How to talk with people who are COVID Vaccine-Hesitant

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How can you best encourage your friend, family member, or coworker to get vaccinated against COVID19 when they’re still reluctant?

You know the facts are on your side: The virus has killed over 600,000 Americans, and in the U.S., we have readily available vaccines that are safe and effective.

Getting vaccinated protects you and the people around you from hospitalization and death. The vast majority of people being hospitalized and dying from COVID in America now are unvaccinated.

But no matter how many facts you cite, your friend or relative seems unconvinced, and even tunes you out as you continue to make your pitch. You may feel tempted to throw your hands up and walk away but given the stakes, you don’t want to give up. What can you do?

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Some people are absolutely dead set against vaccines, and convinced that the vaccines are being foisted on us as part of some conspiracy. People in this group are very unlikely to ever get vaccinated. But then there are people who aren’t completely against vaccines, but have a lot of questions and concerns, which is making them delay getting it.

A New York Times article describes the challenges of convincing people in this group to get vaccinated, regardless of the facts and science supporting vaccination. In June, Dr. Anthony Fauci spent time talking with vaccine-hesitant people on their front porches in Newark, NJ, but only persuaded a few to get a dose. “If a celebrity doctor is struggling to change people’s minds, what chance do we have?” asks the Times reporter, Jonathan Wolfe.

In a search for alternate strategies, Wolfe spoke with Arnaud Gagneur, a neonatologist who developed a successful method of speaking with mothers who were hesitant to get their children vaccinated in pre-pandemic times.

Gagneur’s method is based on motivational interviewing, an approach that emphasizes rapport building, and balances listening with talking. When using motivational interviewing, you would avoid starting with an argument or lecture on the benefits of vaccination.

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Instead, you would start by asking the other person what they think about vaccination, and what more they would like to know about it. You don’t hide the fact that you are in favor of vaccination, but you also express an openness to listening to the other person’s point of view and their questions. By listening carefully, you show them that you are genuinely, respectfully trying to understand their point of view.

Because you don’t start with forceful arguments, the other person is less likely to reflexively put up walls. By adopting a stance of non-judgmental listening, you can open up a space of dialogue, and foster connection and mutual listening.

This isn’t a disingenuous, manipulative ploy; you have to embody a genuine, non-judgmental willingness to hear the other person’s point of view, and tolerate differences of opinion. When you’re willing to listen to them, you may be surprised to find how much more likely they are to listen to you.

Once this connection has been established, you can ask the person’s permission to share with them some information you’ve learned about vaccination.

By asking permission, rather than launching into an unsolicited lecture, you show respect for the other person and give them the opportunity to consent or refuse, which again makes it more likely that they will listen to you. If they give permission, then you can start to dive into some of the science and the facts, now with an audience that’s likely to be more receptive.

People who are vaccine-hesitant usually have mixed feelings. In the face of their ambivalence, you may be tempted to just list all the ways that their lives will be better if they are vaccinated.

But instead, see if you can elicit from the other person their own thoughts on this, and what some of their own motivations for vaccination and preventing illness might be.

Ask these things in an exploratory, open-ended way, like, “Do you think there could be any advantages to being vaccinated? What do you think they might be?” Building their motivation will work better if the ideas come from them, not you, because they know best what is important to them. For some people it might be a desire to travel more, or to protect a loved one—you can’t know for sure until you ask them.

Another challenging but important tip is to be patient, and realize that the other person may not change their mind in one brief conversation, especially if they are very reluctant or worried about vaccination.

Your discussion with them may need to be a process that extends over the course of a few conversations in order to lead to change…although ideally these conversations could be pretty close together in time, since time is of the essence in getting people vaccinated.

But by maintaining a stance of openness and respect, and a willingness to listen, understand, and share information with their permission, you foster the growth of connection and trust, and they may well be up for revisiting it with you.

This may all sound nice, but does it work? There is research evidence indicating that motivational interviewing does increase the chances that vaccine-hesitant parents of pediatric patients, as well as adults, will choose to get vaccinated. And it’s being recommended as an evidence-based approach for talking with people reluctant to take the COVID19 vaccine.

Why does it work? Motivational interviewing is effective, at least in part, because it uses the power of interpersonal connection, in particular, the power of attunement.

Rather than getting caught up in a whirl of stress and anger about the other person’s vaccine hesitancy, you try to maintain a stance of relaxed awareness. You listen to their thoughts and feelings, in an effort to understand.

And you meet them where they are, by taking an interest in their own thoughts and their own motivations, instead of immediately imposing your own. This can result in a sense of trust, connection, and support for their own motivations to get vaccinated.

This scenario also highlights an important point about attunement: You don’t have to agree with each other on everything to be well attuned to each other. Part of attunement is recognizing and tolerating each other’s differences.

Even after a great discussion of vaccines, using a motivational interviewing approach, you may not convince the other person to see things the way you do. But the strength of the connection you develop with them may be enough to support the side of them that wants to get vaccinated.

Some people don’t need much convincing. They were the ones who couldn’t wait to get vaccinated, based on the scientific, medical, and public health recommendations. But for those who are ambivalent, the power of connection can make all the difference.

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