If you're one of the millions of Americans who've already been fully vaccinated, it may be hard to believe that anyone would skip an opportunity to get the COVID-19 vaccine. The shots have been deemed safe and effective by the Centers for Disease Control and Prevention (CDC), yet the prospect of getting them still makes some people nervous. Many also fear that the shots aren't tough enough to face "breakthrough" cases of the coronavirus (and its variants).
In March 2022, CDC data revealed that about 30.5 percent of eligible Americans were not fully vaccinated (with about 18 percent never having had a single shot). Booster uptake was even worse, with half of those eligible skipping it. According to the U.S. Census Bureau, the unvaccinated were most likely to cite worries about side effects and lack of trust in the vaccine and government as reasons to pass.
With the country itself divided, it's no wonder that so many families are having disagreements about the COVID-19 vaccine. Maybe your parents are unnerved by things that they've heard, or your brother doesn't believe he really needs it. (Cue prickly debates around the dinner table.) But the thing is, vaccination remains the top option we've got to fight the coronavirus, in whatever form it takes.
"It's our best way out," says Namandjé N. Bumpus, Ph.D., director of the department of pharmacology and molecular sciences at Johns Hopkins University. To put it in simple terms, the vaccine can prevent people from getting sick or seriously ill with COVID-19 and associated viral strains.
Here are six common concerns about COVID-19 vaccines and what to say to loved ones who are reluctant to get vaccinated.
Illustration: Caitlin-Marie Miner Ong
They say: "I'm not getting it because it's not been tested enough."
You say: It's passed all the same tests that other vaccines we take go through.
The vaccine rollout was fast, compared to what we usually see with new medications, but all of the shots out now have been rigorously tested. "They've gone through all of the same phases of clinical studies that drugs we take all the time went through," says Dr. Bumpus. "Not one corner was cut."
SARS-CoV-2 (the coronavirus that causes COVID-19) may be new to all of us, but researchers have been studying SARS and MERS coronaviruses for years. They've also spent decades working with the mRNA technology used in vaccines, and they understand well how it can prompt an immune response to help to shield us from infection. "It seems quick, but it's really just a lot of knowledge coming together around a very important problem," Dr. Bumpus emphasizes.
They say: "I'm not getting it because I may want another child."
You say: All signs point to it being safe, but talk to your doctor if you're worried.
Dr. Bumpus recommends people talk to their health care providers, but all signs point to the vaccines being safe for people who are pregnant, breastfeeding, or planning to become pregnant. Indeed, organizations like the CDC, the American College of Obstetricians and Gynecologists (ACOG), and the American Academy of Pediatrics (AAP) support vaccination in these circumstances. And there's no scientific reason to think that mRNA technology impacts fertility.
They say: "I'm not getting it because I don't want to be injected with a microchip."
You say: That's a conspiracy theory and there's no truth to it.
Dr. Bumpus has studied HIV for two decades, so she's familiar with virus-related conspiracy theories. "People have them and they're hard to refute," she acknowledges. But in the case of the COVID-19 vaccine, there is, indeed, no microchip involved. When the conversation shifts that way, Dr. Bumpus refocuses it on the humans behind the vaccine. "We need to look at the actual people who are doing the work," she says. "It's really scientists and physicians who have dedicated their lives and careers to understanding, treating, and preventing disease. This is really the life work of these people."
They say: "I'm not getting it because vaccines have made me sick in the past."
You say: What you felt was your vaccine working, not you getting sick.
When people feel achy or feverish after a vaccine, it doesn't mean they're sick from the shot. It means the vaccine is working, and their body is mounting an immune response, says Dr. Bumpus. Common side effects of the COVID-19 vaccine include pain, redness, and swelling around the injection site; some people also experience fever, chills, fatigue, headache, and other symptoms. The effects are mild-to-moderate, and tend to go away within 1 to 3 days.
"It's something we would often expect from a vaccine," Dr. Bumpus explains. "You're not getting sick with COVID."
It's true that the COVID vaccines have been linked to serious side effects in rare occasions. For example, Pfizer and Moderna have been associated with myocarditis (inflammation of the heart)—usually in young males after the second dose. Johnson & Johnson has been linked to a slightly increased risk of blood clots and Guillain-Barré syndrome. All of these serious side effects are very rare, however, and experts say the benefits of vaccination outweigh the risks. (But note that in most cases, the CDC now recommends Pfizer or Moderna instead of Johnson & Johnson because of the small risk of adverse effects.)
They say: "I'm not getting it because I have allergies, and I'm worried about an allergic reaction."
You say: Check with your doctor if your allergies are a concern.
The CDC helpfully lists the ingredients found in each COVID-19 vaccine, none of which contain eggs, preservatives, latex, or metals. It advises users to avoid vaccines with allergens that affect them; most individuals will know if they're allergic to those substances because they've reacted to medications before, says Dr. Bumpus. People should consult their doctors if they have previously had an immediate allergic reaction to a vaccine or injectable therapy, but those who have had severe reactions only to "food, pet, venom, environmental, or latex allergies" can still get vaccinated. As a safety measure, everyone must wait at least 15 minutes after they get vaccinated to make sure they're doing well.
They say: "I'm not getting it because I don't think the vaccines are very effective."
You say: All of the vaccines work—you just have to find the one that is right for you.
Vaccines come with a confusing collection of numbers about their efficacy. Some appear better than others. But we shouldn't compare those numbers side by side, says Dr. Bumpus. The trials were done on different people and at different times and locations where new variants of the virus may have emerged. "What we need to take away is that they work, and that's amazing," she says.
Breakthrough cases of COVID-19 do happen, even to people who are fully vaxxed and boosted and think they've done everything right. There's no vaccine that's 100 percent effective in every situation. The good news is that getting vaccinated keeps the coronavirus and its variants from getting stronger, and cuts down on the likelihood that you'll suffer the worst symptoms.
Tips for Seeking Common Ground
Vaccine refusal is hardly new, and it's something families have grappled with before. Keith Holyoak, Ph.D., a professor of psychology at UCLA, has studied parents who are skeptical about vaccines. He recommends finding common ground with those who tend to be critical of the shots.
"One approach is saying, roughly, 'Can you imagine anything that might convince you that it would be good to have the vaccine?'" he says. If someone can come up with situations in which they would allow themselves to be vaccinated, they might eventually be persuaded to do it.
Be compassionate as you have these conversations with family members, urges Diane Gottsman, a national etiquette expert and founder of The Protocol School of Texas. Don't start the conversation angry and go on to challenge Grandma or Uncle Bob at every turn. Dial down your reactivity and don't make threats. Remember: People may be more inclined to get vaccinated as they see others do it.
"It's not a matter of making someone else wrong or proving yourself right," she said, "but just letting people know in a very respectful way, 'This is how we feel.'"