U.S. vaccinations: Starving to death, or refusing to eat?

America’s unusual vaccine challenge

Hi, Ari here — so why won’t more Americans get vaccinated? That’s my new piece below.

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Starving to death, or refusing to eat?

The best way to protect yourself from Covid is also the best way to help end the pandemic across society -- get vaccinated. That’s what the science and medicine shows.

In many poorer and underdeveloped countries, there still aren’t enough vaccines. People are desperately trying to get them, or “cut” in line, to protect themselves before they become the next Covid victim. 

The U.S. has a different problem: 

There are enough vaccines, but not enough people willing to take them. 

That group of people is not monolithic, however. 

Here’s how Dr. Michael Osterholm puts it:

We have the vaccine-hesitant -- the people who are actually really concerned about the safety of the vaccine. 

And then we have the vaccine-hostile -- the ones that believe that, ‘the pandemic is a hoax;’ it's ‘not real,’ ‘these vaccines are meant to hurt them’...

It’s a key distinction, backed up by extensive polling.

The hesitant can change their minds. 

You may have concluded that lingering fears about the vaccine are not backed by evidence, as doctors have stressed. It is still understandable and valid, however, for someone to want safety assurances before trying a relatively new shot.  

In interviews and polling, the hesitant often point to three objections:

• They think the vaccine is unnecessary because they won’t get Covid, or get a ‘bad case’ of it (a personal probability calculation)

• They don’t trust vaccines in general (a longstanding belief)

• They think or heard this particular vaccine was “rushed”
  (a pejorative view of a true thing - the vaccine was the fastest developed in history, with great success)

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There are other related concerns that also arise -- people with skeptical views of the government’s role in medicine may focus on negative information about this vaccine rollout. (That group can be quite ideologically diverse, ranging from “anti-government” libertarians to people familiar with the CDC’s racist record in the Tuskegee experiments).  So, if we listen to people and the data, we see there is diversity among the vaccine hesitant.

As for the vaccine hostile, they tend to be people who were “against vaccines” to begin with, or who are wedded to personal beliefs that trump any “new evidence” about this vaccine, (for example, an overriding political or religious worldview.) 

Comedian Neil Brennan recently talked about trying to reason with people who are convinced the vaccine itself is the “conspiracy”:

The vaccines are safe, they’ve given out 5 billion of them! That’s a lot -- we would’ve heard some bad stuff [if the vaccines were dangerous]. If you think it’s a conspiracy, fine. But a year ago, everybody thought: ‘It’s a conspiracy that China invented the virus.’ So, which conspiracy [do you believe?] Like, I’m gonna ride with China, I’m going to ride with their virus?”... 

I get the lack of trust, but it’s killed 5 million people. The vaccines have killed — from what I can tell — none!”

Comedians can just let it rip. And there may be something cathartic in hearing their blunt delivery.

If you are engaging someone about getting vaccinated, however, much of what passes for vaccine commentary and discussion nowadays is unlikely to move them.

In the news, it’s not a journalist’s job to try to “direct” people’s actions. The job is to get the facts out. If someone’s choice is primarily based on a misunderstanding or lie, of course, then presenting the facts may impact their choice. (Example: Someone heard they ‘can’t vote if they have unpaid parking tickets.’ A journalist fact-checks this as false voter suppression propaganda. The person decides to go vote, knowing they can.) Part of the vaccine debate may follow this framework, if people’s reservations are based on falsehoods.

As for dialogue - people talking to people, apart from the news - there’s lots of evidence about what does and doesn’t work.

Organizational psychologist Adam Grant, an expert on persuasion, recommends “motivational,” open-ended discussions over trying to “lobby” people to get vaccinated:

“..telling people why they should change is less effective than helping them find their own reasons to change.”

He says the data also shows that attacking or stigmatizing people for their choice is counterproductive. That’s striking, since some of the very people who say they want to encourage more vaccination seem to do exactly that. As for what moves someone to go from vaccine hesitant to getting vaccinated, we can learn more about their shift by asking them about it, which we’ve done recently on The Beat.

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What’s next?

Overall, the U.S. is administering almost one million vaccine shots per day. The regrettable surge of Delta, and new partial vaccine mandates, are adding attention and urgency to the push for higher vaccination rates. Education and “persuasion” are just one part of this process, and as “soft” tools and “carrots” fail, governments may increasingly turn to “hard” tools and “sticks” to increase vaccinations.