By the end of May, the Centers for Disease Control reported that more than half of Americans 18 and older were fully vaccinated against COVID, and 62 percent had gotten at least one vaccine dose. As the number of newly vaccinated people dwindles, however, public health experts are homing in on the holdouts. Chances are good that you personally know at least one of them. It could be a cousin preoccupied with “big pharma” on Facebook, or a single parent friend working two jobs who doesn’t have time to get the shot or deal with vaccine side effects. It could be your kid’s best friend’s dad who thinks the vaccine was developed too quickly and therefore has concerns about its safety.
If you’re vaccinated and wondering whether you should butt in and try to persuade others to get vaccinated, too, you’re not alone. Experts are debating whether vaccinated citizens might be effective foot soldiers to promote vaccination against COVID-19. But not everyone agrees on what, if any, role they should have in encouraging friends and family to get the shot, too.
“I don’t know if we want to ‘deputize’ the public to be policing those things,” says New York psychologist Shane Owens, Ph.D. “The ‘we’re all in this together’ phrase kind of inspired us all to be Karens, very finger-waggy and judgmental. I think an important thing the public needs to hear is that you might not be able to change others’ behavior.”
That’s partly because research is revealing the complexity behind people’s reasons for not getting the COVID vaccine, so there’s no one-size-fits-all vaccine-promoting approach. And although many people are staunchly pro-vaccine or anti-vaccine, there’s a significant number of Americans who fall somewhere in the middle. Citing a recent survey, the authors of an article in the New England Journal of Medicine wrote that there’s “a spectrum of vaccine ‘hesitance,’ ranging from being ‘vaccine ready’ to ‘vaccine neutral’ to “vaccine resistant.’” A person who is “vaccine ready,” for example, might not be willing to make an appointment at a large vaccination site but would likely accept being vaccinated if it required minimal effort, such as if it were offered at their doctor’s office, they wrote.
So, the short answer to “Should I talk to vaccine-hesitant friends and family about their decision?” then, is “maybe.”
Trying to persuade someone distrustful of all vaccines, and maybe distrustful of doctors and the government too, is likely a waste of time, Owens says. But you might have a shot with the people in the middle — those saying things like, “I’ll wait and see what happens to the ‘guinea pigs’ first” or “I don’t get a flu shot, so why should I get the COVID vaccine?”
It’s much easier to persuade someone who’s ambivalent about something rather than against it. A useful tool in overcoming ambivalence is something called “motivational interviewing,” Owens says. It’s a technique often used in substance misuse therapy that can be effective in overcoming vaccine ambivalence, too.
“It’s complicated, but the general idea is that any time a person makes a change, there are stages,” Owens says. “Motivational interviewing is assessing where people are in their stages of change.”
Laypeople can use some of the tactics of motivational interviewing to encourage the vaccine hesitant in their lives to get vaccinated, says Christienne P. Alexander, M.D., associate professor at Florida State University College of Medicine.
“I’m not saying people should debate [vaccines], but engaging openly is completely fine no matter who you are,” Alexander says.
Here’s some advice for taking on the challenge.
1. Meet Vaccine Hesitant People Where They Are
If you don’t think you can talk about the COVID vaccine without getting frustrated or dismissive with people who haven’t gotten one, it might be best not to bring it up at all.
“People are concerned and worried and they have a right to be,” says Emma Frances Bloomfield, Ph.D., an assistant professor at the University of Nevada, Las Vegas, who studies communication strategies to address science skepticism. “It is challenging for people who have been following guidelines to see people who aren’t and think they’re preventing us from getting back to normal. But if you really want to be productive, it’s probably best to leave that kind of judgment out of the conversation.”
For example: Something that comes up often among Alexander’s patients is concern about the vaccines’ side effects, she says. When they express fears about them, she says, “Tell me more about that.”
“Responding that the vaccine is not a big deal and the side effects are not that bad isn’t meeting that person where she is,” she says.
2. Bring it Up at the Right Time
If you suspect someone in your life is hesitant about the COVID vaccine, one option is to simply ask them if they want to talk about it. You can say, “Hey, not sure where you are in your decision-making about the vaccine, but let me know if you want to chat about it,” Bloomfield suggests.
Another opportunity for vaccine discussion is social events, Bloomfield says. If your child is invited to a friend’s house, it’s perfectly acceptable to ask if the family has been vaccinated, Owens says. Or if you’re hosting an event, you can set ground rules such as, for example, that people who haven’t been vaccinated should wear masks.
“If someone [texts], ‘Okay, I’m not coming to your party because we’re required to wear masks,’ maybe pick up the phone and talk about it and try and understand where they’re coming from,” Owens says.
If you discover a loved one or acquaintance is willing to talk about vaccines with you, make sure it’s a comfortable environment for everyone, Bloomfield says. Does the person prefer to talk on the phone, or video chat or in person? Do they want to chat and catch up first before talking about something difficult? Consider what you know about the person, find common ground and start there, she says.
“It could be as simple as starting with, ‘I loved our last picnic on the 4th of July and would love to have it again,’” she says.
3. Ask Questions
People’s motivations and questions about vaccines can be very different, but there are common threads that are helpful when having a conversation about them, says Chris Wyant, executive director of Made to Save, a nonprofit promoting vaccination. Make it personal, talk about your experience, such as any side effects you had and what they were like, he suggests. Instead of telling them why you want them to get it, ask what questions they might have, and avoid judging their decision.
Asking questions is a positive way to engage people because it encourages them to think for themselves and possibly answer their own questions, Bloomfield says. If someone says they want to wait to see how the vaccine affects people who have gotten it, for example, maybe ask, “When would it be safe?” or “How many would have to get it before you decide it’s safe for you and your family?”
It could be a way to engage someone to come to terms with what the real obstacle is for them, she says.
4. Listen to and Acknowledge Their Specific Concerns
One reason laypeople can be effective vaccine messengers is because you don’t have to be a scientist to acknowledge someone’s concerns. And doing so can be powerful, Alexander says.
“Just saying, ‘I hear you, it’s hard to know what to believe,’ helps a person feel heard,” Alexander says. “We’ve become so polarized that we’re often not hearing each other. So saying, ‘I hear you, tell me more about what your concerns are,’ might not change someone’s mind, but it’s a start.”
In addition to fears about side effects, the idea that people who get the vaccine are all guinea pigs is pervasive, Bloomfield says.
“No one wants something untested, but this idea that this vaccine is experimental is just not true,” she says.
Although most laypeople don’t have a great understanding of how vaccines are developed and approved, vaccine-hesitant people are likely to have done some research about them, so it’s important to reinforce that, Owens adds.
“Say, ‘You’ve clearly read a lot about this and that’s great,’ and engage them in a conversation about the sources of that information,” he suggests. “Ultimately, we make decisions based on what is right in front of us.”
5. Keep It Positive
Fear is a lousy motivator. “It tells us what not to do and doesn’t give us an idea of what to do,” says Owens. “It shrinks our life and fences us in.”
If instead you focus on your ability to live a healthier, happier, mask-free life if more people are vaccinated, the case is easier to make, he adds. Also important: If you care about preserving your relationship with the person, abort if the conversation takes a sour turn, Bloomfield says.
“A good strategy is to reiterate your common ground,” she says. “Share your own story and why you made those decisions. Ask if you can trade news articles and links, so their concerns are heard and you’ve shared resources to get them out of that echo chamber.”
6. Suggest They Talk to Someone Else They Trust
The messenger is as important as the message, Owens says. If friends and family are genuinely concerned and have questions about the COVID vaccine, have a variety of reliable sources ready to share. Also consider suggesting “bridges” your friend can also talk to, Bloomfield says: maybe a friend or family member who’s more conservative than you whom they might regard as less biased.
It’s perfectly fine to say something like, “Don’t take it from me, talk to your own doctor about it,” Alexander says. Pastors and celebrities whose opinions matter to people might be good referrals as well, or suggest they check out the Twitter page (Dr. Kizzy) of well-known immunologist and coronavirus vaccine researcher Kizzmekia Corbett, Ph.D., Alexander says.
Don’t be discouraged if you don’t immediately change hearts and minds. It’s typically not a one and done conversation, even for health care providers, Alexander notes.
But you can boost your chance for success if, before bringing it up to someone, you think about what gets you to change your own behavior, Owens says. Think about a time when someone persuaded you to do something: What characteristics did that person have, and how did you arrive at the conclusion you did? Then apply that to everyone you’re trying to influence.
“Taking that perspective is important, because you’re likely hanging out with people who learn things the same way you do,” Owens says. “If you know telling people to quit smoking won’t work [for example], then just telling people to get vaccinated is likely not going to work either.”
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