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How to combat vaccine hesitancy? Take a cue from psychology

Molly Wilson is a professor at St. Louis University School of Law.
Evie Hemphill
St. Louis Public Radio
Molly Wilson is a professor at St. Louis University School of Law.

St. Louis University School of Law professor Molly Wilson has long explored how patterns of decision-making influence, and should influence, law and policy. The lingering COVID-19 pandemic prompted the professor of law and psychology to seek a deeper understanding of vaccine hesitancy — and the possibilities for breaking through such hesitancy.

With pediatric inoculation against the coronavirus ramping up in the wake of the FDA’s recent approval of Pfizer doses for children ages 5 to 11, Wilson is hopeful that social science can refine public health strategy to get through to more parents. Many U.S. adults remain “willfully unvaccinated” against COVID-19, Wilson added. And the factors at play in that decision are worthy of deep inquiry.

“There are lessons to be learned here,” Wilson said. “This is not the last time we’re going to have a public health crisis.”

A key question, Wilson told St. Louis on the Air, is this: “Are we making the right assumptions about how these policies actually influence people, or are we mistaken?”

On Friday’s show, she joined host Sarah Fenske for a closer look. She noted that there are three main camps of parents right now, and people in general, when it comes to deciding whether to get the COVID-19 vaccine.

“Many parents are very, very eager, myself included — I’ve been waiting for one of my own kiddos — to get their children vaccinated, so that’s certainly a significant group. … And then there’s another group that’s still deciding,” Wilson said.

She explained that the members of this vaccine-hesitant group are not exactly opposed but perhaps holding off until they know more or see what other families’ outcomes are.

Then, a third group is outright hostile. Wilson estimates it includes as many as 30% of Americans.

The psychological biases vary among these camps, the professor said, which can inform different efforts at persuasion.

With the second group, the vaccine hesitant, a first step toward thwarting such hesitancy is understanding where it comes from, Wilson explained.

“There’s lots of data to show that things that are novel, new, unfamiliar and uncommon cause fear,” she said. “So even novel therapies and treatments that seem really promising [can] be concerning to people who don’t have experience in how a vaccine is developed [and] how it works in the body. Most of us don’t understand that. … This group feels like it’s unknown.”

SLU professor offers strategies for thwarting vaccine hesitancy
Listen as host Sarah Fenske talks with Molly Wilson.

But that doesn’t need to be where the conversation ends.

“Explaining that we now have a lot of data is really important, and then flipping it around and framing the question or the decision about risk in terms of not getting the vaccine I think can be really helpful,” Wilson said.

In addition to offering suggestions for everyday conversations about vaccination, Wilson shared ideas on a collective level.

“For example, companies have long been concerned about the fact that people don’t save enough for retirement. And so there’s been an effort to put people into opt-out situations. … They come into a position, you put them in a retirement savings account, and they have to opt out of it [to not save],” Wilson said. “I think there’s an opportunity to do some clever things … like maybe giving children appointments for vaccines and having the parents opt out if they would prefer not to have their child vaccinated.”

A local pediatrician, Dr. Ken Haller, called in to the show and offered his insights.

“Validating the emotion is really important,” Haller said of working with parents and children. “If I can say to them: ‘You know, I can see you're scared. This is very scary. I've heard these scary things, too. This shows me how much you love your child,’ that really gets the conversation going, and shows them that I’m taking their concerns seriously. And then we can move forward with the facts.”

Wilson also answered a question from a listener eager to combat online misinformation in the push to encourage inoculation. She explained that narrative is a powerful force, for good or for ill.

“Things like the [false idea that] vaccine rearranges your DNA, or causes skin lesions, are all sorts of things that are just patently untrue. But they’re so vivid and memorable that people think of them,” the professor said. “[W]e can replace those sort of thoughts with other thoughts that are positive, like examples of vaccine drives that have been really positive where hundreds of people have been vaccinated. Situations where people have been at high risk, maybe exposed to COVID, but because they’re vaccinated, they don’t develop serious symptoms.

“If we can replace the misinformation with positive good information, especially depicting it in really vivid and memorable ways through narratives, perhaps that might be one helpful strategy.”

St. Louis on the Air” brings you the stories of St. Louis and the people who live, work and create in our region. The show is hosted by Sarah Fenske and produced by Alex Heuer, Emily Woodbury, Evie Hemphill and Lara Hamdan. Jane Mather-Glass is our production assistant. The audio engineer is Aaron Doerr.

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Evie was a producer for "St. Louis on the Air" at St. Louis Public Radio.