Rupali Limaye talks with people about vaccines every chance she gets. The Johns Hopkins University behavior and public health researcher has brought up vaccination so often among family, friends, and neighbors that now, people bring their concerns to her directly. Recently, an acquaintance approached her at the community pool. “I was there with both of my kids and someone that we know from my daughter’s soccer team, she came over, and she said, ‘hey, do you mind talking to a friend of mine, because she’s not sure whether her son should get the shot’.”
Limaye agreed to chat with the friend-of-a-friend poolside. She listened and answered questions about side effects and long term consequences. “I just sat down and had a conversation with her.”
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Why is it important to talk about the vaccine?
The US is currently experiencing another wave of rising COVID-19 cases, hospitalizations, and deaths. Vaccines save lives—reducing hospital overcrowding, minimizing severe disease and death, and reducing transmission. But vaccination numbers in the US have waned since their winter peak and, amid the spread of the super contagious Delta variant, many Americans remain hesitant to get vaccinated.
More than 192 million people in the US, and more than 70 percent of adults, have received at least one dose. And all three coronavirus vaccines currently available have been demonstrated to be safe and effective, yet not everyone is joining in. Even though barriers to access and healthcare disparities play a big role in stalling vax rates, polls suggest that, if the opportunity for vaccination was available to everyone, many still wouldn’t take it.
Individuals’ medical decision making is influenced by many factors, says Limaye, and during the pandemic, political views and the media sources people turn to are having an outsized impact on whether or not they get their shot. There is lots of misinformation out there, she adds, and the anxieties, fears, or reservations people have about the COVID vaccine don’t come out of nowhere. But conversations with loved ones can still do a lot to sway behavior, says Rachael Piltch-Loeb, a public health emergency preparedness and risk communication researcher at New York University and a fellow in emergency preparedness at the Harvard T.H. Chan School of Public Health. “Family and friends can be incredibly influential in health decision making and in vaccine decision making,” she says. “Family and friends are trusted sources of information. They’re the people we talked to most frequently. And, they’re the people that we, consciously or subconsciously, also model our behavior off of.”
If there are friends or family in your life resistant to getting vaccinated, a conversation with a loved one may be the most likely thing to change their mind. “I think, far and away, hearing from people who are closer to us or our own personal network is more effective than a mass media campaign,” says Piltch-Loeb. The closer a person is to you, the higher you tend to value information they share, she adds.
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What are the best strategies when talking about vaccine hesitancy?
So, how do you have a productive conversation about getting vaccinated? Asking questions is key—as is listening to the other person’s concerns with empathy. “We all need to recognize that people who are vaccine hesitant are not dumb. They’re not stupid or naïve,” says Piltch-Loeb, emphasizing that shared humanity should be the basis of all of these conversations. She explains that the vaccine hesitant have often gone through their own information seeking process and have concerns that are very real to them. “There needs to be a recognition of like, ‘oh, I see where you’re coming from’, or ‘I see how you may have picked up on that.’”
And it’s important to understand the root of someone’s hesitancy before trying to respond to it, says Emma Frances Bloomfield—a communications researcher at the University of Nevada, Las Vegas who studies the best strategies for combating science skepticism. Questions are critical to developing that understanding. “It’s one of those strategies of ‘well, where is the problem?’ And then once you’ve located the problem, you can try to address some of those concerns,” she says. There are different reasons a person may be wary of the coronavirus vaccine, and it doesn’t help to provide information that’s not specific to their worries. Asking questions like, ‘why did you make that choice’ or ‘where did you hear that information’, helps to clarify the direction you should take the conversation in next.
Listening and expressing empathy also plays a big role in building trust—a key component of successful communication, says Limaye. Listening doesn’t just mean responding to every concern with a ‘that’s wrong’ or contrasting fact, it means validating that we’re in a scary situation, and it can be difficult to know what to believe, she says.
Once trust is established, and you have a clear idea of the root cause of someone’s anxiety, then you can begin to share what you know about the benefits of vaccination. This could be data from a trusted source, like the CDC or local health department, a personal story about why you chose vaccination, or a combination of numbers and narrative, says Limaye. Not everyone connects readily with facts and figures, says Bloomfield, so including the emotional appeal and personal experience is important. “It’s a mistake to over-rely on the science,” she adds. Explaining that, although the data is valuable, “concretizing COVID, and putting specific stories or faces to people can be really helpful.” For example, referencing mutually known people who’ve gotten sick, been hospitalized, or are immunocompromised can help reframe someone’s risk assessment.
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It can also help to share your own motivations and thought process. “It’s really important to highlight that maybe you also went through a decision making process and you automatically didn’t just say, ‘yes, I’m going to get the vaccine’,” says Limaye. This offers a way for your vaccine hesitant loved one to relate to you, and understand that there are valid reasons someone might make a different choice from them.
Further, all of the experts agreed, your tone is important. Condescension, dismissiveness, and anger can completely shut down a conversation, and put people on the defensive, says Bloomfield. You should also know when to stop a conversation if it isn’t panning out. “If it is starting to get heated and you feel as though the person is getting defensive, maybe then that’s not the best conversation to have,” adds Limaye.
Finally, if someone you spoke with does decide to get the vaccine, Limaye suggests helping them come up with a plan, and doing everything you can to assist in removing access barriers. For example, helping an older family member access an online appointment, or driving someone to a vaccination center.
And patience is key. Not everyone will be swayed in a single conversation. It took some of Piltch-Loeb’s family members weeks of conversations with her to eventually decide to get the vaccine.. “I think that these are hard conversations to have,” she says, but they are important nonetheless. “If you can have a conversation with someone who is vaccine hesitant, even if the conversation itself doesn’t change their mind, you’ve now started that seed,” says Bloomfield. Which could lead to that person doing further research, or being open to future conversations.
Perhaps you’ll get a result like Limaye, who’s interaction with a stranger at a pool led to one more person protected against COVID’s most serious consequences. Through empathy and exchanging questions and information, she was able to allay the mother’s fears about vaccinating her teenage son. “After that, [the mother] was like, ‘I feel much more comfortable. I just haven’t been able to talk to someone that I feel like is listening to me’.
