Multiple COVID-19 vaccines are available, but some people are on the fence about getting their shot. Approaching a conversation with vaccine-hesitant friends and family may be challenging.
Three scientists and public health experts spoke to more than 250 members during a Fearless Science Seminar Series on March 31, 2021, hosted by the Morgridge Institute.
The panel featured Dominique Brossard, professor and chair of Life Sciences Communication at UW–Madison; Tess Ellens, a registered nurse and the Immunization Coordinator with Public Health Madison & Dane County; and Ajay Sethi, associate professor of Population Health Sciences at UW–Madison. Gabriella Gerhardt from the Morgridge Institute moderated the session.
The following is an abridged transcript of selected questions. A recording of the webinar can be viewed in full above.
Gabriella Gerhardt: Please note, none of the panelists are medical doctors, and you should always consult your doctor for specific recommendations related to your health and medical decisions.
What is vaccine hesitancy, and in a general sense, why are certain individuals concerned about getting this vaccine?
Ajay Sethi: Vaccine hesitancy is a sort of reluctance to accept a vaccination despite it being available.
When you have hesitancy, it can cause people to essentially delay getting vaccinated. The reasons are going to be pretty wide-ranging. Sometimes they’re associated with not having full confidence in a given vaccine, or maybe just having some complacency about it. Sometimes it’s unrelated to attitudes. It might also be related to logistics—it may not be convenient to get vaccinated.
And are the concerns about the COVID-19 vaccine in particular different than concerns in general? Like what’s different about this particular vaccine?
Ajay: There is some overlap, certainly. If somebody had a tendency for hesitancy towards vaccination before COVID, they may continue that attitude now.
But during the pandemic—where there’s been a year of a lot of uncertainty, a lot of stress, and anxiety—it has an ability to potentially impair our judgment and decision-making. Some people feel the vaccines came about rather quickly, and that also gives them some reluctance toward vaccinations. We’re in a little bit of uncharted territory. We’ve never been in this situation before and never had a vaccine developed rather quickly.
If you’re approaching a conversation about the vaccine, what are the first steps you would take?
Dominique Brossard: Asking people, “Have you been vaccinated?” is actually a kind of private question. Why do I have the right to ask a person if they’ve done something that is not my business, right?
You could start talking about COVID-19 and hoping that the family hasn’t been impacted. And if the family has been impacted, empathize with the problems. The conversation can potentially naturally turn to a vaccination.
I think anything that may be potentially unclear in people’s minds needs to be approached with tact, respect, and empathy. And certainly with no judgment.
Gabriella: Tess, you have a lot of these conversations.
Could you share a little bit about what it’s like to constantly have those conversations about vaccination?
- National Academies of Sciences: Communication Strategies for Promoting COVID-19 Vaccine Acceptance
- Johns Hopkins Medicine: FAQs on COVID-19 vaccines
- Mayo Clinic: COVID Vaccine Myths
- Public Health Madison & Dane County: COVID-19 Vaccine Factsheet
- Public Health Madison & Dane County: COVID-19 Vaccine FAQs
- The National Academies Press: Strategies for Building Confidence in the COVID-19 Vaccines
- FDA: COVID-19 Vaccines
- Wisconsin Department of Health
Tess Ellens: I always consider my job as never convincing because that gets right into that “I need to win this person over” mindset. And that’s not my job.
These are all very personal decisions. I really try and go in with, “Tell me more. Tell me more about your experiences. Tell me more about your perspective.” It is always really enlightening to hear what people have to say.
And again, I’m just one person, and I come from a privileged background, and it’s really easy for me to be connected to science and data and good information.
But not everybody has those privileges. I try really hard to be listening. I give people the information to make an informed decision themselves. And I direct them to the right place and getting them connected. Some people leave without receiving a vaccine. That’s ok. Because that’s information they can think about and talk with others in their life about — and hopefully make a decision that’s right for them, and their family and loved ones.
Gabriella: Ajay, do you have something to say about approaching these conversations?
Ajay: We should not always put ourselves in a position where we’re approaching somebody else about encouraging vaccination. People have autonomy; they deserve their autonomy.
And you should ask yourself before approaching someone, “Why are you initiating that conversation? Do you have a trustful relationship with that person?”
I don’t want to put myself in a situation where a conversation might escalate. I think there’s a pre-conversation checklist. It’s not a bad idea to make sure your emotions are in check. Ask yourself, “Why are you approaching this person?” If you have the right conditions, you can share a conversation and understanding of each other.
What are the things that you should be keeping in mind as you navigate vaccine conversations?
Ajay: The first thing is to put on your listening hat and do a lot more listening than talking. If you really want to understand what is causing a reluctance, you’ve got to listen.
And if you’re not sure what somebody is saying, ask more questions. And along the way, you can validate somebody’s frustrations—just acknowledging that can build trust. That’s really important. We want to advance the conversation so that maybe you can talk again at another point in time and continue to advance that encouragement.
Gabriella: It’s kind of meeting people where they are?
Ajay: Yes. Think of it as, how would you want somebody to talk to you if you were in that position? Would you want it to feel like you’re buying a car and feeling pressure to sign the dotted line? Probably not.
I think we can put ourselves in the other person’s shoes if we replace the context of vaccine decision-making with things like car purchase, or buying a house, or other things in our lives that sometimes we don’t want to feel pressure about.
Dominique: Something that we should highlight is that the vast majority of Americans want to get vaccinated. We have 36 percent of Americans who already had one shot.
As far as those who do not want to get vaccinated, I think that group is interesting for us to think about. They say they want to wait. This is a human way to deal with new things that are unexpected. So they’re waiting to see their neighbors, their family, and so on.
Rule number one is knowing where people are coming from. And, most importantly, avoid repeating false claims. Because we’ve seen things such as “no side effect for the vaccine.” Well, that’s not true. There is a slight number of side effects. Let’s recognize the fact; let’s be truthful about the fact. And also, let’s recognize uncertainty.
Are there particular concepts that people can learn more about to use in their conversations about vaccines?
Ajay: In my class, we rely on principles of motivational interviewing and crisis counseling in which listening and validation are real tenets. Mindfulness is also important to think about. Really it does come down to just having respect and listening.
Dominique: What we need to keep in mind is that Americans at large want to actually have the right information in hand. They want to actually have the correct fact or the correct statement.
I think when we talk to people, we need to also think about the “hat” we have on. Is it an uncle that we always fight about with at the Thanksgiving table? That may not be worth it.
Tess: Everybody just wants to be safe and healthy. That’s a common seed that we can all share.
When I’m chatting with people, I always try to find the middle ground that we can always find. “I’m here vaccinating you today because I’m trying to keep you safe and healthy. I know that that’s what you want as well.”
I think that’s a really important piece to keep in mind as well when we’re chatting with people. Yeah
Gabriella: Tess, in your day-to-day, you answer a lot of questions.
If people have specific concerns, are there resources that they can reach out to?
Tess: Definitely. There’s a ton of resources, and it’s kind of hard to wade through all of the different websites and pieces of information. We use the Public Health Madison & Dane County website, but there is also the CDC and the Mayo Clinic.
Even when people come through the Alliant Energy Center to get their vaccine, they already have scheduled an appointment, and they still have questions. So we’re happy to chat through those questions because we want to make sure that people are feeling comfortable and fully onboard.
I always say that every vaccine is a big decision to be made for protecting your health and the health of others.
I was hoping we could go through and talk about what brings you hope for the future.
Ajay: The fact that the vast majority of Americans want to get vaccinated gives me a lot of hope. As more people get vaccinated, I have a feeling that number is going to continue to climb.
Tess: Something that really gives me hope is looking at our data. Every day I go home, and I think, “How many doses did we put in arms today?” That’s something that really, really keeps me going. We’re getting to a point where we’re starting to see the scales tip a little bit, which is giving me hope.
And having more conversations is giving me hope. Something that I really try to use in my practice is a quote that says, “Nothing about us, without us, is for us.”
Dominique: I will second everything Ajay and Tess have said. But I also feel like people are coming together. We’re beginning to see the light out of the tunnel, and we can do this all together. And that gives me a lot of hope.