COVID-19 vaccine hesitancy: where it's originating from and how to overcome it

By Maria Elena Villar, Ph.D. and Susan Jacobson, Ph.D.

In December of 2020, the first people in the United States received the COVID-19 vaccine, potentially marking the beginning of the end of the shutdowns, masks and social distancing that has characterized life during the pandemic.  

While there was much excitement about the arrival of the vaccine, there is also some skepticism, with polls showing that up to 30 percent of Americans say they are not sure that they will get the vaccine. Even among health care providers, there is substantial vaccine hesitancy.

Where does this hesitancy come from? And what can be done to help people understand the risks and benefits and make informed decisions based on their values and self-interest? 

At the Steven Cruz Institute for Media, Science + Technology (SCI), housed in the College of Communication, Architecture + The Arts (CARTA), we research science communication and investigate how to effectively communicate science to general audiences. We see the following issues associated with science communication around the COVID-19 vaccine.

Medical jargon 

Vaccine communication must be empathetic and people-centered, addressing people’s fears and concerns, while also providing accurate and transparent facts that are relevant to their needs. However, this isn’t always the case.

Stories about the COVID-19 vaccines are often filled with medical jargon that is unfamiliar to the general public, making them hard to understand. The structure and phases of clinical trials, for example, are concepts that most people are unfamiliar with. Both the Pfizer and Moderna vaccines use a new mRNA technology to create an immune response within the human body. Most Americans, however, are unfamiliar with how the immune system works, and many believe that vaccines can cause disease-promoting vaccine hesitancy.

One thing science communicators should do to counteract this is provide exposure to counterarguments to prepare people to resist misinformation. For example, discussing routine side effects of the vaccine and advising the public to practice healthy skepticism when hearing about other side effects from outside sources.  

Trust

Messages about the vaccine come from a variety of sources, and these sources have a variety of motivations. Historically, Americans have had high levels of trust in the Centers for Disease Control (CDC), which has been a key source of information about the COVID vaccine. However, the CDC’s reputation has suffered during the pandemic for several reasons. For example, early COVID-19 test results were shown to be faulty. 

On the other side of the spectrum, there has been a small, but enduring, strain of vaccine skepticism in the United States, where arguments about vaccine safety, health freedom and suspect pharmaceutical industry motivations have been surfacing since the 1990s.  

The politicization of the pandemic itself by both politicians and news organizations has further fueled confusion in the general public regarding COVID-19 and how, or whether, to try to minimize its spread. The choice of the title “Operation Warp Speed” for the development of the vaccine, and its approval under Emergency Use Authorization (EUA) designation, may also reinforce the notion that the vaccine approval was rushed for political purposes, without the standard safeguards for safety. 

Another great source of mistrust around vaccines is the shameful history of abuse of minority communities in clinical trials and the continuing inequality in access to care. Many communities have valid reasons to think that the health care system and the “pharmaceutical industrial complex” do not have their best interest at heart. Overcoming this kind of mistrust will require working directly with communities, finding credible spokespersons and a commitment on the part of the public health system to distribute the vaccine equitably and with transparency. 

Misinformation and disinformation

There is a lot of commentary in the news about misinformation and disinformation associated with the COVID-19 pandemic and the vaccines.

Misinformation is misleading information that is shared in error, without the sharer realizing that the information is misleading. For example, a friend sharing a social media post that claims, without evidence, that eating a particular food will help fend off infection. Your friend may think that they are doing you and everyone in their network a favor by sharing this information, unaware that it is false.

Disinformation occurs when someone knowingly shares information that is misleading and that is designed to cause harm. An example might be when a politician spreads false rumors about a political rival.  

Research has shown that misleading information spreads faster than true information online, in part because misleading information may be more novel. As a result, misleading information may be spread by individuals who wish to grow their online audience size. When faced with farfetched stories related to the vaccine, social media users should practice healthy skepticism and check the source.  

Risk and uncertainty

Risk communication is one of the most challenging aspects of promoting vaccine confidence ethically. We have to provide people with the information they need to make an informed decision, without bogging them down in the statistics. But we also need to be honest about the uncertainty of a new vaccine.   

The answer to the question “Is it safe?” is not a simple yes or no. Interpreting risk requires weighing the severity and likelihood of a negative outcome with the likelihood and expected benefit of a protective action. Therefore, how the media, medical professionals, policymakers and community leaders talk about these probabilities of harm versus benefit will play a major role in how the public assesses risk and makes decisions about getting the vaccine.

Media framing

How different media outlets and sources frame stories about the COVID-19 vaccine also shapes the vaccine narrative in the minds of the public. Framing is when the media selects some aspects of a perceived reality and make those aspects more relevant, in order to promote a particular problem definition. For example, media may frame the COVID-19 vaccine as the beginning of a return to normal life or emphasize the safety of the vaccine.

The media must be careful about framing the vaccine as the end to all COVID troubles. There is still much to learn about the vaccine and the disease, and recommendations may change as the data comes in. We must prepare people for this, frame it as a normal process of scientific development, and be transparent about what we know and don’t know – the good and the bad – to foster trust.