Scientific arguments to use when talking to COVID-19 vaccine sceptics

Recent reports on certain COVID-19 vaccines, coupled with the decision by some states and authorities to restrict their use within certain age groups, have prompted mistrust, notably decelerating the rhythm of vaccination.

According to the most recent CIS survey, some 6.5% of Spanish society will refuse the vaccine when their turn comes around, and 5% are still hesitant or have not yet decided what they will do. This percentage has also increased following recent reports. 

After reports from the European Medicines Agency on rare cases of blood clots among recipients of one of the vaccines, the number of people failing to turn up for their vaccination appointments or directly refusing the vaccine, explicitly motivated by the issues raised and the potential associated risks, has multiplied. In the Community of Madrid, to give just one example, figures show that the number of people refusing to be vaccinated jumped from 3% in late March to over 60%, owing to recent reports and to decisions made in mid April regarding the administration of the vaccine in some age groups. 

"Information mismanagement and decisions based on unscientific, anti-statistical criteria have dealt a heavy blow to vaccine confidence. Caution is a fundamental aspect and we need to remain alert and investigate each case, but we also have to be aware that all drugs have secondary effects and that these vaccines are no different from the thousands of other drugs that we have taken before and that we take every day", says Salvador Macip i Maresma, doctor and lecturer at the UOC Faculty of Health Sciences, Head of the Mechanisms of Cancer and Ageing Laboratory at Leicester University and science writer, who considers that the issue has been exaggerated.

Arguments of anti-vaxxers

The following are some of the arguments based on individual liberties, secondary effects or risk, used by people to turn down the vaccine or raise doubts about the campaign. "While getting vaccinated or not is an individual issue, it is also a community one, as not getting vaccinated affects society and those around us, so it is partly a civic matter", says Macip.

In this regard, Manuel Armayones, psychologist, lecturer in Psychology and Education Science, and researcher with the UOC eHealth Center, points out that agreeing to get the vaccine is an altruistic move, benefiting not only oneself but also wider society. "By getting vaccinated, we are contributing to building a safer society, one that cares for the wellbeing of all citizens, including its most fragile and vulnerable members, such as old people, and people who, for whatsoever reason, cannot be vaccinated", says Armayones.

Taking the information in context, we see that among vulnerable groups, such as the elderly, who are more prone to health problems and complications, deaths in nursing homes fell from 700 a week in January and February, to just two a week in March, according to IMSERSO records, a drop that can be attributed to mass vaccination in nursing homes over the first few months of the year. 

Another misgiving of anti-vaxxers is the speed with which the vaccines have been developed, overlooking the massive financial and professional investment made over the past year. 

"Europe is using very innovative vaccines, but that does not mean that they are new or that they were invented last year. RNA vaccines were first put forward 20 or 30 years ago and a lot of research has gone into developing them since then. What's more, clinical trials were already underway before the pandemic hit, but the results have been expedited because of the pandemic and the huge investment that has been put into them," says Macip. 

Increased motivation

Another of the fundamental aspects towards gaining social acceptance and massive COVID-19 vaccination is human behaviour. In other words, we need to create an environment that favours our goal. For this to be possible, three essential factors need to concur, i.e. people must be able to receive the vaccine, they must be motivated to do so and they must receive a "signal" to do so. 

"We have the capacity to be vaccinated, because everybody will be offered vaccination free of charge and because, as a group, we are fortunate to have skilled professionals and a healthcare system that provides the time and place in which to do it. On the other hand, the third component required for vaccination to take place, i.e. the signal, is transmitted to each person individually, by means of a call or message. If this is not possible for whatsoever reason, each Autonomous Community is equipped with the means to let everybody to know when they are due for vaccination", says Armayones.

Armayones also agrees with other investigators around the world that the main challenge to mass vaccination is motivating people, particularly right now, when we are being bombarded with disinformation in the media and particularly social media. He adds that, that in order for the message to be effective, it must be easily understood and adapted to each social group, and that people's doubts must be listened to and clear answers offered in response. Another strategy for increasing motivation is to recruit influential persons as role models, to persuade people who may still be hesitant by their example. 

In this way, information must be used in a balanced manner, using verifiable facts to help people understand the enormous benefits of COVID-19 vaccines compared to the risks of failure to take action. "Unfortunately, there will always be a percentage of sceptics who won't listen to reason, but if we provide scientifically validated data in a clear, graphic manner, and establish reliable channels of communication, via social media and platforms, this percentage will be minimal and will not be an issue. However, if the percentage increases, the social risk is far more serious," says Macip. 

Keys to overcoming doubts 

In this regard, the best tools for winning over vaccine sceptics and other people with qualms about possible risks are based on transparency of information and a positive focus on the current vaccination situation and the benefits of herd immunity to society. 

"We need to highlight the positive aspects of vaccination compared to the negative effects of not being vaccinated, basically the high death rate and the null possibilities of economic and social recovery, when vaccination is part of the solution. The fact is that vaccination offers benefits not only to the recipient as an individual, but also to society as a whole", says Armayones, who suggests looking at the flip side as a bleak alternative: what would happen if scientists had not developed vaccines against the pandemic? How much longer would society have been able to hold out without a much harder global crash than the one we are already living through, particularly in certain sectors?

Likewise, we have to emphasize the importance of accurate, verifiable information, easily understood by the general public, to explain the data in context, instead of extraordinary occurrences, such as the rare incidence of blood clots when certain therapies are used, but also using real figures, such as the percentage of people do get blood clots, compared to the adverse effects of much more commonly-used drugs or the number of people that the vaccine is saving from dying of SARS-CoV-2.

"In the field of public health, we need to explain the benefits that society as a whole will be seeing thanks to increased vaccination and herd immunity, such as the dramatic reduction in deaths in nursing homes since the vaccine campaign was rolled out, or the fact that a higher level of immunization among the population will allow us to set and meet goals in regard to gradually recovering activities we miss so badly, in relation to work, culture and leisure. By seeding hope among the population and highlighting the huge collective effort involved in the vaccination campaign, most people will accept it as working towards a common goal," he adds. 

Thus, the dual combination of transparency and mass vaccination will prove that the vaccines are working and get most people to see how important they are. "Once we have the information, the example of the real effect of the vaccine in society will be more important, as people see the situation improving. Thus, little by little, we will gain the trust of more people and the number of sceptics will drop", says Macip.

Ten points to use when talking to anti-vaxxers