They’re not all anti-vaxxers. What we learned by asking why people didn’t get COVID vaccine | Editorial

·6 min read

We all know how to end the coronavirus pandemic: Get vaccinated. But we also know that reality has run into resistance from millions across the nation who are hesitant to get the vaccine.

Today, the Miami Herald Editorial Board and more than four dozen opinion outlets across the country are taking part in an effort, initiated by The Boston Globe, to address misinformation about the vaccines. In doing so, we hope that factual information will persuade many members of the community with legitimate concerns to rethink their resistance — for the greater good.

They’re not all “crazies,” conspiracy theorists, anti-vaxxers, anti-science or COVID deniers.

And labeling people who have opted not to receive vaccinated against COVID-19 is certain to not change their minds — has it ever? If there’s anything that will, it’s understanding the various reasons why roughly 40% of Americans still haven’t received at least one shot.

Yes, many might be convinced that the vaccines are not effective, even though, despite reports of breakthrough cases, they are preventing serious illness and death; or that the side effects are worse than catching the virus. (They are not: While vaccine side effects tend to dissipate within 48 hours and complications are rare, COVID has killed more than 40,000 Floridians and 620,000 Americans, way more than any vaccine).

Recent surveys suggest many of the unvaccinated are unlikely to change their minds — 35% say they probably will not get it, and 45% say they definitely will not, according to a poll from The Associated Press-NORC Center for Public Affairs Research released in late July.

But there are a number of people, even if small, whom we can still convince. They might have concerns that, while not founded on available facts or scientific research — or easily debunked — are not illegitimate.

“I am not against science, but with all my allergies and blood-clot history, I’m just really not interested in a vaccine that hasn’t been around long and was hastily produced,” wrote a reader who answered a Herald Editorial Board call-out asking why people have decided to remain unvaccinated.

“I feel that the vaccine is far too new to truly understand long-term side effects. I don’t trust how much the vaccine is being shoved down our throats. The government has NEVER pushed anything so hard through any pandemic,” wrote another.

We wouldn’t call these people crazy. Misinformed about the fact that researchers were able to quickly leverage knowledge from previous vaccines developed for other coronaviruses? Yes, but they are far from your tin-foil-hat conspiracy theorists.

How can we persuade at least some of them that their beliefs about the vaccines are wrong?

Board member Amy Driscoll posed that question during a panel about vaccine hesitancy that the Editorial Board hosted on Aug. 12 as part of our “Speaking of Miami” series. Here are some takeaways:

A matter of trust

Forget Dr. Anthony Fauci. People trust their own doctors and those closest to them more than bigwig public-health experts.

It was a conversation with his doctor, as well as friends in the medical field, that changed Miami Lakes Mayor Manny Cid’s mind. He got vaccinated in July after being “extremely hesitant.”

“I went out, I tested my antibodies, I have no antibodies. Seeing the delta variant, when I sat down with my doctor, I called close friends of mine — nurses, other ER doctors, my pharmacist — they all told me, ‘Manny, protect yourself. This delta variant is no joke,” Cid said during the panel.

He tweeted about his experience, and now he has helped persuade other vaccine-hesitant constituents and friends to get a shot.

Facts aren’t enough

You can quote all the data that show vaccines are safe, or that hospitals are flooded with people who have not been vaccinated — for example, all patients in the COVID-only intensive-care unit at Jackson Memorial Hospital in Miami were not vaccinated at one point earlier this month, the Herald reported.

Accurate health information is the foundation of behavioral change — and misinformation is the biggest issue affecting low vaccination rates — but just citing accurate information to your unvaccinated friends and relatives isn’t everything.

“Yelling at someone or doing finger-wagging and things like that ... it’s not helpful and it just doesn’t work,” said Dr. Steven Safren, director of the University of Miami’s Center for HIV and Research in Mental Health and the Health Promotion and Care research program.

Instead of nagging, ask questions — with empathy. That’s a method in psychology called “motivational interviewing.”

“So If someone says something like, ‘You know, I just really don’t think vaccines are around long enough,’ instead of starting with, ‘Oh, the vaccines are fine, and the side effects are minor’ ... you might say, ‘Yeah, a lot of people do have those concerns. ... What do you think of the research that shows that most side effects go away within 24 to 48 hours?’ Safren said.

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Tuskegee still haunts

“As an African American, I don’t trust the healthcare system, as we have seen countless times where we’ve been given [substandard] care,” a reader answered in our call-out.

That’s understandable. Many African Americans are still traumatized by the Tuskegee Experiment, a study that began in the 1930s with the federal government deceiving Black men in Alabama into thinking they were receiving free healthcare when, in fact, they were human guinea pigs in a study about the effects of syphilis. Researchers denied the men proper care despite the fact that, by the 1940s, penicillin had become the recommended treatment for the disease.

Dr. Carol Biggs, chief nursing officer at Jackson Memorial Hospital, has heard Tuskegee mentioned many times as the reason African Americans do not to trust today’s vaccines. She assures them that, while the experiment denied people medical care, the COVID-19 vaccines are distributed to everyone, regardless of race.

The real issue is the disparity in care that Black people receive once they have COVID.

“I say the vaccine is the same, it’s going to be equitable,” Biggs said during the panel. “My worry is when you go to the various different hospitals, I’m not sure if you go in with COVID, if the treatment might be the same.”

Where’s the FDA?

“Why is everyone trying to push this crap on people, calling them names and suggesting we shame the unvaccinated, when the FDA hasn’t even cleared this vaccine fully,” another reader wrote in the call-out.

The three vaccines currently available in the United States have received emergency approval from the Food and Drug Administration, which is temporary clearance for public-health emergencies. Full approval can take months, but some officials believe the Pfizer vaccine could be approved by late summer or early fall, the Washington Post reported.

Once that happens, how many vaccine skeptics will change their minds? Cid, the Miami Lakes mayor, believes many, according to conversations he’s had.

“I was definitely hesitant, specifically when we saw that [the vaccine is] still under emergency use from the FDA,” Cid said. “Fortunately, we know that the FDA — hopefully, very soon — will be approving it fully, which I know is going to have a great impact on folks that are still hesitant.”

Full FDA approval might be our best hope. Fingers crossed.