As the months go by and the pandemic drags on, it only gets harder for Amber Giese to talk with her parents about the coronavirus vaccine. Each time she brings it up, the conversation devolves into an argument. Facts and data don’t seem to register. Emotional appeals haven’t worked either.
It's even more frustrating when the 33-year-old from Milwaukee considers the worrying turn the public health crisis has taken lately. The highly transmissible delta variant of the novel virus is rapidly driving infections and hospitalizations back up for the first time in months. Yet her parents refuse to get the shots.
"It's exhausting, so I've started to back off lately. But I think about it a lot, especially now that the delta variant is spreading aggressively among the unvaccinated," Giese said. "I think about it daily."
The vaccines are proven safe and are more widely available than ever, but countless Americans still find themselves in the same position as Giese, struggling to convince vaccine-hesitant loved ones of the importance of getting inoculated. Even in the face of what the Biden administration warns could be a "pandemic of the unvaccinated," millions of people are avoiding the jabs or rejecting them outright.
There's evidence that vaccine resistance is hardening. A recent Washington Post-ABC News poll found that 29% of Americans said they are unlikely to get vaccinated. That's up from 24% three months ago.
But experts say there's still plenty of room to reach friends and family who have held out on getting the shots - it just might take closer listening, a refined message and more patience.
"The effort is worthwhile," said Stacy Wood, a professor at North Carolina State University who has studied coronavirus vaccine promotion. "A lot of people are convinced over time from small bits of information that trickle in."
Here's what experts say about navigating these difficult conversations.
- Be a good listener. People cite a range of reasons for being reluctant or unwilling to get the coronavirus vaccines. Some view their refusal as an integral part of their political identity. Others, particularly members of minority populations, may hold a long-standing distrust of government institutions or health-care companies that have historically failed them. Before even opening up a discussion, it's essential to consider why a person holds their beliefs, experts said.
"Realize that all the different reasons for why people aren't currently vaccinated are diverse and various," Wood said. "You can't start persuading someone unless you know what reason is the real hurdle."
Moreover, not all vaccine hesitancy is rooted in personal beliefs or ideology. For many people, practical considerations - seemingly minor complications at home or at their job - may be holding them up. Those things may not be obvious, even to close friends and family.
"Maybe they have to take days off work, maybe have trouble with transportation or child care," said Gretchen Chapman, a professor of social and decision sciences at Carnegie Mellon. "Don't make assumptions about what the barrier is. Listen to them and hear where they are. There could be a reason that surprises you."
- Tailor your message. Behavioral scientists, psychologists and marketing specialists who study vaccine uptake tend to divide the hesitant into a few general groups, all with a degree of overlap. One group is the apathetic, those who view the shots as an inconvenience or unnecessary given their circumstances. Another includes people who are skeptical of the medical science behind the shots or wary of their safety. A third is made up of people who refuse the shots for political or ideological reasons.
It's important to think about who you're approaching, experts said. A friendly nudge to a college student who simply wasn't motivated to get the jab probably won't fly with a longtime vaccine skeptic who takes his health cues from Facebook memes.
For the apathetic group, incentives tend to work well, according to experts. Wood said it may help to barter with these individuals.
"You can say, 'I get it. I respect your decision that it's not that important to you, but it's causing me to lose sleep. What can I do for you that would make it worthwhile?' " she said. " 'Can I mow your lawn? Can I take your kids for the weekend? Let's trade.' This is the kind of thing that family can do that the CDC can't do."
Those who distrust the vaccine because they think it was approved too quickly or wasn't properly vetted may be more difficult to convince. For them, a logical appeal may carry more weight, according to Wood. She proposed framing the decision as a choice: "Should you take a chance on the vaccine or should you take a chance on covid?"
People who oppose vaccines for political or identity reasons can be the hardest to approach. They're often surrounded by like-minded people in their communities and social networks, where their beliefs are continually reinforced. This can make changing course a challenge because it feels like changing an aspect of their identity.
"We humans like to be consistent," Chapman said. "If I've said now for months and I've illustrated to myself that I'm the sort of person who's not going to get vaccinated, now I need a cover story to change my mind."
A good approach, experts said, is to point them to people who share their identity who have argued in favor of vaccinations. "Here's someone you really respect of the same political persuasion, and they say you should do it," Wood said. "It's making the narrative fit the identity."
- Focus on your relationship and avoid debate. Data on the safety and efficacy of vaccines is easy to come by. But pelting vaccine holdouts with facts and figures is all but certain to be a losing strategy, experts said. If anything, it will probably cause them to dig in further.
Health workers sometimes use "motivational interviewing" - which involves asking questions about what might boost people's confidence in the shots - to address vaccine hesitancy. Experts said this approach may be useful in one-on-one conversations too. But it can be a difficult balance, especially in this stage of the country's mass immunization campaign.
"We're in a tough place right now," Chapman said. "People who have held out, they have some reason they don't want to get vaccinated. The easy customers, we've already convinced them. We're now down to tough customers."
Wood echoed her concerns. "The evidence is piling up that the vaccine is good. But the personal evidence that they don't need it is also piling up," she said. "Until that person actually gets ill, they have evidence - personal evidence - that they don't need it."
De-escalation is key if a vaccine conversation gets heated. Trying to get the last word in a debate could only inflame things further, experts said. Instead, they said, it's important to remind people that your love or friendship is why you're approaching them in the first place.
"You have to keep saying over and over again how much the person means to you," Wood said.
"You don't have to be successful right off the bat or in some conventional way," she said. "But they themselves will feel better and the relationship will only grow if you let people know you're concerned about their health because you want them around."
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The Washington Post’s Allyson Chiu contributed to this report.