How do we get to yes?
Which is to say: How can public health experts and policymakers convince the persistently recalcitrant fraction of people who haven’t gotten vaccinated against Covid-19? It’s the key to ending the pandemic, and a brutal irony in the United States, one of the few countries with the money and wherewithal to have enough of the drug for every citizen. Yet still, something like 25 percent of US adults and teens haven’t done it. Or maybe more relevantly, between 15 and 30 percent of US residents tell pollsters and researchers that they will never get one—nope, nuh-uh, no way.
More than 700,000 Americans and more than 5 million people around the world have died from the disease. Vaccines against it reduce illness, deaths, and transmission. It’d be very good to get unvaccinated people to become vaccinated people.
One theory says: If someone could just find the exact combination of words, that might bring people around. Another idea is that vaccination should be mandatory. Carrots versus sticks, nudges versus shoves.
The literature on finding those perfect conceptual frames is a years-old canon. (Oh, you like hesitating about vaccines? Check out this T-shirt from resisting the human papillomavirus vaccine mandate.) But Covid is new, and the pandemic has been fast-moving and protean; that has made it frustratingly hard to assemble a coherent, effective public health campaign in the US, where resistance to vaccination (and other measures, like masks) has taken many forms.
New data from the polling company Civis made public this week has some insights here. Researchers there asked more than 5,000 unvaccinated people to look at eight different ways of talking about vaccination—“messages,” in the parlance of political communication—and then asked them if, after hearing those messages, they were more or less likely to go do the thing. People got randomized into groups that heard different approaches to talking about vaccines, and there was a control group of people who didn’t see any of the messages being tested. The messages were stuff like “It protects kids” and “You’ll be able to do things that require proof of vaccination,” all the way through “Vaccines are very safe” and even the deathbed words of someone who didn’t get vaccinated and got the disease.
The answer? It was complicated. Protecting kids made people about 6 percent more likely to say they now planned to get vaccinated. The safety and deathbed messages actually caused a guilt-induced backlash—people said they were less likely than they were before the test. Each message had varying effects depending on the recipients’ demographic backgrounds and political affiliations—a patriotic, do-it-for-America message worked only on Latinx respondents, but a message of personal decisionmaking only moved conservatives. (The biggest caveat, of course, is that people only reported their intention to get vaccinated. The study didn’t count actual needles in shoulders.)
That’s all in keeping with previous research. In a study of vaccine hesitancy in the United Kingdom in late 2020—before Covid vaccines were available—researchers at Oxford University asked 5,114 people how willing they’d be to get vaccinated, and why or why not. Of the ones who said they wouldn’t, the most common reason was that they didn’t believe in its “collective importance.” They either didn’t think there was a dangerous pandemic going on (belief in conspiracy theories correlates with vaccine resistance) or they didn’t care that a vaccine would help other people.