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 5^th or 6^th 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.

Why do parents choose not to vaccinate?

Readers of this blog will know that I have written several times about vaccinations.  I have become increasingly frustrated about the low rates of vaccinations and the sense that some people are essentially putting their heads into the sand on this important issue.  If I was forced to stake out a position then I think my underlying view was not dissimilar to the above New Yorker cartoon that has been circulating on Facebook.

There were two items on NPR this morning that discussed why, even in the face of the current Measles outbreak, parents are still failing to vaccinate their children.  Both items endeavored to understand the psychology of this resistance.  The first article by Jon Hamilton shares the story of a Mom who chose not to vaccinate her daughter because she felt that there was a risk of Autism and conversely very little risk from disease.  She was also in a group that she referred to as the  “crunchy mums” who questioned “mainstream medicine and things that aren’t natural”.

For such parents they perceived no downside risk of not vaccinating and conversely vaccinating would in essence break a covenant with the “natural” way of being that they aspired to.  In the case of the Mom in this story her daughter was subsequently diagnosed with Autism.  Because her daughter had not been vaccinated at the time of the diagnosis it was clear that there was some other as yet unknown cause for this disorder.  The Mom also kept talking through the issues with her pediatrician and over time, after becoming aware of the Autism diagnosis, made the decision to vaccinate her daughter.

The second article was by the amazing Shankar Vedantam.  Vedantam was doing a follow up story to an earlier study that showed that espousing the health benefits of vaccines to parents, that did not trust vaccines, actually made them less trusting of science and vaccines.

For these parents trying to debunk their beliefs about vaccines had the perverse result of reinforcing those beliefs.  Vedantam suggests that the way to work with these parents is to spend time trying to build a relationship with them and to truly understand their fears.  It seems to me that the pediatrician in the first story epitomized this kind of philosophy by working with the mum over a long period of time, and by keeping that relationship and the discussion open, was finally able to help the Mom get to a space where vaccinations became the right decision.

Of course the only problem with this is that it does take a long time and the current Measles outbreak is building so quickly that we know that some innocent children will be hurt.

On that somber note – have a great day.

Regards

Ken Gordon

Executive Director