What to Say to Someone Who Is Hesitant to Get the COVID-19 Vaccine

Vaccine hesitancy is real, but not necessarily in the ways that some assume. A recent poll shows that the top four groups with the highest percentage of individuals who would refuse to be vaccinated if they were eligible are: Republican men (49 percent), Trump supporters (47 percent), Republicans in general (41 percent), and white men without college degrees (40 percent). One common misconception is that low rates of COVID-19 vaccine coverage among people of color is due to their reluctance, rather than huge disparities in access to vaccines, good services, and information. A recent poll confirms that there’s been an overall rise in vaccination willingness among people of color since last winter. In other words, we need to confront a broader context when considering why some people are not getting vaccinated and how we enter conversations with them.

With the failure of our public health system to reach all people with adequate services and good information, you might find yourself with an opportunity to speak to a friend, neighbor, or family member about getting the COVID-19 vaccine. As volunteers of Clinton Hill/Fort Greene Mutual Aid (CHFGMA), we’ve been working together with community groups and local leaders in our area to overcome logistical barriers to vaccination, but also to reach out person-to-person through existing networks (like food pantries, senior programs, tenant associations, and our mutual aid network) to offer our neighbors clear and accurate information about the vaccine.

It’s been well worth it. Thanks to the efforts of mutual aid volunteers, we’ve helped 315 of our neighbors get vaccinated, through weekly phone banks and two dedicated pop-ups events in partnership with local pharmacies. It wasn’t easy—between making over 2,000 phone calls, going door-to-door, scheduling appointments, sending reminders, and making arrangements for translation and interpretation as well as transportation to and from the pop-up, we’ve had some tough conversations along the way.

Throughout this work, we’ve been writing and revising our approach to best serve all of our neighbors, and documenting ways to address frequently asked questions and concerns on our call script. So far, we’ve collected the following best practices for navigating conversations around COVID-19 vaccination, especially for those expressing doubts due to lack of information or easy access. No two conversations have been the same, and each of our callers makes the script their own with every number they dial. Below is what we’ve learned about having open—and informative—discussions with people who are not vaccinated, and who have questions or concerns, no matter who they are. It can be difficult to engage in an informed conversation with the people we know and who are in our communities, but to us it feels urgent—and feasible—to do what we can to overcome this hurdle and help everyone, especially the most vulnerable among us, get reliable information and access about vaccination. 

What we’ve learned from our phone-banking efforts since last June is that while this pandemic has clearly shown us that we’re all in this together, it is also clear that we’re all very much in different boats. Unless you’re close with the person you’re talking to, you may have no idea what they’ve been through and what kind of year they’ve had to weather. Either way: Let them lead the conversation, and give them the space to express themselves fully—many, especially seniors, may have been feeling incredibly isolated even before this pandemic began. Here are some tips about empathetic listening.

Of course, the way to navigate these conversations depends entirely on who is on the other end—a Bangladeshi immigrant elder might have completely different concerns than a young, MAGA-hat-wearing Trump supporter, or someone who has an aversion to vaccines because they’re “unnatural.” Misinformation about COVID vaccines could be the main factor behind hesitancy, or doubts could simply stem from anxiety around the difficulties of accessing the vaccine. Since “vaccine hesitancy” is a very broad concept and can exist for many varied reasons, you have to be willing to ask questions in a non-judgmental manner to find out exactly what the source of the hesitancy is. You might be surprised that it’s not what you assume. (And, whatever it is, we’ve offered specific tips about how to respond to different doubts—and misinformation—below.)

Just because some of us have access to vaccine information through computer and internet literacy does not mean we have more expertise on a specific situation than others. People are the experts of their own lived experiences, and their trust is to be earned, not assumed. In fact, if the person is someone you’re not very close with, they absolutely do not owe you the time of day, even if you may be the friendliest of neighbors! 

Still, it could be useful to just let someone know that the vaccine is available and that they are eligible—sometimes, this confirmation is all someone needs to hear. Avoid shaming the person, or arguing with them because they have different political views. Find what common ground you do have—something as simple as “what a tough, strange year this has been” can be enough to help someone open up. You can then follow up with an open ended question such as “what have you heard about the COVID-19 vaccine?”

Vaccine hesitancy among Black Americans continues to fall because the people that folks trust are getting vaccinated and doing outreach, both formal and informal. Dr. Raynard Washington, deputy director of the Mecklenburg County, N.C. Health Department refers to this as a “tree of dissemination”—where community members (fellow clergy members, community group leaders, social service providers) can be an effective way to spread information with care.

For people who have vaccine hesitancy because of experiences of medical racism, overcoming distrust is a major challenge, but one that can be surmounted with the patient ear and testimony of a trusted messenger who is willing to affirm lived experiences and disseminate credible information while committing to their own learning. 

If you don’t know much about the documented history and experience of medical racism, consider this 2018 article by journalist George M. Johnson, who writes, ““New research and a more conscious exploration of health disparities in this country show us that Black Americans have worse health outcomes than white Americans across the board.” He notes, “[b]eing rich and Black won’t exempt you from social stressors, either. (Last year Serena Williams, who nearly died following the birth of her daughter, pointed to a CDC report that stated that black women in the United States are more than three times more likely to die from childbirth-related causes.)”

In your own conversations, the best way to account for hesitancy rooted in medical racism is to listen, affirm, and validate. You might say to someone recounting their experiences,“Tell me more about that,” or lead with empathy (see above), and ask, “how is that experience affecting how you feel about the vaccine?” 

It is OK and, in fact, best to admit when you don’t know something. The person you are talking to has more reason to trust you if you’re transparent about what you do and don’t know. And when you don’t know something, offer to do the research, and come back with credible, science-informed sources. Better yet, guide the person on how to do the research on their own, or do the research together. Ask them how they like to learn new information (newspapers? personal documented stories?) and come back to them with a list of reliable, accessible sources that you can look through together. This will take up some time and require patience, but it’s better than making up facts that are then discovered to be untrue by the person holding the doubts, or offering sources they don’t typically trust.

Some sources to check out and share:

• Johns Hopkins Medicine, FAQs on COVID-19 vaccines: https://bit.ly/3ebUGHI
• FDA short video from Office of Minority Health and Health Equity:
  •  English (with captions): https://www.youtube.com/watch?v=gymnt-UeEKc
  • English (with Spanish subtitles): https://www.youtube.com/watch?v=fzVKfHT-_RM
• Dr. Dave Chokshi, Commissioner of Health, presents COVID-19 Vaccine Facts: youtube.com/watch?v=sLNZJ12Kt7A (available in multiple languages on the NYCHealth YouTube page)
• Dr. Torian Easterling presents COVID-19 Vaccine Facts:
  youtube.com/watch?v=q0GDExe-FVY&t=3s
• NPR on Questions About the Johnson & Johnson Vaccine
• USA Today: More info about all 3 vaccines
  

• “Has the vaccine been tested enough?”
  • “I want you to know this single fact: no one who has gotten a vaccination has become seriously sick or died of COVID-19.  The vaccine protects you and allows you to go out into the world more safely. All currently approved vaccines—Pfizer, Moderna, and now Johnson & Johnson—have undergone clinical trials with tens of thousands of participants to test safety and have been approved by the Food and Drug Administration (FDA). Millions of people in the United States have received COVID-19 vaccines under the most intense safety monitoring in U.S. history.” 
• “I’ve heard people have reactions. I don’t want to be sick.”
  • “Minor side effects are possible. The side effects are normal signs that your body is building protection. The most common are pain and swelling in the arm where you received the shot. In addition, you may have fever, chills, tiredness, and headache. These side effects should go away in 1–2 days. Once you get the shot, you will not have to worry about the disaster of COVID.”
  • If you have already been vaccinated, or know people who have, feel free to speak to your personal experience! 
    
• “Where can I get the vaccine? How would I get there? Will I have to wait in a line? I have mobility issues.”
  • Keep in mind that transportation and lack of easy access are key factors contributing to vaccine anxiety, especially in big cities where people sometimes don’t have cars. Before you have these conversations, do some research and have a few options ready for vaccination sites in the nearby area, and, if you can, offer support with transportation planning. CHFGMA has been crowd-funding for transportation in the form of cars for hire through our mutual aid network, but we’ve also been helping neighbors schedule free services like Access-a-Ride, which is NYC’s door-to-door public transportation for people with disabilities.
  • Keep in mind that there are options being added across the country for vaccinating homebound individuals. If you know that the person you’re talking to has significant mobility issues, research city vaccination programs for homebound people.
    
• “I’ve already had/currently have COVID-19.”
  • “Even if you have had COVID, you should get vaccinated. The amount and duration of protection you have from having COVID-19 antibodies is not certain. With the shot, you can be sure you will have longer-term protection.” 
  • “If you currently have COVID-19, or symptoms of COVID-19, you should wait until you have recovered and completed isolation to avoid exposing other people at the vaccination site while you are contagious. This means you should not be vaccinated until all the following are true:
    • At least 10 days from when symptoms started (or, if you never had symptoms, 10 days from the date you were tested).
    •  You have not had fever for the prior 24 hours without use of fever-reducing medicine.
    • Your overall symptoms have improved.” 
      
• “I stay inside all the time—do I need to get the vaccine?”
  • “One day in (hopefully) the near future, we will start to integrate ourselves back into society. At that point, it’s important for everyone to be vaccinated to protect ourselves and others. It is especially important if you have family members or friends that would like to visit you in your home.”
    
• “I need to do more research; I’m really not sure if I want to get it or not.”
  • “I totally understand wanting to do research on your own time. Where do you like to get your information from? Is it OK if I text or email you a link or two for more info?”

No matter how you choose to go about talking to the person in your life who isn’t sure about the vaccine, don’t be discouraged if their mind isn’t instantly changed. Let the other person know that they can reach back out to you with more questions, concerns, or reactions to what you shared with them so that the conversation can continue—as we’ve found in our volunteer outreach, it’s one worth having as many times as you can.