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Five Ways to Change an Antivaxxer's Hesitancy

Mena Mirhom, MD

Disclosures

August 13, 2021

As our battle with the COVID-19 pandemic rages on, so does the contentious conversation around SARS-CoV-2 vaccines. For many people, the vaccines are the lifesaving answer that can move us and our society forward. To many others, they're seen as an invasive healthcare intervention forced on the masses without any regard for freedom of choice. Such polarizing perspectives can make it seemingly impossible to even have a discussion.

But what do we know from psychological science about approaching this difficult conundrum?

1. Begin with Empathy, Not Evidence

For many in the scientific community, we are accustomed to simply having the right answer and delivering it with precision. However, in some discussions, such as vaccine hesitancy, we have seen that the evidence is not enough in itself to reduce vaccine hesitancy. One of the reasons for this is that evidence without empathy can feel intrusive. No matter how many data charts we have or how many infographics we may use, it falls on deaf ears. If empathy is missing in our evidence, then we are not speaking to people; rather, we are speaking at people.

2. Consider the Context

As we now know, the hesitation that some communities have is rooted in decades or centuries of mistreatment. This may also be more recent for someone with a negative experience in healthcare. If we are to truly and adequately address the hesitation of a community, we must take the time to understand the reason for that hesitation and know the context it comes from. We may not always agree, but we must begin with the humility and curiosity to begin to understand it.

3. Find Common Ground

The healthcare community can acknowledge that the general skepticism found in the public can sometimes be found in healthcare as well. There is a reason that physicians may scrutinize a study that is sponsored by the pharmaceutical industry. There is also a reason that a lecture must provide their financial disclosures before teaching medical information. The missteps of the pharmaceutical industry are well documented to the public. This certainly does not negate the lifesaving advances they have contributed, but it does paint a more complete picture.

The scientific community can meet the general public on the common ground of initial skepticism. We certainly do not accept everything that is presented to us as evidence. But rather, we use a process to carefully review, critique, and evaluate that evidence.

4. Validate the Strengths

In motivational interviewing, a modality that is often used to motivate change, a critical concept is looking for and encouraging the strengths. If someone, for example, was to say that on a scale of 1 to 10, their readiness to change is "only 3", the response would be, "That's great that it isn't 1 or 2." The conversation with the healthcare community and the general public would go very differently if we begin by validating the strength that is displayed. If we begin by saying it is admirable that someone cares about their family and wants to make the healthiest choices possible. If we acknowledge that someone prone to throwing out random Google facts is willing to try to be better informed, then that's progress.

This positive approach makes a person more receptive to receiving information. Once a person feels heard, validated, and understood, they are far more likely to listen.Changing a mind can strategic. In our rush to save lives, we may not realize that if we are not careful, we work against ourselves.

5. Answer Questions Patiently and Respectfully

We have discussed that the vaccine is safe and effective. Yet there are plenty of conspiracy theories suggesting otherwise — theories that some patients will be reluctant to ask their physician about because of embarrassment. These ideas may seem silly to us, but they remain a real fear for someone who is unsure about the mechanism of these vaccines altogether. And some vaccine concerns center around potential side effects.

For this reason, we should ask and even elicit some of the common vaccine myths. By bringing them to light, we do not give them further credence; rather we show the public that we are aware of their fears and that there are real answers to what they are wondering.

When we approach this conversation with empathy, consideration, validation, and respect, we align ourselves with the individual we are speaking to. After all, we are all in this together.

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About Dr. Mena Mirhom
Mena Mirhom, MD, is an assistant professor of psychiatry at Columbia University and teaches writing to public psychiatry fellows. He is a board-certified psychiatrist and a consultant for the National Basketball Players Association, treating NBA players and staff.
Connect with him on Twitter @drmirhom, Instagram (@drmirhom), or at Drmirhom.com

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