Medical Examiner

What if We Can’t Change Vaccine Skeptics’ Minds?

A hand holds a vaccination needle.
A health care worker prepares a dose of a COVID vaccine in Skopje, North Macedonia, on Wednesday. Robert Atanasovski/AFP via Getty Images

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Dan Diamond, a health reporter for the Washington Post, recently noticed some polling that showed how white Republicans have grown more likely to say they’d refuse a vaccine. Right now, the best protection from the coronavirus virus is a vaccine, and it turns out the people who most staunchly oppose the shot fall within this group. Diamond has been talking to these vaccine skeptics to try to figure out what kinds of messages can reach them—but even if they can be swayed, will the government be able to get to them in time to establish herd immunity? I spoke with Diamond about the myriad problems posed by this skepticism on Wednesday’s episode of What Next. Our conversation has been edited and condensed for clarity.

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Mary Harris: I think it’s important that we acknowledge how important Trump is to most of the people you talked to, and how his own back-and-forth over vaccines could have been confusing to his supporters. He’d talked about an autism link to vaccines before he was president, which, of course, has been disproven. And once COVID happened, he would say it wasn’t serious, it’s just the flu—and then he himself got COVID, went to the hospital, but then came out and said, I’m stronger for it.

Dan Diamond: I think “back-and-forth” is almost generous to him. I was talking to some former officials who worked closely with him, and they made the point that just getting him to get the flu vaccine, which has been around for decades, was a real effort. Trump’s a guy who is not easily convinced that vaccines are necessary. The incredible irony is that perhaps the most vaccine-hesitant president we’ve had is the president who was in charge of this vaccine breakthrough and rollout. But with Trump, talking about the vaccine wasn’t a public health issue to him. It was really in the context of, look at this political victory.

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You mentioned that when you spoke to one of these vaccine-hesitant Trump voters and brought up that Trump helped develop the vaccine, it didn’t seem to move her. Why not?

I brought it up with every voter that I talked to. Some were more amenable than others to Trump’s involvement. One gentleman told me, “Well, that does make me think twice now that you bring it up.” But the lady you’re referencing said Trump didn’t develop the vaccine, that scientists did it, and that Joe Biden didn’t do it. It exists in this weird space. Trump supporters think he was wronged by the media, not just around the coronavirus but also in how the pandemic was portrayed. A lot of them believe the pandemic was used in a way to damage Trump politically. With vaccines, Trump isn’t getting the credit that perhaps he deserves, but the vaccine itself is not Trump’s creation. And a number of folks said to me he should get the vaccine. He’s out there doing all this risky behavior. He doesn’t wear a mask. One guy told me, Trump needs a vaccine, and I’m staying home and I’m doing everything that I should be doing to avoid the coronavirus. It’s worked for a year. Why do I need to be first or third mine or 10th in line to go get the vaccine? Maybe I’ll go in a year.

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I was struck by the fact that many of the Republicans you spoke with had a kind of supercharged, individualistic response to this vaccine. They done their own research and found that they doubted the vaccine, or some of them even had COVID and didn’t think it was so bad. These were the reactions of people who are purely making the decision for themselves, and it made me wonder if the messaging around the vaccine needed to change.

There was a campaign unveiled a few weeks ago by the private sector, led by a group called the Ad Council, which is the industry consortium that has made public health ads dating back decades. If you know Smokey Bear, “Friends Don’t Let Friends Drive Drunk,” those were Ad Council creations. The campaign they came out with for COVID is called “It’s Up to You,” which I initially took as a call for individual responsibility. But when I asked about that, they said, no, the goal is not convincing people that it’s their responsibility. They’re trying to acknowledge the hesitancy.

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Pollster Frank Luntz is doing lots of surveys right now to get the messaging right around the COVID vaccines.

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Luntz and his team found that saying “emergency use authorization”—the technical term for what the Food and Drug Administration decided to do with the vaccines, in lieu of “approving” them—alarms Americans.

It stood out to me that he’s finding all of these little nooks and crannies of understanding how people want to talk about the vaccine that I hadn’t even thought of, like people prefer the word vaccine to jab.

The messaging that Luntz found is centering in on things like “if you get the shot, you’ll be able to spend more time with your family.” Making it personal matters a lot more than getting the shot so the economy can come back.

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Can the United States reach herd immunity without these groups of white Republicans getting vaccinated?

There are a couple of ways to reach herd immunity. One is everybody gets sick. Another is everyone gets vaccinated. I guess a third is some people get sick and get immunity that way and others get vaccinated and we get to a level of immunity that makes the virus hard to spread.

But can we get to a place public health experts want us to get to? Tony Fauci has said we might need nearly 90 percent of the population vaccinated. If I’m doing back-of-the-envelope math, Donald Trump got almost 75 million votes. If about one-third of adult Republicans don’t want to get the vaccine, that’s 25 million. And that’s not necessarily including the communities of color where there still is vaccine hesitancy. So maybe 10 percent of all adults in the country could fall into this bucket of not wanting want a vaccine. Could we still get to herd immunity with enough other people getting vaccinated as well as people who don’t get vaccinated? That’s less ideal, because the more people who get sick with the coronavirus, the higher likelihood there is that mutated forms of the coronavirus will emerge. If I’m sick and I didn’t get the vaccine and I had COVID in my system for days or weeks, the virus can develop mutations that might emerge and make it harder for the vaccines in circulation to stop the mutated form from spreading.

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I guess I worry we could end up having herd immunity some places and not others. And those people who are vaccinated, who feel like they’re safe, are traveling. Then you go to a place, maybe get a mutated version of the coronavirus, and then have something that’s harder to stop.

I think that’s the fear of public health experts too.

And we might have to keep getting vaccinated. That’s the thing I keep thinking about. We have these new variants. We may have to get booster shots. This might be something we’re going to have to keep messaging for a while. And I guess you can think about that as: We’ll have more opportunities to convince people and show people how things work. But there are also more opportunities for things to fall through the cracks.

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Right. And some of the Republican voters I talked to even made that point that they’ve heard we might need to be vaccinated every year, like a flu shot. So several of them said, why should I be first in line to get this COVID vaccine when I’ll have to come back in six months, nine months, next year? Why don’t I just wait until next year? So the reality of needing to get vaccinated regularly against COVID, which seems to be where we’re heading—that is being used by some holdouts as a reason not to get vaccinated at all.

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