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Your Friend Doesn’t Want the Vaccine. What Do You Say?

Albert Tercero

Dr. Gagneur is a neonatologist and a professor of pediatrics at the University of Sherbrooke. His research has led to programs that increase childhood vaccinations through motivational interviewing. Dr. Tamerius is a former psychiatrist and the founder of Smart Politics, an organization that teaches people to communicate more persuasively.

The difference between people who eagerly want the Covid-19 vaccine and people who are hesitant is not as great as it may seem. Most vaccine holdouts are not anti-vaxxers or conspiracy theorists.

Before you demand that your loved ones get a shot, know that not all conversations are created equal. Research shows that many common persuasive styles — commanding, advising, lecturing and shaming — not only don’t work but also often backfire.

To help you learn the basics of a method that works, we’ve created a vaccination chatbot based on the principles of motivational interviewing, a research-backed approach for encouraging people to get vaccinated that’s used by health care professionals to harness people’s innate drive for change.

Hey! 👋
I heard you just got vaccinated.
Aren’t you scared?
I’ve heard a lot about it that makes me think it’s a bad idea. 😖

Now it’s your turn to respond. Choose one of the three following responses to interact with the bot:

Wait, wait, wait 😐are you an anti-vaxxer?
Covid is scarier. It’s killed more than three million people.
Oh 🤔you’ve heard some things that make you worried and unsure?
Select your reply
Wait, wait, wait 😐are you an anti-vaxxer?
Covid is scarier. It’s killed more than three million people.
Oh 🤔you’ve heard some things that make you worried and unsure?
Don’t you watch the news? People have DIED from the vaccine!
Yeah, but they were already sick and old. My chance of dying from Covid is very low.
Right. I don’t know what to do! 😫 I’m worried the vaccine isn’t safe.
Dr. Tamerius
Dr. Tamerius
Dr. Tamerius

Not a good choice. This response tells them their concerns are irrational and overblown. This will just make them defensive and angry. Try this instead:

Not a good choice. When you dismiss people’s concerns, they take it personally. As a result, they’re likely to reject what you have to say, even if it’s true. Try this instead:

Good choice! When people are anxious about getting the vaccine, the first thing they need is for you to listen to their concerns without judgment and then offer compassion. They’re more likely to trust you if they know you understand their fears, respect their perspective and care about their welfare.

Oh 🤔you’ve heard some things that make you worried and unsure?
Dr. Tamerius
Dr. Tamerius
Dr. Tamerius

Good choice! When people are anxious about getting the vaccine, the first thing they need is for you to listen to their concerns without judgment and then offer compassion. They’re more likely to trust you if they know you understand their fears, respect their perspective and care about their welfare.

Right.
I don’t know what to do! 😫
I don’t want to get Covid …
But the vaccine might not be safe ☠️
The science is pretty clear. The vaccine is safer than Covid.
OK, so you’re conflicted. You want to be safe from Covid, but you’re worried about the shot and want reassurance?
Don’t believe everything you read on Facebook. I’ll send you some reliable articles.
How would you reply?
The science is pretty clear. The vaccine is safer than Covid.
OK, so you’re conflicted. You want to be safe from Covid, but you’re worried about the shot and want reassurance?
Don’t believe everything you read on Facebook. I’ll send you some reliable articles.
No. The science isn’t clear. The vaccine hasn’t even been fully tested. I’m not going to take that risk. ☠️☠️
No. That’s OK. I’ve seen plenty in the news already. And, NO 😡 I don’t get all my news from Facebook.
Dr. Gagneur
Dr. Gagneur
Dr. Gagneur

Not a good choice. Giving advice doesn’t work because it triggers a desire to resist. Humans have an innate need for autonomy. When people sense that we’re trying to control them by telling them what to do, it generates distress and anxiety. In response, their first impulse is to rebel, even when we’re trying to be helpful. Try this instead:

Good choice! To reassure others about the vaccine, begin by reflecting their concerns — briefly summarizing what they said to show you are listening and understand why they’re hesitant. When appropriate, it’s also good to highlight their ambivalence, noting that a part of them wants the shot even though another part is wary.

Not a good choice. At this early stage in the vaccine conversation, the others aren’t ready to accept new information from you. You must first earn their trust by showing you understand and care about their concerns. Try this instead:

OK, so you’re conflicted. You want to be safe from Covid, but you’re worried about the shot and want reassurance?
Dr. Gagneur
Dr. Gagneur
Dr. Gagneur

Good choice! To reassure others about the vaccine, begin by reflecting their concerns — briefly summarizing what they said to show you are listening and understand why they’re hesitant. When appropriate, it’s also good to highlight their ambivalence, noting that a part of them wants the shot even though another part is wary.

Yes, exactly.
I want to be sure I’ll be OK if I get the shot.
You’ll be fine. This kind of fear is what’s keeping this pandemic going.
Look at me! I got vaccinated, and I’m fine. You’ll be fine, too. 😉
Doubts are normal! What scares you exactly? What would make you feel better about it?
How would you reply?
You’ll be fine. This kind of fear is what’s keeping this pandemic going.
Look at me! I got vaccinated, and I’m fine. You’ll be fine, too. 😉
Doubts are normal! What scares you exactly? What would make you feel better about it?
Well, at least I think before putting a foreign substance in my body! That’s more than I can say for you!
You mean fine so far. Who knows what will happen tomorrow? Or next week. Or next year. Besides, you’re just one person. Maybe you got lucky.
Dr. Tamerius
Dr. Tamerius
Dr. Tamerius

Not a good choice. Personal attacks don’t change minds or behavior. If anything, insulting the intelligence of vaccine-hesitant people will make them dismiss your perspective and lower the chance they’ll get vaccinated. Try this instead:

Not a good choice. Trying to directly refute others’ fears with your example will likely trigger resistance, causing them to argue. Try this instead:

Good choice! This nonjudgmental response validates their concerns and elicits more information, with an open-ended question about what they need to feel more secure. Not everyone is vaccine hesitant for the same reason. Asking a curious, nonthreatening question and listening to the answer will enable you to address their specific concerns later in the conversation.

Doubts are normal! What scares you exactly? What would make you feel better about it?
Dr. Tamerius
Dr. Tamerius
Dr. Tamerius

Good choice! This nonjudgmental response validates their concerns and elicits more information, with an open-ended question about what they need to feel more secure. Not everyone is vaccine hesitant for the same reason. Asking a curious, nonthreatening question and listening to the answer will enable you to address their specific concerns later in the conversation.

The vaccine seemed so rushed … 🏃‍♂️💨
Maybe they didn’t test it enough, you know?
How do we know they didn’t cut corners?
I was worried about that, too 😖 Can I share some stuff that made me feel better?
We can trust researchers and doctors. They know what they’re doing. 👨‍⚕️👩‍⚕️🏥
They’ve been working on a version of this vaccine since the SARS outbreak in 2003.
How would you reply?
I was worried about that, too 😖 Can I share some stuff that made me feel better?
We can trust researchers and doctors. They know what they’re doing. 👨‍⚕️👩‍⚕️🏥
They’ve been working on a version of this vaccine since the SARS outbreak in 2003.
Oh, please. Everybody is in it for the money. Especially Big Pharma. I don’t trust them one iota.
Well, it’s not like they were injecting it into millions of people like they are now. I still don’t trust it.
Dr. Gagneur
Dr. Gagneur
Dr. Gagneur

Good choice! This response validates their concerns and shows you understand where they’re coming from because you once had similar worries. Next, it asks permission before providing information. In this way it respects their autonomy and ensures they’re ready to learn.

Not a good choice. This is just another way of dismissing their concerns and telling them what to do. Rather than encourage them to consider an alternative perspective, it will make them feel frustrated and unheard. And as a result, they’ll probably take issue with your argument. Try this instead:

Not a good choice. As a general rule, you should ask before sharing information to make sure others are ready to hear it. It’s also a mistake to directly contradict what they say, even if they’re wrong. Instead, offer new information in a nonconfrontational manner to avoid triggering resistance. Try this instead:

I was worried about that, too 😖 Can I share some stuff that made me feel better?
Dr. Gagneur
Dr. Gagneur
Dr. Gagneur

Good choice! This response validates their concerns and shows you understand where they’re coming from because you once had similar worries. Next, it asks permission before providing information. In this way it respects their autonomy and ensures they’re ready to learn.

Oh, OK
Sure
Thanks
Here’s an article that lays out exactly how the vaccine was developed step by step 🤓
Do you remember the SARS outbreak back in 2003? That was caused by a virus very similar to Covid.
The research shows that the main side effects are mild fever, pain at the injection site and fatigue. So, much better than Covid, which often makes people very sick.
How would you reply?
Here’s an article that lays out exactly how the vaccine was developed step by step 🤓
Do you remember the SARS outbreak back in 2003? That was caused by a virus very similar to Covid.
The research shows that the main side effects are mild fever, pain at the injection site and fatigue. So, much better than Covid, which often makes people very sick.
Oh. OK. Kind of busy now. Maybe I’ll get to it later ...
Ugh. That sounds awful. I’m tired and sore enough as it is.
Dr. Tamerius
Dr. Tamerius
Dr. Tamerius

Not a good choice. It’s time to provide information, but this isn’t how to do it. Most people are too busy to sit down and read an in-depth history of the vaccine. Instead, share information in a way that is engaging and easy to absorb. Try this instead:

Good choice! First, this response offers relevant information about their primary concern: the speed with which the vaccine was developed. Second, it builds on their existing knowledge. Third, the question creates a collaborative process that gives them a sense of ownership over what they learn.

Not a good choice. Listing side effects to show the vaccine isn’t as harmful as they fear will probably make people more nervous, not less. Also, this doesn’t address their specific concern about vaccine development. Try this instead:

Do you remember the SARS outbreak back in 2003? That was caused by a virus very similar to Covid.
Dr. Tamerius
Dr. Tamerius
Dr. Tamerius

Good choice! First, this response offers relevant information about their primary concern: the speed with which the vaccine was developed. Second, it builds on their existing knowledge. Third, the question creates a collaborative process that gives them a sense of ownership over what they learn.

Hmm.
Interesting
So you’re saying they started working on this vaccine way back then?
Yes. And because they’ve been working on it so long and so many people have gotten it, it’s well studied and very safe.
You got it! And the way they figure out if vaccines are safe is pretty interesting 🤓🤓 Do you know much about it?
Yes. So the socially responsible thing is to get vaccinated.
How would you reply?
Yes. And because they’ve been working on it so long and so many people have gotten it, it’s well studied and very safe.
You got it! And the way they figure out if vaccines are safe is pretty interesting 🤓🤓 Do you know much about it?
Yes. So the socially responsible thing is to get vaccinated.
Hmm. Maybe. Or maybe not.
Lay off, OK? This is my decision. I don’t give a damn what you think.🙄
Dr. Gagneur
Dr. Gagneur
Dr. Gagneur

Not bad, but also not the best choice. The weakness of this response is that it tells others what to think rather than let them draw their own conclusions about the evidence. This can generate resistance and prevent them from developing a sense of ownership over their new knowledge. Try this instead:

Good choice! This response works for three reasons. First, it affirms their efforts to figure things out with your guidance. Second, it refers to existing knowledge, so new knowledge can be integrated with old. Third, it encourages construction of concepts that support vaccination.

Not a good choice. Commanding the other person to get vaccinated is even less effective than recommending it. No matter how good your reason, they will resist attempts to control their behavior and seek to reassert their autonomy. Try this instead:

You got it! And the way they figure out if vaccines are safe is pretty interesting 🤓🤓 Do you know much about it?
Dr. Gagneur
Dr. Gagneur
Dr. Gagneur

Good choice! This response works for three reasons. First, it affirms their efforts to figure things out with your guidance. Second, it refers to existing knowledge, so new knowledge can be integrated with old. Third, it encourages construction of concepts that support vaccination.

Um 🤔🤔🤔
Maybe they compare whether more people get sick …
Depending on whether people were vaccinated or not?
Right. And unvaccinated people got sick and died ☠️ a lot more than people who were vaccinated.
Sort of 🤓 It’s a little more complicated than that because they’re looking at side effects from the vaccine and Covid symptoms separately.
Yeah, exactly! They looked at vaccinated and unvaccinated people, then found out who got Covid and what their side effects were. Kind of cool, right? 😎
How would you reply?
Right. And unvaccinated people got sick and died ☠️ a lot more than people who were vaccinated.
Sort of 🤓 It’s a little more complicated than that because they’re looking at side effects from the vaccine and Covid symptoms separately.
Yeah, exactly! They looked at vaccinated and unvaccinated people, then found out who got Covid and what their side effects were. Kind of cool, right? 😎
OK … But maybe the people who got the Covid shots just haven’t gotten sick from them yet …
Oh. Well, whatever 🙄 I never was good at biology. Still, I know it’s generally not a good idea to inject foreign substances into my body.
Dr. Tamerius
Dr. Tamerius
Dr. Tamerius

Not a good choice. This response is problematic because it offers more information than requested and draws conclusions, cutting short other people’s opportunity to figure things out for themselves. Try this instead:

Not a good choice. This response is problematic because it provides unnecessary information and focuses more on what’s wrong than what’s right with what they said. Instead, try to provide affirmation for what they get right. Try this instead:

Good choice! This response works for three reasons. First, it affirms others’ ability to master the material, which in turn increases their confidence. Second, it offers new information within a collaborative relationship that respects their autonomy. Third, the question at the end verifies understanding.

Yeah, exactly! They looked at vaccinated and unvaccinated people, then found out who got Covid and what their side effects were. Kind of cool, right? 😎
Dr. Tamerius
Dr. Tamerius
Dr. Tamerius

Good choice! This response works for three reasons. First, it affirms others’ ability to master the material, which in turn increases their confidence. Second, it offers new information within a collaborative relationship that respects their autonomy. Third, the question at the end verifies understanding.

Hmm, OK
That makes me feel a little better 🙃
But even if it’s mostly safe
Maybe it’s still more dangerous than getting Covid, since I’m young and healthy 💪
Yeah, I wondered about healthy people, too, and it turns out we're more likely to be struck by lightning than have a bad reaction to a shot. Does that help?
Nah! You’re three times as likely to be struck by lightning as to have a deadly reaction to a Covid shot ⚡️But Covid is deadly.
No. Besides, it’s not just about you. If you care about others, you’ll get the shot to protect them.
How would you reply?
Yeah, I wondered about healthy people, too, and it turns out we're more likely to be struck by lightning than have a bad reaction to a shot. Does that help?
Nah! You’re three times as likely to be struck by lightning as to have a deadly reaction to a Covid shot ⚡️But Covid is deadly.
No. Besides, it’s not just about you. If you care about others, you’ll get the shot to protect them.
I don’t know. No one I know has died of Covid, but my third cousin Carl was on an airplane that was struck by lightning back in the ’90s. It seems rare, but it happens.
Don’t you dare run a guilt trip on me! Everything I do is to protect others! Staying home, wearing a mask, avoiding people I love. I just don’t want to do this ONE thing.
Dr. Tamerius
Dr. Tamerius
Dr. Tamerius

Good choice! This response works for two reasons. First, it avoids direct contradiction of incorrect information. Instead, it highlights what they got right and adds to their knowledge using “yes and.” Second, it offers new information in the context of your experience rather than by itself or in the form of an argument. This narrative form is less threatening and more memorable.

Not a good choice. Directly contradicting the other person triggers resistance. Instead, whenever possible, replace “no” with “yes and” to avoid a struggle over who is right and who is wrong. Try this instead:

Not a good choice. Shaming doesn’t make people more likely to get vaccinated. It makes them defensive, angry and resistant. Instead of making them feel bad about their hesitancy, foster positive thoughts and feelings about vaccination. Try this instead:

Yeah, I wondered about healthy people, too, and it turns out we're more likely to be struck by lightning than have a bad reaction to a shot. Does that help?
Dr. Tamerius
Dr. Tamerius
Dr. Tamerius

Good choice! This response works for two reasons. First, it avoids direct contradiction of incorrect information. Instead, it highlights what they got right and adds to their knowledge using “yes and.” Second, it offers new information in the context of your experience rather than by itself or in the form of an argument. This narrative form is less threatening and more memorable.

Yes. I’m definitely feeling better. The vaccine doesn’t seem so scary now that I know more. Maybe I will get it after all. Thanks for talking with me about it.
Absolutely. I’m glad you’re thinking this through. Happy to talk more whenever you want.

How did it go? You probably found that some responses moved the vaccine conversation forward while others brought it to a screeching halt. The skills introduced here are the same ones needed in any conversation in which you want to encourage behavior change, whether it’s with your recalcitrant teenager, a frustrated co-worker or a vaccine-hesitant loved one. When you talk with people about getting vaccinated, there are four basic principles to keep in mind:

Safety and rapport: It’s very difficult for people to consider new ways of thinking or behaving when they feel they are in danger. Vaccine conversations must make others feel comfortable by withholding judgment and validating their concerns. Rather than directly contradict misinformation, highlight what they get right. Correct misinformation only late in the conversation, after they have fully expressed their concerns and have given you permission to share what you know.

Respect for autonomy: The choice of whether to get vaccinated is others’ to make, not yours. You can help guide their decision-making process, but any attempt to dictate the outcome — whether by commanding, advising, lecturing or shaming — will be met with resistance.

Understanding and compassion: Before people will listen to what you have to say, they need to know you respect and appreciate their perspective. That means eliciting their concerns with curious, open-ended questions, showing you understand by verbally summarizing what you’ve heard and empathizing with their worries.

Collaborative learning: The best way for people to absorb new information is for them to play a part in the process of discovery. Rather than tell them what to think, it’s best to share what you know in the form of a narrative that is subject to their interpretation or through a back-and-forth process of question and answer that helps them learn

In other words, trust your loved ones. When you make an effort to understand their perspective, refrain from judgment and respect their autonomy, positive change becomes more likely.

Arnaud Gagneur is a neonatologist and a professor of pediatrics at the University of Sherbrooke. His research has led to the development and implementation of a program to increase childhood vaccinations through the use of motivational interviewing with parents in maternity wards in Quebec.

Karin Tamerius is a former psychiatrist and the founder of Smart Politics, a nonprofit dedicated to teaching progressives how to communicate more productively and persuasively with people across the political spectrum.