Social networks are full of publications that discredit those who doubt whether or not to get the covid vaccine – 19, but these reactions to an otherwise complex issue are doing more harm than good.
There should be no question about it: covid vaccines – 19 are saving lives.
Take some recent UK statistics as an example.
In a study that followed more than 102. 000 people, nearly all of the participants had developed antibodies to the virus within two weeks of their second dose.
And despite initial concerns that current vaccines may be less effective against the delta variant, analyzes suggest that both AstraZeneca and Pfizer-BioNTech reduce hospitalization rates by 92 – 96% .
As many health professionals have repeated, the risks of serious side effects of a vaccine are minimal compared to the risk of the disease itself.
Even so, a considerable number of people continue to be reluctant to apply the vaccine . According to a recent report by the International Monetary Fund, this figure ranges from 10% and the 19% of people in the UK, around 50% in Japan and the 60% in France.
The result is turning into a kind of culture war on social media, and many commentators claim that vaccine doubters are simply ignorant or selfish.
But psychologists who specialize In medical decision making they argue that these choices are often the result of many complicated factors that must be addressed with sensitivity , if we are to have any hope of achieving immunity at the population level.
Question of indecision
First, let’s make some distinctions.
While it is tempting to assume that anyone who rejects a vaccine has the same beliefs, the fears of most people who doubt vaccines should not be confused with the strange theories of staunch anti-vaccines.
“They are very vocal and have a strong presence both on and off the internet,” says Mohammad Razai, from the St George’s Population Health Research Institute of the University of London, who has written about the various psychological and social factors that can influence people’s decision-making about vaccines.
“But they are a very small minority.”
The vast majority of those who doubt vaccines do not have a political agenda and are not committed to an unscientific cause : they are simply undecided.
The good news is that many people who initially doubted are changing their minds.
“But even a delay is considered a health threat, because viral infections spread very quickly,” says Razai.
This would have been problematic if we were still dealing with the older variants of the virus, but the higher transmissibility of the new delta variant the urgency to reach as many people as possible as quickly as possible has increased.
The 5 C’s
Fortunately, scientists began studying vaccine vacillation long before SARS-Cov-2 was first identified in Wuhan in December 2019, and have explored various models that attempt to capture differences in people’s health behavior.
One of the most promising is known as model of 5 C , which considers the following psychological factors:
Confidence: the person’s confidence in the efficacy and safety of vaccines, the health services that offer them and the policy makers who decide on their implementation.
Complacency: if the person considers that the disease itself is a serious risk to their health.
Calculation : the individual’s participation in an extensive search for information to weigh costs and benefits.
Convenience: how easy is it for the person in question to ac give in to the vaccine.
Collective responsibility (which in English would be collective responsibility , that is why it is part of the 5 C ): the will to protect others from infection through one’s own vaccination.
In 2018, Cornelia Betsch of the University of Erfurt in Germany and her colleagues asked participants to rate a series of statements that measured each of the 5 Cs, and then compared the results with their acceptance of relevant procedures, such as the vaccine against influenza or HPV (human papillomavirus).
Indeed, they found that the 5 Cs could explain the great variety in people’s decisions and consistently outperformed many other potential predictors, such as questionnaires that focused more exclusively on trust issues without considering the other factors.
In an unpublished research, Betsch used the model to predict the acceptance of covid vaccines – 19, and their results so far suggest that the 5 C’s model can largely explain the variation in people’s decisions .
There will be other contributing factors, of course. A recent study from the University of Oxford suggests that the fear of needles is a major barrier to around the 10% of population.
But the 5 C’s approach certainly seems to capture the most common reasons for doubts about vaccines.
Confirmation bias
Jessica Saleska, University of California, Los Angeles, points out that humans have two seemingly contradictory trends: a “negativity bias” and an “optimism bias” that can tip the balance in people’s assessments of risks and Benefits.
Negativity bias refers to the way one evaluates events that are beyond one’s control. “When they present negative information to you, that tends to stay in their mind,” says Saleska.
The optimism bias, on the other hand, refers to your beliefs about yourself, such as believing that you are fitter and healthier than the average person.
These biases can work independently, meaning you can focus on the dangerous side effects of vaccines while believing that you are less likely to have the disease, a combination that would lower confidence and increase complacency.
Then there is the famous confirmation bias , which can also distort people’s perceptions so The risks of the virus through the availability of misinformation from dubious sources that exaggerate the risks of vaccines. of “calculation” of the 5 C scale (people who actively seek data) tend to be more averse to vaccines than people who obtain a lower score.
“If you already believe that vaccination could be dangerous, so you search (on the internet) by typing ‘is this vaccine dangerous?’ So all you will find is information that confirms your previous opinion ”, says Betsch.
Context
Remember that these psychological tendencies are extremely common. Even if you have accepted the vaccine, they have probably influenced your own decision making in many areas of life.
Ignore them, and assume that those who have doubts about the vaccine are somehow deliberately ignorant, It is in itself a foolish position.
Nor should we forget the many social factors that can influence people’s decision: the “limitations / convenience” factor of the 5 Cs.
Simply put, the perception that a vaccine is difficult to access will only put off people who are already reluctant.
When we spoke, Betsch suggested that this could have slowed the acceptance of the vaccine in Germany, which has a very complicated system for identifying who is eligible at what time to receive the vaccine.
People would respond much faster, he says, if they received push notifications.
Razai agrees that we need to consider the question of convenience, particularly for those in poorer communities who may be hampered by expenses and the time it takes to travel to a vaccination center.
“Traveling to and from there can be a great problem for most people who receive minimum wage or unemployment benefits, ”he says.
That is why vaccines are often best administered at local community centers.
“I think there has been anecdotal evidence that it has been more successful in places of worship, mosques, and churches.”
Finally, we must be aware of the context in which people make decisions, he says, such as structural racism that could have led certain ethnic groups to have lower overall confidence in the a Medical authorities.
It’s easy to dismiss someone else’s decisions if you don’t understand the challenges they face in their daily lives.
Distrust
There is no easy solution, but health authorities can continue to provide accurate and easy-to-digest information to address major concerns .
According to a recent report by the Global Health Innovation Institute (IGHI) at Imperial College London, the main barriers remain patients’ concerns about side effects and tem or that the vaccines have not been adequately tested.
When considering these different factors and the ways they may be influencing people’s behavior, it is also helpful to examine the various cognitive biases that are known to influence our perceptions.
Consider the first two Cs: confidence in the vaccine, complacency on the dangers of the disease itself.
For the first, graphs showing the relative risks of vaccines, compared to the actual disease, may provide some context.
For the latter, Razai suggests that we need more education on the history of vaccine development.
The use of mRNA in vaccines has been studied for decades, for example, with long trials proving its safety.
This meant that the technique could be rapidly adapted for the pandemic.
“None of the technologies that have been used would be in any way harmful, because we have used these technologies in other areas of healthcare and research,” he explains. Razai.
Open dialogue
Sarah Jones, PhD researcher who co-directed the IGHI report, suggests that a specific approach will be necessary.
“I would urge governments to stop thinking that they can reach the large number of niches that exist with a vaccine message to the mass market and working more creatively with many effective communication partners, ”he says.
That could mean closer collaborations with influential role models within each community, he says, who can provide “consistent and accurate information” on the risks and benefits of vaccines.
Regardless of how they choose to disclose information, health services must make it clear that they are engaging in an open dialogue, says Razai, rather than simply dismissing them.
“We have to listen to people’s concerns, acknowledge them and give them information so that they can make an informed decision.”
Saleska agrees that a two-way conversation is essential, and that is something we could all learn from discussing these topics with our friends and family.
“Be respectful and acknowledge their concerns s. I think this could actually be more important than just talking about the facts or the statistics, ”he says.
“Many times, it is more about the personal connection than the actual information you provide.”
This article was published on BBC Future. Click here to read the original English version.
David Robson is the author of The Intelligence Trap: Why Smart People Do Dumb Things ( “ The intelligence trap: why smart people do dumb things ”). Your next book or The Expectation Effect: Transform Your Health, Fitness, Productivity, Happiness and Aging will be published at 2019 .
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