Social networks are littered with messages that discredit the people who doubt whether or not to get the covid-19 vaccine, but these responses to an otherwise complex problem do more harm than good.
There should be no question about it: Covid-19 vaccines save lives.
Take, for example, some recent UK statistics.
In a study of more than 200,000 people, almost all 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 will 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.
Still, a significant number of people remain reluctant to be vaccinated. According to a recent report by the International Monetary Fund, this figure varies from 10% to 20% of people in the UK, to around 50% in Japan and 60% in France.
The result is something of a culture war on social media, with many commentators claiming that those who doubt the vaccine are simply ignorant or selfish.
But psychologists who specialize in medical decision-making argue that these choices are often the result of many complex factors that need to be addressed sensitively if we are to hope for achieving immunity at the population level.
Question of indecision
Let us first make some distinctions.
While it is tempting to assume that anyone who rejects a vaccine has the same beliefs, the fear of most people who doubt about vaccines should not be confused with the early theories of staunch anti-vaccines.
“They are very vocal and have a strong presence both on and off the internet,” said Mohammad Razai of St George’s Population Health Research Institute at the University of London, who wrote about the various psychological and social factors involved. t can affect people -making about faxes.
“But they are a very small minority.”
The vast majority of those who doubt about faxes have no political agenda and are not committed to an unscientific cause: they are simply undecided.
The good news is that many first-time doubters change 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 increased transmissibility of the new delta variant has increased the urgency to reach as many people as possible.
De 5 C
Fortunately, scientists began studying vaccine vaccination long before SARS-Cov-2 was first identified in Wuhan in December 2019, and they have studied several models that attempt to capture differences in vaccine behavior. People regarding health.
One of the most promising is known as the 5C model, which considers the following psychological factors:
Confidence: the person’s confidence in the effectiveness and safety of vaccines, the health care they provide, and the political leaders who decide on their implementation.
Satisfaction: if the person considers that the disease itself is a serious risk to their health.
Calculation: the participation of the individual in a comprehensive search for information to weigh costs and benefits.
Ease: how easy it is for the person in question to access the fax.
Collective responsibility (which in English would be collective responsibility, therefore it is part of the 5 Cs): the will to protect others from infection by self-vaccination.
In 2018, Cornelia Betsch from the University of Erfurt in Germany and her colleagues asked participants to evaluate a series of statements measuring each of the 5 Cs, and then compare the results with their acceptance of the relevant procedures, such as the flu or HPV (human papillomavirus) vaccine.
In fact, they found that the 5 Cs could explain the great diversity in people’s decisions and consistently performed better than many other potential predictors, such as questionnaires that were more exclusive to rights issues without considering the other factors.
In unpublished research, Betsch used the model to predict inclusion of COVID-19 vaccines, and its results so far suggest that the 5 C model may explain to a large extent variation in individuals’ decisions.
There will of course be other contributing factors. A recent Oxford University study suggests that fear of needles is a major barrier for about 10% of the population.
But the 5 C approach certainly seems to conquer the most common reasons for faxing interests.
Jessica Saleska of the University of California, Los Angeles, points out that people have two seemingly contradictory tendencies: a “negative bias” and an “optimism bias” that can tip the balance in people’s assessments of risk. And benefits.
Prejudice to negative refers to the way one evaluates events that are beyond your control. “If they present negative information to you, it tends to stay in their minds,” says Saleska.
The prejudices of optimism, on the other hand, refer to your belief in yourself, as well as belief 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 self-confidence.
Then there is the notorious fixing feature, which can also disrupt people’s perception of the risks of the virus by the availability of incorrect information from dubious sources that exaggerate the risks of faxing.
This reliance on misleading sources means that people who score high on the ‘calculation’ of the 5C scale (people who are actively looking for data) often deviate more often from faxes than people who score lower.
“If you already think that vaccination can be dangerous, then search (on the internet) by typing ‘is this vaccine dangerous?’ That all you find is information that confirms your previous opinion, ”says Betsch.
Remember that these psychological tendencies are extremely common. Even if you have accepted the vaccine, they are likely to influence your own decision making in many areas of life.
Ignoring, and assuming that those who doubt the vaccine are somehow deliberately ignorant, is in itself a foolish position.
We must also not forget the many social factors that can influence people’s decisions: the “limitations / convenience” factor of the 5 Cs.
Simply put, the perception that a vaccine is difficult to access will only delay people who are already reluctant.
When we spoke, Betsch suggested that this could delay acceptance of the vaccine in Germany, which has a very complex system for identifying who is eligible to receive the vaccine at what time.
People would respond much faster, he says, if they received push notifications.
Razai agrees that we should consider the issue of convenience, especially for those in poorer communities who may be hampered by the cost and time it takes to travel to a vaccination center.
“Traveling to and from there can be a big problem for most people who receive minimum wage or unemployment benefits,” he says.
Therefore, faxes are often best given at local community centers.
“I think there has been anecdotal evidence that it has been successful in places of worship, mosques and churches.”
Ultimately, we need to be aware of the context in which people make decisions, he says, as well as structural racism that could lead certain ethnic groups to a lower general trust in medical authorities.
It is easy to reject another’s decisions if you do not understand the challenges they face in their daily lives.
There is no easy solution, but healthcare providers can continue to provide accurate and easy-to-digest information to address major concerns.
According to a recent report from the Institute for Global Health Innovation (IGHI) at Imperial College London, the main barriers remain patient concerns about side effects and fears that vaccines have not been properly tested.
When you consider these different factors and the ways in which they can influence people’s behavior, it is also helpful to examine the various cognitive biases that are known to influence our perceptions.
Think of the first two Cs: confidence in the vaccine, satisfaction about the dangers of the disease itself.
For the first time, graphs can show 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 their safety.
This meant that the technology could be quickly adapted to the pandemic.
“None of the technologies used would be harmful in any way because we have used these technologies in other areas of health care and research,” explains Razai.
Sarah Jones, PhD candidate leading the IGHI report, suggests that a specific approach will be needed.
“I would urge governments to stop thinking they can reach the myriad of niches with a mass-market fax message and work more creatively with many effective communications partners,” he says.
That could mean working more closely with influential role models within each community, he says, who can provide “consistent and accurate information” about the risks and benefits of faxing.
Regardless of how they choose to disclose the information, health care providers need to make it clear that they are engaging in an open dialogue, Razai says, instead of simply rejecting it.
“We need to listen to people’s concerns, recognize them and provide information so they can make an informed decision.”
Saleska agrees that a two-way conversation is essential, and that we can all learn from discussing these topics with our friends and family.
“Be respectful and acknowledge their concerns. I think this can actually be more important than just talking about facts than statistics, “he says.
“Often it’s more about the personal connection than the actual information you provide.”