results consistently showed that people were much more critical of the federal government’s handling of the situation, compared to the response by their own state and local authorities.
Given that the agency in charge of evaluating and approving vaccines is at the federal level, we knew that trust in the process could be a potential issue for many people. When the first vaccine was rolled-out in December, we conducted a survey with our community to better understand how they felt about it.
What we saw was that just 39% were extremely or very confident in the FDA's evaluation and review process. On the other hand, 24% of the people we asked said they were not very or not at all confident in the evaluation and review process.
A much larger poll by the Kaiser Family Foundation found that 55% of people who were vaccine hesitant cited lack of trust in the government to ensure the vaccines’ safety and effectiveness as the primary reason for their hesitation.
Comfort level with taking the vaccine.
At this point, the comfort level in taking the vaccine appears to be increasing steadily. In December, just 35% of the people we asked felt comfortable taking the vaccine right away, while 26% said they would wait at least 12 months before taking the vaccine.
The good news is that a more recent Kaiser Family Foundation poll reported that 18% of U.S. adults said they have received at least one dose of the vaccine and 37% plan to get it as soon as they can, figures that are consistently trending up.
However, that same Kaiser poll found that a persistent one in five people say they will get the vaccine “only if required for work, school, or other activities” or will “definitely not” get vaccinated.
Let’s remember that certain demographics, like people of color and immigrant communities, have historical reasons for not trusting health officials. This shows up in the Kaiser poll data from earlier this year– only 40% of Black respondents said they would take the vaccine, compared to 61% of Hispanic and 65% of White respondents.
Differences like this indicate that a successful rollout is going to require significant community-based outreach, particularly to leaders who communities trust – these are the people who can help change attitudes and alleviate mistrust.
Responding to people who are offered the vaccine but refuse to take it.
Start by listening – it’s important to understand exactly where the resistance comes from. If someone has doubts about the science or approval process, you can point them to factual resources that address questions about this like the CDC or NIH.
For those with concerns about side effects, the CDC and NIH address these, but for people who are looking for information from outside a government agency, major research hospitals like the Mayo Clinic and Johns Hopkins offer a wealth of information curated by experts.
A source that is specifically tailored to the hesitant person may be a more helpful and effective way to ease concerns. The AARP has articles about side effects tailored for older Americans and many major non-profit organizations offer information focused on people living with specific chronic illnesses – vulnerable groups that have understandably higher concerns about the impact of taking a vaccine.
Some people who are offered the vaccine may experience guilt based on a belief that other people need it more than they do. In this case, it may be helpful to point out that the key to ending this pandemic is for as many people as possible to get vaccinated as quickly as possible, and so by accepting the vaccine, they could very well be protecting someone else they come into contact with, potentially someone more vulnerable than they are.
Being vaccinated also empowers people to do more to help those who are vulnerable—things like picking up needed items, offering transportation, or helping them get registered for their own vaccine appointment.
Tapping into the power of experiences.
Ultimately, convincing people who are vaccine hesitant or resistant can’t be done with data alone. We’ve all heard about the rising death toll, week in and week out for the last year. Over half a million people have died, a number that is devastating but still isn’t “personal.” For many people, moving the needle at all takes knowing or hearing about somebody who has become severely ill or died from infection.
That’s where the power of stories comes in. Public officials need to continue to amplify the stories of people who have had to personally battle this disease or even worse, lost a loved one to it. These experiences can be heart-breaking, but sometimes that’s what it takes to make it “real” for people.
Hearing about the devastating impact a COVID-19 infection has had on another person’s life, in their own words, can be the key to somebody reconsidering their views. If this leads to enough people who are on the fence deciding to take the vaccine, we’re much more likely to reach that 80% figure required for herd immunity.
Vaccines are critical components in this battle but helping to spread trust in their safety and our collective benefit in taking them is what it will take to end the pandemic.