Understanding and Identifying Vaccine Hesitancy

By | July 8, 2021

As we continue to focus on optimally providing COVID vaccinations for as many people as possible, there has been a digression into labeling those that are not yet immunized, as being “hesitant.” This labeling oversimplifies the situation and is frankly, incorrect in many cases. Simplifying such language is detrimental to our vaccine success. Similarly, when we identify people that do not always take their medication as prescribed as “noncompliant,” we are layering our own biases on others behavioral make up. Seldom do people arise in the morning proclaiming, “Today I will be noncompliant or hesitant.” Instead, they wake up professing, “How am I going to deal with all the “dis-eases” of my life?”

Though vaccine hesitancy is genuine, we are underestimating another significant component, which is, vaccine disinterest. The innate human nature of survival drives an individual to worry regarding matters that are paramount to them. It is a component of our physiologic “fight or flight” makeup. Many disagree with the impact of COVID on one’s risk of hospitalization and death, as well as the importance of masking.  So it isn’t surprising that people tune out all commentary and instead, focus on their day-to-day living. Consequently, they are just disinterested. In fact, this phenomenon is evident with all vaccinations. As we know, mandates are necessary for childhood vaccination enforcement, implementing them as a requirement for school enrollment.

Therefore, we should shift our focus to segmenting the unvaccinated into the appropriate categories of hesitancy, disinterest, apathy, or lack of vaccine convenience. The reason this is so critical is that the solutions are vastly different for each bucket. Educating those regarding the vaccine to overcome hesitancy does nothing for those merely apathetic or where convenience is the major obstacle.

There are numerous persuasion pathways available to activate people based on their “hooks,” or what drives them from a behavioral science perspective. The person who delivers the appropriate message is also critical, in addition to providing the access needed. As we continually strive for higher vaccination rates, we must first identify the barriers and then adapt our messaging and messengers to fit the situation best. This idea is no different than everyday marketing for consumer products. It behooves us to learn the lessons from other industries on how to “sell” our product. Certainly, healthcare has always been a “supply” sided industry, meaning we solve the majority of problems from our perspective. For healthcare to adapt, it must pivot to a “demand” type model. This involves understanding those we serve and delivering services and messaging within the context of their lives and behavioral makeup. Thus, our goal is to be successful, and not to proclaim that we gave it our best and it isn’t our fault if we failed.