Chipping Away at Vaccine Hesitancy

The COVID pandemic is continuing to grow, and it appears that we are now entering a period many call a "pandemic of the unvaccinated." Recent data shows that those who have not been vaccinated are:

People who have been vaccinated are 7 times more likely than others to test positive for COVID-19.

49 times more likely to need hospitalization than people who have been vaccinated

The risk of COVID-19 is 32 times greater for people who have not been vaccinated than those who have.

Although these numbers may vary depending on where you live, they are representative. Although the Delta variant may have contributed to the recent spike, the COVID vaccines are still about 80% effective against infection. To maximize vaccine effectiveness, we are currently debating and studying when to give a booster. 55% of Americans are fully vaccinated. 64% receive at least one dose. To have effective herd immunity, we need to reach 80%. How can we achieve this?

Complexity is the cause of vaccine hesitancy. A major factor in the rise of vaccine hesitancy is distrust towards the government. These beliefs are often deeply rooted and tied to ideologies and political identities. Information cannot be trusted because it is not trustworthy.

Fear of side effects can be another reason for hesitancy. However, it is difficult to separate this issue from a lack of trust. Information alone can counter fear of side effects in cases where trust is not the underlying problem. People are more likely to fear an immediate, tangible and active harm (such a vaccine) than a distant theoretical and passive injury (such a failure to prevent COVID). Although rationally, it would be easy to run the numbers and perform a risk-benefit analysis. Humans are not rational. However, information from trusted sources, such as your doctor, can help in these situations.

Recent research has focused on a subset of people who have not yet been vaccinated. They believe the vaccines work well and are safe. This disconnect could be due to many factors. People may be too busy, distracted, procrastinate or face practical obstacles to getting vaccinated. This group could be the lowest-hanging fruit of the unvaccinated and a better use for resources than trying to convince partisan refusers or anti-vaxxers.

Researchers used cognitive dissonance to determine if they could influence the behavior of the subjects in the intervention group. The intervention group was asked to advocate best practices for the pandemic. This included wearing a mask and getting vaccinated. The intervention group asked them to recall any recent actions that they had taken that were not in line with these best practices. Cognitive dissonance is a psychologically distressing feeling psychologists refer to as cognitive disconnect. The subjects were then followed up one week later with those from three control groups that had no dissonance. They reported:

Our findings showed that participants in dissonance were more likely than those in non-dissonance conditions to follow guidelines and seek vaccination.

It may prove difficult to implement these findings. For example, contests could be used where participants have to create a pro-vaccine campaign and winners receive prizes. Maybe ad agencies can be engaged because they have a history of using psychological factors to change customer behaviour (including cognitive dissonance).

Perhaps the most important conclusion is that COVID vaccine adoption should be increased by those who are persuasable. They don't need convincing, but just a push in a positive direction. It is unlikely to bring about any significant change in the minds of antivaxxers.

It remains to be determined what the limit is for increasing vaccine uptake by persuasive methods. This leads us into the debate about vaccine mandates. These mandates are being demanded more frequently, and the discussion seems to be moving away from whether mandates should exist to the details of their implementation. Although forced vaccinations are not being discussed or considered by anyone (which isn't a policy in the US), there has been a long history vaccine mandates for many purposes, including travel, school, and certain occupations like health care workers.

Unvaccination should not be considered a personal choice. Employers have the right to require vaccinations for their employees (with an exception made for medical reasons). The duty of protection is on the part of professions to require their members to get vaccinated. A proof of vaccination can also be a privilege in situations where you are required to be in close quarters, such as on a plane.

These are common-sense public health policies. Protests that are based on the principle personal freedom are invalid because they affect the personal freedoms of others. Speeding on the highway is a dangerous practice that puts others at risk. Because of its harmful effects on other health, smoking has been banned from public places.

Let's just say that the bottom line is that society collectively has the right limit individual behavior in public spaces that threaten public safety. Nobody has the right put others in danger. The economic damage caused by the pandemic to the economy is also damaging. This is because the non-vaccinated cause the damage to increase and continue. There are many legal, historical, moral, ethical and logical reasons for vaccine mandates. There is no strong argument against them. They might also be necessary to attain herd immunity.