Conversations with a skeptic: Friends and family who are COVID vaccine hesitant

Illustration by Jonathon Rosen

When people are reluctant to accept science, or recommendations based on science, my curiosity comes alive. When that person is a twenty years-long friend, I’m even more curious. Matt* is my late husband’s best friend and we talk a lot about topics typically off the table: religion, politics and covid vaccination.

It turns out, seven months into vaccine availability for his risk group, Matt is still not vaccinated. I was vaccinated at my first opportunity. Our chats about covid vaccines have ramped up as his deadline of workplace mandated vaccination looms.

Since I knew these would be ongoing conversations and not just a one-time thing, I wanted to think more about Matt’s background to see if there might be some clues to his perspective. If I were to profile Matt, I’d note that he was raised as an evangelical Christian but no longer practices; graduated college; is a politically moderate gay man; he doesn’t sleep well so has time on his hands; he consumes podcasts, alternative channels and mainstream news more than most people I know; he fact checks sources when he has time; he’s considered going into local politics to be a changemaker; he’s held numerous jobs including realtor, ELL instructor in Taiwan, maintenance supervisor, painter and beer guy at the stadiums.

At first I was just overwhelmed with how much Matt was reading and sharing with me regarding his vaccine hesitancy. Mostly I just listened to him and then started watching and reading the information he referenced. One afternoon at Cowen Park, after our 5th or 6th impromptu talk on covid vaccines, I had this “Dolby sound” moment where things just coalesced.

Matt doesn’t trust the pharmaceutical industry. But he never said this directly.

Matt thinks his immune system is capable and doesn’t need priming by a vaccine. But he never said this directly.

According to Dr. Amitabha “Guppy” Gupta, one of Fred Hutch’s philanthropy scientific content analysts, people form mental anchors, or deeply-tethered ways of thinking, about things. In Matt’s case, his main anchor is distrust of the pharmaceutical industry. One of his secondary anchors is the belief that his body’s immune response outperforms influences from pharmaceuticals.

Once I recognized Matt’s anchors (after hours of listening and hours of watching his YouTube suggestions), I realized that all along he sought and presented tons of data to back up his deeply-tethered beliefs. The way Matt seeks data is a kind of confirmation bias, or “myside bias.” Probably unknowingly, Matt seeks information that supports his anchors. Most of us do! To be fair he does sometimes receive information counter to these anchors, especially when I openly disagree with conclusions/experts/data that we’ve discussed.

So I summarized back to Matt: “Tell me if I’m wrong, but it sounds to me like you don’t trust the pharmaceutical companies and you’re worried that the vaccine will mess with your immune system.”

Matt actually looked peaceful. I think just being understood and feeling respected made a big difference for him. Don’t get me wrong. Matt didn’t run out and get the jab because of our talks. But our friendship grew deeper and I feel we can talk about this anytime with mutual respect.

During NWABR’s recent Communication Workshop I was asked how to overcome negative feelings towards people with whom we strongly disagree. Remember that not everyone is a good candidate for a feisty conversation. Discern when to engage and when to let things go. If you let it go, release the conversation with uber-politeness. For example, “I know you’ve put a lot of thought into this. I admire your passion.” If you decide to engage, it’s important to remember that in these dichotomous situations your best bet is to surprise your person with a willingness to compassionately listen to their perspective; this is not about winning an argument. Secondly, see your person as a human being. As someone’s child. When I do this I see my person with love and respect along with a desire to care and lift them up. Remember that their view on covid vaccines isn’t what defines them or their character.

Walking with someone as you disagree with them is not easy, but from personal experience I highly recommend the journey. Best wishes on yours.

*I’ve shared these stories with Matt’s permission.

Jen Wroblewski, MPH, is Public Engagement Manager at Northwest Association for Biomedical Research (NWABR). She co-founded Seattle’s Science on Tap and is a public science communication advocate. Jen welcomes your thoughts and questions on this article: engagement@nwabr.org.

At Home Ethics During COVID-19

In my work at NWABR I often think about things with an ethics filter. The discipline of bioethics can sometimes seem like a hypothetical exercise, but this pandemic is the real deal and we need to listen to our ethicists. For me, the SARS-Cov-2 novel coronavirus pandemic highlights two key ethical dilemmas:

-How do we allocate scarce medical resources?
-How can everyone enact behaviors and choices that maximize the best outcomes for the most people?

I assert that there is an ethical imperative for each person to do their part to stretch resources and maximize positive outcomes. Many factors affect individual roles, therefore we all have different obligations to the ultimate outcome, and to one another, guided by our capacity. The ethical challenge here is that we have to examine our capacity to contribute honestly and with the sure knowledge that our contributions will not be cost free.

Here is my situation. I still have an income and live in a house with my three young kids. I am well-connected to a community and can work from home while I teach my three kids. I have asthma but otherwise we are healthy. I am hyper-aware that I have extra resources when many don’t have enough. How can I help others to maximize good outcomes?

My children and I are staying home. We aren’t out playing soccer with friends or touching playground equipment. When I get take out, groceries or packages delivered, I meticulously bring these items into my home. Everything seems to take more time during this season. I am doing my best to keep me and mine healthy so we do not have to use scarce resources; I even reduced my daughter’s dislocated kneecap to save mask use by first responders. We are supporting local restaurants and donating to non-profits.

Will it be enough if everyone does everything they can? I hope so.

Leaders and health providers across the globe right now are juggling these ethical issues on a huge scale. Who receives resource-depleting treatments? How much liberty do we need to forego for the common good? How do you balance the competing needs of the linked economic and health crises?

Biomedical ethicists have been dealing with such issues for millennia and have provided a range of ethical frameworks to help think through such constraints. Let us listen more to our ethicists as we continue to work through this pandemic.

Stay tuned for more on this topic!