Vaccine Voices: How to Talk to a Vaccine Skeptic

Vaccine Voices, a project of the AAMC and the CDC, is working to promote confidence in COVID-19 vaccines in communities and among health care personnel. They offer the following tips on how to talk to a vaccine skeptic. The full article can be found online

Start by listening.

Resist piling on the facts. “Patients don’t want to be lectured or marketed to,” says Miller. “They don’t want to feel like it’s a campaign.”

Find out what they are concerned about instead. “What are the reasons that they’re voicing?” says Frieden. “Then try to empathize with those reasons and validate what they’re feeling.”

“Don’t lead with, ‘Here, I’m going to tell you all the reasons why you should get vaccinated,’ but begin with, ‘What’s going on? Tell me about where you are with this?’” suggests Buttenheim.

Customize the conversation.

“At this point people are getting information overload,” says M.A. “Tonette” Krousel-Wood, MD, MSPH, president of the American College of Preventive Medicine, which has launched a Vaccine Confidence campaign. “So you want to give them the information that’s most important for them to know as individuals.”

If someone is worried about side effects like blood clots or myocarditis, for example, address those concerns. Likewise, if they are in the “wait-and-see” phase, Buttenheim says, ask them what they are waiting for. “If they’re waiting to see if it’s safe, remind them that we now have hundreds of millions of doses in arms,” she says.

Focus on where you can make a difference.

Not everyone is receptive to discussing COVID vaccines. So, focus your efforts where it counts.

“What we have found is that there is a small proportion of people, 1% to 10%, who are really dug in and arguing with them just makes them dig in deeper,” says Frieden. “So we look at the ‘moveable middle’ (between those already vaccinated and those who won’t vaccinate) and focus on that group for what we need to do.”

Don’t lead with fear.

While it’s important to acknowledge and validate the fear that people are experiencing, try not to promote it, says Wen-Ying Sylvia Chou, PhD, MPH, program director in the Health Communication and Informatics Research Branch of the National Cancer Institute, who has researched social media misinformation.

“Research shows that fear makes you vulnerable to misinformation,” Chou says. “Anti-vaccine messages have been successful because a lot of them are fear-based appeals.”

A more optimistic approach may get you further. “We suggest promoting positive emotions, with messages of hope, togetherness, love and connection, and the prospect of resuming social activities,” Chou says.

Personalize persuasion.

Certain kinds of messaging seem to be particularly effective at getting shots into arms, experts say. One is personalizing your own vaccination experience.

“You can say, ‘I was hesitant too, and I changed my mind, and here’s what made me change my mind,’” suggests Buttenheim. “This can be powerful coming from a health care provider. You bring the person along in your own decision process.”

For months, Darcy Vierow, 44, founder of a travel planning website, had qualms about getting vaccinated. She finally asked her doctor about it.

“She shared with me that she and all her family had gotten the vaccine and had no issues with bad side effects, and she was confident that I would also tolerate the vaccine well,” says Vierow, who lives in Greenville, SC. “I made an appointment immediately.”

Emphasize the safety over effectiveness.

“There are a lot of people who believe that vaccines work in preventing COVID, but that they’re not safe,” says Miller. “One of the things that seems to work well is comparing the unknown risks of the vaccine with the known long-term effects of COVID.” After all, even young people who are otherwise healthy may experience long-term COVID effects.

In fact, a new study from Resolve to Save Lives suggests that educating people about long COVID may be effective at getting people to roll up their sleeves. After learning about long COVID symptoms like fatigue, brain fog, and gastrointestinal problems, 32% of unvaccinated people said they were more likely to consider getting the shot. (That number rose to 39% when people were shown video testimonials from long haulers.)

“If a doctor were to say, ‘You know, my patient who I saw this morning is still suffering with brain fog, headaches, and shortness of breath four months after COVID,’ that might convince the reluctant patient to get vaccinated,” says Frieden.

It worked for Stacy Harris, a music industry publicist in Nashville, who was concerned that drug makers had cut corners to develop COVID vaccines so quickly. Ultimately, she decided that getting vaccinated was preferable to the chilling prospect of becoming a long hauler.

Rinse and Repeat

Keep in mind that it may take several no’s to get to yes. Trying again or multiple times can eventually lead to success.

“You may not get to a place where the person is ready to make a decision at the end of one conversation,” says Buttenheim. “Be open to circling back in another visit. I’ve seen many people change their minds over time.”