Currently, 62 percent of Americans age 5 and up are fully vaccinated for COVID-19, with 34 percent having received a booster dose. That leaves more than 100 million Americans who have made the choice to skip the COVID-19 vaccine despite clear evidence that the jabs help prevent serious illness.
Vaccine hesitancy is a serious public health challenge—one that researchers are learning more about. What’s going on here?
A systematic review published by researchers in Singapore last year provides a laundry list of reasons people across the globe avoid vaccination. People who are younger, female, less educated, and not white are all more likely to feel hesitant above COVID-19 vaccination.
Not surprisingly, people who have not gotten flu vaccines in the past are less likely to get COVID-19 vaccines. In addition, those who believe they have a lower risk of contracting COVID-19 and those who are not worried about severe illness are less likely to get vaccinated.
In many studies, those hesitant reported worries that the vaccines are not safe or effective. They also raised concerns that the vaccines were developed too quickly.
While these data are interesting, the real question is, what can we do to encourage more people to get vaccinated?
It turns out, there is also a growing body of literature on the best ways to encourage vaccination.
A Cochrane systematic review of people age 60 and up found several effective methods to encourage vaccination. Patients were more likely to receive a vaccine after a health provider educated them on the benefits of vaccinations. Reminders by office staff, both in person and via letters and postcards, also increased the likelihood of patients getting vaccinated.
A more recent study in the journal Nature found that people who received text messages encouraging them to get COVID-19 vaccines were more likely to get vaccinated. The study included more than 93,000 people in a large health care system. The control group did not receive any text reminders; 13.9 percent of this group received their vaccines within four weeks of becoming eligible. A second group received a text message with a link to schedule their vaccines; 17.1 percent of this group got vaccinated within four weeks. A third group received text messages with language designed to create “psychological ownership,” such as telling people, “The vaccine has been made available for you”; 18.1 percent of this group got vaccinated within four weeks. These results demonstrate that digital reminders work and the language used in them matters.
Another recent review looked at the evidence on encouraging parents to get their children vaccinated. It also found that reminders, both digital and in-person, were effective in increasing vaccination rates among children. The study also suggests that health care providers use a presumptive approach to parents when discussing vaccines; for example, “We are planning to give your child the recommended vaccines today.” Lastly, the review found school vaccine mandates increase vaccination rates among kids.
Finally, the American Medical Association, the Cleveland Clinic, and the U.S. Centers for Disease Control and Prevention offer evidence-based tips for talking with people who are hesitant to get vaccinated.
The first and most important step, the data suggest, is listening to the person’s specific concerns about vaccination. Maybe they are worried about potential side effects, or maybe they have concerns about how quickly the vaccines were developed. The organizations recommend engaging with empathy and without casting judgment on the person.
The next step is to share factual information about the vaccines, making sure to ask first! The person will be less likely to feel bombarded with information if they agree first. Be sure to cite the sources of your information and use a matter-of-fact tone of voice. Consider sharing the reasons that you chose to get vaccinated and discuss your goals, such as feeling safer when visiting at-risk loved ones or looking forward to traveling.
Finally, if the person does indicate interest in getting vaccinated, offer to help them find local appointments or assist with transportation.
The take-home message: Vaccine hesitancy is a significant public health challenge. There are steps that health officials can take to encourage vaccination. Everyday citizens can help by having thoughtful, caring conversations with friends and loved ones who are hesitant to get vaccinated.
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