Vaccine Hesitancy

What do vaccines cause?

Individual immunity → Antibodies

Herd Immunity → decreases transmissions and protects the ones that cannot get the vaccine

Vaccines are what?

One of the most powerful public health measures

What is vaccine hesitancy?

A delay in acceptance or refusal of vaccines, despite the availability of vaccination services

What are the 5Cs factors contributing to vaccine beliefs?

Confidence → Vaccines, public authorities, providers and vaccine

manufacturers are producing safe and effective vaccines

Constraints → Convenience or barriers make getting a vaccine difficult

Complacency → Vaccines are unnecessary/not urgent because the

disease is not severe

Calculation → Need to fully understand vaccine benefits versus risks

before getting vaccinated

Collective responsibility → If others are vaccinated, I don’t need to/I

want to contribute to the collective good

What is availability bias?

Assessing vaccine risk based on memorable personal stories rather than statistics

Because most people only know mild cases of vaccine-preventable diseases (or explain away severe ones), these illnesses seem less dangerous than they are

What is Omission bias?

Fearfully avoiding action with a miniscule risk of harm (vaccine)

Easier to do nothing despite greater risk of harm

Vaccine Indifference when avoiding vaccine feels safer even when it isn’t

What is confirmation bias?

People pay more attention to stories that confirm their beliefs about vaccines

Like not getting vaccinated either → gets no harm and false confirmation, or harmed and not considered noteworthy

Getting vaccinated → No harm is expect, but a reaction is sensationalized

What is the Moral Foundations Theory?

That moral judgements are driven first by intuition, then by reasoning second

the elephant and the rider

What are the six moral foundations in moral foundations theory?

Is the six categories that cause the elephant to react

Each can cause positive and negative reaction, not every foundation is triggered?

What is the Care vs. Harm foundation?

People are vulnerable

Vaccines can cause care or harm

Care → Vaccine protect

Harm → side effects

What is the Fairness vs. Cheating foundation?

Society should be fair and cooperative

This in vaccines;

Some see its unfair that they have to get it, an overreach

Some see its unfair that because others aren’t vaccinated it causes high infection risk

What is the Loyalty vs. Betrayal foundation?

People prioritize loyalty to their social in-group

in vaccines;

People may avoid vaccination or hide it if it goes against group norms

What is the Sanctity vs. Degradation foundation?

Maintain purity

In vaccines;

Want vax because fear of serious illness

Do not want vax because of fear of ingredients

What is the Authority vs. Subversion foundation?

Regard for a moral leader

In vaccines;

Listen to scientists and evidence

Listen to political voices, conspiracy theorists

What is the Liberty vs. Oppression foundation?

Should be able to do what I want and not be controlled

in vaccines;

We should have greater vaccine uptake so society can have less risk

I should not be forced get vaccinated, face loss and autonomy

How to interact with a vaccine hesitant patient?

1. Do not make things worse → good attitude, trust they are trying to do what is best, no demeaning

2. Assume vaccine confidence at first → We are doing flu shots today, have you had yours?

3. Get your mindset ready → Poised rider brain, not fight fight elephant brain

4. Have flexible goals for the interaction

5. Open conversation

6. Listen and reflect back

7. Ask permission before giving info

8. Empathize

9. Humbly build Credibility

10. Be respectful and have a long term view