< Vaccines

How to discuss between pro and anti-vaccine?

Text updated on 2021-05-03


The first thing you have to do is listen to the other one! If you've read the questions/answers from Adios Corona, you probably have a lot to contribute. In order to change a person's point of view about vaccination, it will always be more effective to guide them to face their doubts, contradictions, and cognitive biases, than to take them from the top or contradict them head-on.

Several reasons can explain the mistrust towards vaccination: a low level of trust in health or political authorities, misinformation and the massive diffusion of "fake news", a human attraction for scandalous facts, the cognitive bias of confirmation which makes people more inclined to retain what confirms their position and less inclined to pay attention to what would not go in the same direction (see question How do our cognitive biases influence us during the epidemic of COVID-19 ?).

For a long time, health professionals have responded to vaccine-experienced patients with evidence-based data, reminding them of the efficacy of vaccines, their positive tolerance and safety. Despite the good intentions of this approach, several studies report that most of these evidence-based interventions are not very effective and may even induce a so-called "backlash" effect. This apparently paradoxical phenomenon, which is well-known in the cognitive sciences, consists of reinforcing the patient's deep-seated beliefs in the face of factual explanations that contradict them. When a healthcare professional provides the patient with information, the patient prefers to hold on to his or her beliefs rather than question them. This diminishes his or her level of trust and may lead the patient to interpret the therapist's instance or annoyance as a clear sign of a hidden mechanism of a conspiracy.

The idea of convincing people on the value of vaccination is to guide the person with whom you are talking to on the awareness of differences, rather than to contradict them. This will allow them to explore the contradictions that exist and empower them to make decisions about their health. This takes time. Making a person feel guilty by evoking dramatic facts and images or altruism will be counterproductive. The goal is for that person to come into conflict with themselves, not with you! It is doubt that can produce a process of change in judgment, as long as that person does not feel pushed in one direction.

Here are some tips for talking to someone who is unsure about the benefits of vaccination:

  1. Take the time to listen to this person, their point of view, their knowledge, their fears, because that is what you will respond to. If you pay close attention to their point of view, it will be all the easier for you to find the arguments to help them change their mind.
  2. Don't take the high road, but stand as an equal. It is important for everyone to be able to question their point of view in the face of new data and new arguments. The discussion should be as symmetrical as possible, so that there is a chance that one or the other person will change his or her opinion as a result of this exchange.
  3. Inform the person by giving additional information in a neutral way, while avoiding arguments: frontal counter-argumentation risks pushing your speaker into a defensive attitude and thus strengthening his or her resistance. The neutral transmission of information avoids being in opposition. All fears are legitimate and no value judgement should be made on the expression of these fears. Information should be provided on adverse effects of vaccines, for example, without trying to conceal them (see question Are adverse vaccine reactions expected? ).
  4. Listen to the person, what they get out of the information you gave them. This person should feel free and valued in his or her skills and decision-making autonomy.
  5. Allow time for reflection, as change may take some time.

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Sources

A more complete version of this question/answer is available here:

Diana, A., Braillard, O. T. L., Eckert, N., & Sommer, J. M. (2020). How can we respond to our patients' hesitation to vaccinate?. Primary and Hospital Care: General Internal Medicine, 20(12), 383-387.

The motivational interview, a tool to talk with those who are hesitating about vaccination.

Winner, A., Gosselin, V., & Dubé, È. (2018). Motivational interviewing: A promising tool to address vaccine hesitancy. Vaccine, 36(44), 6553-6555.

One of the reasons that can explain the mistrust towards vaccination is misinformation and the widespread and very rapid dissemination of fake news.

Vosoughi, S., Roy, D., & Aral, S. (2018). The spread of true and false news online. Science, 359(6380), 1146-1151.

Methods that don't work when talking to parents to convince them to have their child vaccinated.

Henrikson, N. B., Opel, D. J., Grothaus, L., Nelson, J., Scrol, A., Dunn, J., ... & Grossman, D. C. (2015). Physician communication training and parental vaccine hesitancy: a randomized trial. Pediatrics, 136(1), 70-79.

Article that seeks to better understand why some methods of explaining vaccination to parents do not work and even produce the opposite "flashback" effect.

Thornock, B. (2017). Heralding the pariahs: What the narratives of vaccine hesitant parents can teach us about the backfire effect and physician-patient relationships. Ann Public Health reports, 1(1), 15-21.

This article studies the "backfire" effect after reading messages from journalists who correct false information. This way of correcting information is often counterproductive and may even increase the risk that people will memorize false information as true.

Peter C, Koch T. When Debunking Scientific Myths Fails (and When It Does Not): The Backfire Effect in the Context of Journalistic Coverage and Immediate Judgments as Prevention Strategy. Science Communication 2016;38(1):3-25.

Tips for dealing with hesitation about vaccination.

Shen, S. C., & Dubey, V. (2019). Responding to hesitation about vaccination: Clinical advice for front-line physicians working with parents. Canadian Family Physician, 65(3), e91.

One of the reasons for refusing vaccination is the lack of trust in the information that is passed on to the general public. In this study, three groups were presented with either: (1) general information about vaccines, or (2) general information about vaccines + a summary of adverse events, or (3) general information about vaccines + a detailed adverse event report. Group 2 shows an increased acceptance of the vaccine and an increase in confidence in the health authorities compared to Group 1. On the other hand, in group 3, there was a decrease in acceptance of the vaccine and a decrease in confidence in the health authorities.

Scherer LD, Shaffer VA, Patel N, Zikmund-Fisher BJ. Can the vaccine adverse event reporting system be used to increase vaccine acceptance and trust? Vaccine 2016;34(21):2424-9.

Study conducted in Great Britain which shows that individuals who are reluctant or refractory to vaccination inform themselves about the COVID-19 significantly more via social networks than via newspapers, television, radio, and government agencies. Furthermore, individuals who are refractory to vaccines have a significantly lower level of confidence in the information disseminated via newspapers, television and radio programs, their physicians, healthcare professionals, and government agencies than those who accept vaccination.

Murphy, J., Vallières, F., Bentall, R. P., Shevlin, M., McBride, O., Hartman, T. K., ... & Hyland, P. (2021). Psychological characteristics associated with COVID-19 vaccine hesitancy and resistance in Ireland and the United Kingdom. Nature communications, 12(1), 1-15.

Further reading

What are the different types of COVID-19 vaccines?

Can I get vaccinated, where and when?

Are RNA vaccines a miracle of science?

Are adverse vaccine reactions expected?