Over the past three weeks, the U.S. rate of vaccination against the coronavirus has slowed. That’s because many people who wanted to get their shots have gotten them, and many people who remain unvaccinated are reluctant. To stop the virus from spreading, we need to deprive it of carriers, and that means persuading the holdouts to roll up their sleeves. Who are they? And how can we change their minds? Researchers have interviewed thousands of these people. Here’s what they’ve found.
To begin with, the pool of reluctant people is shrinking. Not a lot, and the decline is slow and sometimes choppy, but it shows up in multiple surveys. But there’s a catch: When polls sort the holdouts by degrees of resistance—typically, by separating those who say they’ll “wait and see” from those who say they won’t get vaccinated—the shift toward acquiescence is largely confined to the wait-and-see group. Those who say they won’t get vaccinated have held firm. Let’s call these two groups, respectively, the hesitaters and the refusers.
The good news is that the pool of refusers is small. On average, across polls, hesitaters represent about 20 percent of the population. Refusers represent about 15 percent. Together, they’re a major problem, because to reach herd immunity—the point at which the virus has trouble finding susceptible hosts to sustain itself—we probably need to inoculate about 70 to 85 percent of the public. We can get to 85 percent vaccination, or close to it, without the refusers. But we need the hesitaters.
Polls shed some light on the demographics of these groups. Together, compared with the rest of the population, they’re more likely to be conservative and young. In a Washington Post/ABC News poll taken last week, only 7 percent of people ages 65 and over were refusers. That number doubled among people ages 40 to 64 (16 percent) and tripled among people ages 18 to 39 (22 percent). Refusers are less likely to be college educated or earn high incomes, and they’re more likely to watch Fox News. Across multiple surveys, Republicans are about twice as likely as other respondents to be refusers. In a Harris poll taken last month, 37 percent of refusers, compared with 21 percent of respondents as a whole, said they were very likely “to register as a user for a potential social media website created by Former President Trump.”
Some refusers say they don’t need a vaccine, since they’re immune due to prior infection. (That immunity isn’t as reliable as a vaccine.) But surveys indicate that refusers, compared with the general population, are less likely to have been infected. In a Harris poll taken two months ago, only 9 percent of refusers, compared with 12 percent of all respondents and 16 percent of people who were already vaccinated, said they’d had COVID. In other surveys, when refusers and hesitaters are asked why they don’t want to get vaccinated, only about 5 percent to 10 percent say their main reason is that they’ve already had the virus.
Research suggests several promising avenues for winning over the hesitaters. When they’re asked why they’re reluctant, their most common answers focus on doubts about the vaccines’ safety and efficacy. Last month, a Kaiser poll addressed that by giving them relevant information—for example, that although the vaccines are new, the science behind them has been developed for 20 years. That information didn’t placate refusers, but it prompted many hesitaters to say they were more likely to get vaccinated. As more and more people get their shots, don’t get COVID, and don’t drop dead, polls confirm that some of the “wait and see” holdouts, having waited and seen, are coming around.
Some people have held back due to logistical problems. But as administrators address those issues by making the vaccination process easier and more accessible, those concerns have subsided. In Kaiser polls, the percentage of holdouts who cited difficulty in reaching a vaccination site or inability to get the vaccine “from a place you trust” fell 10 points between February and March. The poll found that roughly a third of hesitaters were more likely to get vaccinated if their employer arranged for it at their workplace or if their regular medical provider offered it during a routine visit. Bribes—which West Virginia is now trying, in the form of $100 savings bonds—also work. The Kaiser survey found that 30 percent of hesitaters would be more likely to get vaccinated if their employer offered them $50. Raising the reward to $200 increased that number, but only to 38 percent.
It’s comforting to think that those who can’t be bribed might be susceptible to penalties, such as not being allowed to board a flight without a certificate of vaccination. In polls, such rules do persuade a segment of the hesitaters—about 7 percent of the total population—who say they’ll get vaccinated only if it’s required. But the refusers don’t budge. In fact, by substantial margins, refusers are more likely to say that vaccine requirements harden their resistance than to say the requirements make them more likely to give in.
What distinguishes the refusers is their deep distrust. In this week’s Harris poll, 20 percent of them said they never get vaccinations, and 40 percent said they wouldn’t accept a COVID shot because “I don’t trust the government.” These numbers match a CBS News poll taken last month, in which 28 percent of refusers and hesitaters, combined, also said they didn’t “trust the scientists and companies that make” the vaccines. When the Harris poll pressed the government-distrusting refusers to explain themselves—about 6 percent of the entire sample—most affirmed that “the government is filled with people with ulterior motives of manipulation and control.” One in three affirmed that “the vaccine was developed to control the general population by injecting us with a microchip or tracking device.”
We’ll probably never persuade the microchip crowd. But to make headway among the other refusers, we’ll have to navigate around their suspicions. In a Harris poll taken two weeks ago, most respondents, including most hesitaters, said they trusted the COVID vaccine opinions of doctors and health care workers. But fewer than a third of refusers agreed. Many refusers are more likely to heed someone like Donald Trump, who shares their antipathy to COVID experts. In the Kaiser poll, 20 percent of Republican hesitaters and refusers, when asked about a hypothetical message from Trump promoting vaccination, said it would make them more likely to comply.
The idea of entrusting this message to Trump, whose lies and sabotage have led to more than half a million deaths in this country, is galling to many Americans. But we’ll just have to suck it up. It’s better to get over our disgust, and get these people vaccinated, than to take our chances with COVID.
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