What would it take for someone to decide to get the COVID vaccine?

When we are speakers, we may ask: How can I present my argument in a better way? Other times, as seekers, we need to ask what we can do to search, listen, and judge correctly.

A focus group of vaccine-hesitant Trump-Republicans

In mid-March 2021, Frank Luntz and Brian C. Castrucci held a focus group by videoconference with “19 vaccine-hesitant Trump Republicans” from “diverse economic backgrounds.” In the United States, fewer than half of white Republicans have already gotten the vaccine or told pollsters that they definitely will accept the vaccine when it is offered to them, so these “vaccine-hesitant” people are representative of a large demographic within the Republican Party. Luntz and Castrucci wanted to know what “ideas and messages” could possibly persuade these people to be vaccinated.

All participants agreed that the virus was real. To the extent that they were disposed to listen to anyone’s advice about vaccination, they said they’d rather take medical advice than ex-president Trump’s advice. Yet they didn’t understand why scientific predictions and recommendations had changed over time, and they felt that competing or changing information caused them to doubt the importance of vaccines.

Furthermore, they had a number of other beliefs that dampened their interest in vaccines. Some had been previously diagnosed with COVID and believed that they were already immune and did not need to be vaccinated. Others were unafraid of the illness or were more afraid of the vaccine (which they called “experimental,” “rushed” and “unproven”), or felt that there would not be sufficient immediate payoff for taking the vaccine (as social distancing restrictions would likely remain in place for a long time in any case). Another complained of “opportunistic politicians” for whom the vaccine was a tool in a mysterious plot for the “manipulation” and “socialization of society.” One said that lockdowns were a method of political “control.”

The group participants needed information and comprehension

The group members were missing basic information. They needed to hear that the vaccine was developed according to existing technologies; that the trials involved an unusually large sample size; that the Trump administration deliberately lifted regulatory requirements to speed up approval; that the vaccine has never killed anyone; that no one who has been vaccinated has gone on to die of COVID-19, either; that almost all doctors are vaccinated when they have the opportunity. Once they absorbed these facts, they were more open-minded toward the vaccine.

Of course people “do not want to be ridiculed, embarrassed or told that their thinking is ‘Neanderthal,’” as Luntz and Castrucci wrote for the Washington Post. As in any dialogue, the discussion needs to focus on the issue and not the person, and people won’t remain in the discussion unless they are treated gently and kindly.

But also: This group was designed within the boundaries of a political affinity

Luntz and Castrucci said everyone in their focus group was “eager to hear the facts.” They described these facts as “apolitical notions” that swayed the participants’ opinions. However, while the facts may have been apolitical, the group dynamics surely were not. They didn’t point this out in their Washington Post article. I am pointing it out.

The focus group itself was a political affinity group. All 19 participants (the subjects, that is) were Trump-Republicans, and we might expect that they were more open-minded and trusting with each other than they would have been in a more politically diverse group, especially given their beliefs that Democratic politicians seek to manipulate and control Americans through COVID policy. It so happens that the focus group was co-led by former Centers for Disease Control and Prevention director Dr. Tom Frieden, as well as four prominent Republican politicians, two of whom also happen to be physicians. The focus group participants enjoyed a once-in-a-lifetime opportunity to speak directly to these people. I don’t think we can assume that they would have been as receptive to physicians’ messages if the physicians had not so thoroughly embodied the imprimatur of Republican leadership. “If we had that kind of time and space with all vaccine-hesitant Americans, we would surely be able to move the needle,” Luntz and Castrucci wrote. Of course. And obviously it’s not possible. Congressional Republicans, governors, and national medical leaders can’t hold the hands of every American in a two-hour personal conversation to catch them up on a year’s worth of news they’ve been choosing every day not to read or listen to.

In other words, for all that the cultural right mocks the desire for “safe spaces” that reduce the likelihood that one’s identity will be challenged, this focus group was the epitome of a “safe space.” And it was only within such a safe space that the group leaders were able to begin to break through a year’s worth of science denial and epidemiologically bad behavior.

People need to take responsibility for their own information diet

Near end of the Washington Post article, this statement was notable to me: one focus group participant expressed interest in more data, while another just needed to hear a single emotionally affecting story.

The latter is a known phenomenon to storytellers, psychologists, and marketing experts everywhere. People generally do respond better to a story. “A single death is a tragedy; a million deaths is a statistic,” the proverb goes.

As for the former phenomenon, the person who craved more information: There are, of course, always people who say they want the statistics and who might really be equipped to begin to make sense of those large numbers. If they are academically interested, or if their intellect gravitates them more toward the logical than the emotional, that is fine.

But what I can’t quite wrap my head around is that these people were speaking in March 2021 rather than March 2020. Now that nearly 3 million people have died worldwide, a half-million of those close to home in the US, with many more people having been seriously sickened from the same disease, we do have the answers. The emotion is there. The logic is there. The answers have been available, and they have been communicated. We don’t need more data before we can decide. We don’t need more people to tell their tales of woe. The right decision is clear, and the right action should follow as a consequence: We need everyone to wear a mask, socially distance, and get a vaccine.

Of course, data can always be corrected and enhanced, and storytelling can always be improved. This is part of maintaining good communication. But the audience also needs to work on reading and listening.

Often the audience isn’t paying attention. It does not help to wield that observation as a deliberate insult, nor to say it quite so directly to someone’s face, as it will be received as an insult. But it is nonetheless true. Scientists and communication professionals have been talking. An important piece of the question is who is listening. If someone doesn’t make an effort to seek good information, pay attention to what they find, and critically evaluate it, they won’t have the knowledge they claim to want. If someone wants epidemiologically correct information, they need to listen to epidemiologists. If a politician whose primary raison d’être is being a racist troll has taken up a media campaign telling people not to worry about a potentially fatal, highly contagious disease, the public needs to assume that the politician is not speaking in good faith, unfollow them on Twitter, and not vote for them again. If the audience isn’t getting what they want from their television series, they need to try a different one. They can’t just sit and complain and blame their own ignorance on the series’ director. For the first week, yes, it’s the television’s fault; for an entire year, no. They are choosing to watch the confusing material. They need to change their own behavior.

Considering the supply-and-demand of good information in the Information Age, the deficit is surely not in the supply. The supply is high-quantity, and people need to learn to weed out the low-quality material. People need to learn to curate what they’re taking in. If someone has had a poor “information diet” for the past year—whether by overconsumption of bad material festering in a terrible corner of the information ecosystem, or by neglecting to read or listen to anything at all—it is their responsibility to change the channel. Ultimately, no one can do it for them.

There are a number of “how-to” books on critical thinking. They come in different flavors: everything from making sound philosophical arguments, to listening to scientists, to escaping cults. A very recent title is Behind the Scoop: Why You Should Think and Act Like a Journalist by the journalist Johannes Koch. It is accessibly written, a manageable length, and it reminds people that they are empowered to clean up their own information diet. It is also a book that you might plausibly give to someone else since it covers other topics, too, beyond just boosting your critical thinking habits.

I can empathize with someone who is wrong, but they are still wrong

I can muster empathy, to a limited extent, for people who are vaccine-hesitant. The part I can potentially empathize with is their general feeling of alienation from some aspect of the modern world—science, politics, culture—or their anxiety that someone is trying to hurt them. I may disapprove of their reason for feeling alienated or anxious, yet, in a far broader sense, I too am a human who knows what alienation and anxiety are. If they say they’re “scared and outraged,” I hear that and I know roughly what they mean.

However: Even if I manage to empathize with them as people and understand that they are having feelings, that doesn’t mean I can tolerate their error. In this particular case, factually, they are simply wrong. We’re all factually wrong about something now and then. Sometimes it’s a tiny detail that can be glossed over. The COVID vaccine is a particularly grave matter, and it is important that we arrive at a general agreement on the indispensability of this virus-fighting tool and that we perform the necessary act of solidarity; otherwise, we will never reach herd immunity from the COVID disease.

I don’t need to actively, directly, personally insult individuals who are vaccine-hesitant. At the same time, when someone holds a dangerously false belief, it’s necessary to be blunt (either with them or about them). They need to begin listening to the general agreement of the scientific and medical community. There is just no way around that outcome. Unfortunately, not everyone has an invitation to a focus group in which they get to have a two-hour personal conversation with the former director of the U.S. CDC, so they need to find another pathway through roughly the same information that will lead them to the same conclusion.

If I were to make (in this context, anyway) too many suggestions about how to think critically, it would sound patronizing. Anyway, I’m neither a scientist nor a science communicator. I’m sure I don’t need to explain how to make a choice about a vaccine. People know how make good decisions about the health of themselves and others. They just need to do it. Critical thinking is a choice about who to trust, what to care about, and when to put the time in. Now is a good time.

[Image of COVID vaccine by Reckmann Tim from Pixabay]

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