Commentary: Where are the vaccine-hesitant actually getting their ‘research’ from?
While similar factors and narratives influence them, there is a crucial difference between those still hesitant about getting a vaccine and those staunchly against it, say SUSS’ Omer Ali Saifudeen and Valerie Ng.
SINGAPORE: The vaccine-hesitant stand at the peripheries of the anti-vaccine echo chamber.
Almost a year after COVID-19 vaccines made their way to Singapore, some people still have surrounding concerns over medical conditions or uncertainty about the science.
Singapore’s own variants of misinformation exacerbate this problem, with anti-vaccine narratives from local sources and across the globe circulating on social media and being shared by, friends, even family.
It’s become a real headache in recent months for platforms and authorities to balance between allowing healthy critical discourse and drawing the line at misinformation, with YouTube and the Protection from Online Falsehoods and Manipulation Act (POFMA) Office taking action against COVID-19 content by a local channel and website.
While efforts to stem misinformation at source continue, these raise the larger question of why there’s even a demand for such conspiracy theories and who these communities are. Why do the vaccine-hesitant prefer listening to peers and anecdotes instead of established medical guidance?
WE WANT STRAIGHTFORWARD ANSWERS FROM TRUSTED PEOPLE
We get conflicting, confusing news every day – some real, others made-up – and it’s been information overload since COVID-19 reared its head. So it's nice when people around us whom we trust help us make sense of what’s going on and give us straightforward answers to complex issues.
People are hard-wired over years of evolution to be tribal, according to social psychologist Jonathan Haidt. We are more likely to be guided by intuition. We resort to a tribal identity of an “in-group” more than data and critical reasoning to go about our lives.
Online anti-vaxxer communities are the epicentres of misinformation, with pronounced echo chamber effects. The “in-group” reinforces each other’s misguided beliefs and grows to trust themselves more than anyone on the outside, discounting opposing views even from loved ones.
Viral misinformation can seem convincing. It thrives on cherry-picking, leaving out valuable context and other variables that present the whole – often more complicated – picture.
Those believing in theories casting aspersions on COVID-19 vaccines look upon efforts to tackle dissenting medical opinions as “cover-ups” especially when discredited by mainstream experts.
Misinformation gains critical mass within their social networks and appears to a “tribe” of vaccine-hesitants and anti-vaxxers to be more widely accepted and “grounded in science”.
In extreme cases globally, the anti-vaxxer agenda blends into seething political grievances about state overreach, medical despotism and other nefarious plans.
ENGAGING THE VACCINE-HESITANT ON THEIR TERMS
There is a crucial difference between the vaccine-hesitant and anti-vaxxers. The vaccine-hesitant are open to reasoning, but need data to address specific concerns to be convinced vaccination makes sense in their personal circumstances.
The vaccine-hesitant are not fully in a misinformation bubble, but turning around the anti-vaccine narratives drawing them in is an uphill task, especially when amplified by frustrations with prolonged domestic restrictions in Singapore.
But there is a way to do that. Marketing professor Jonah Berger in his book The Catalyst: How to Change Anyone’s Mind talks about “reactance”, our innate anti-persuasion system, comprising concerns with changing our mind about a subject once it’s made up.
The vaccine-hesitant could simply be frustrated or fatigued by restrictions. They may think information about vaccine effectiveness and side-effects has been unclear and don’t want to “take risks”.
Or they may feel discriminated by vaccination-differentiated measures and being made to pay their own COVID-19 healthcare bills.
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Prof Berger suggests four steps to tackle misinformation – understanding where one is coming from, offering a menu of options, asking not telling and highlighting gaps in assumptions. He says this will help individuals to self-evaluate and come out of entrenched misconceptions on their own.
We can apply all this by having conversations that lead to actionable steps. We can point the vaccine-hesitant around us to information sources from legitimate authority and other anecdotes to seed the possibility of alternative narratives from a moderate middle ground.
We should remember these could be our own friends and family. Ultimately, we want to protect them and avoid drastic outcomes.
So let’s listen and empathise without judgement, understand their frustrations and triggers, and find an opening to establish trust over safe conversations.
HOW DO WE PITCH THE COUNTERARGUMENT?
It’s always a delicate tango. The vaccine-hesitant too consider themselves “critical thinkers”, put a high premium on having “done their own research” and may distrust authorities or mainstream experts.
We must be mindful the more we contradict their worldview and research effort, the higher the risk they may dig in and see engagement efforts as “attacks” on their beliefs.
If they are uncomfortable with mRNA technology of the Pfizer-BioNTech or Moderna vaccines, point out that the Sinovac inactivated virus vaccine has been authorised and recognised in Singapore and ask if this is a possible option. We can also remind them those certified to be medically ineligible will have concessions to visit shopping malls and dine-in at eateries.
If they think the data has been unclear about vaccine effectiveness, show them the clearer statistics the Ministry of Health has recently provided on the risk of critical illness and death of vaccinated (0.5 and 0.4 per 100,000 vaccinated) and unvaccinated individuals (5.2 and 9.1 per 100,000 unvaccinated) and check if this addresses their concern.
If they are concerned about their underlying medical conditions, advise them to seek professional advice from a family doctor more familiar with their health without admonishing them for trusting a stranger on social media.
The crux is to try to understand their hesitations and gently address them, one by one.
Another important aspect is to tap on trusted advocates in their lives whom they are more likely to listen to. By empowering and equiping everyone with information against commonly cited misinformation about the vaccine, anyone from friends, family, acquaintances at the market or work colleagues could be a force for good.
For example, to improve the vaccination coverage of the elderly, the government encouraged younger people to talk to their grandparents and general practitioners to reassure their patients.
Understanding where people get their information is also useful to reach out effectively. Young vaccine-hesitant people may favour social media and other online sources where their echo chambers tend to be louder due to social media platform algorithms.
Deliberate efforts to use social media, alternative messaging formats like videos and online influencers may more easily get a foot in the door with them.
It can be exhausting and demand patience to deal with those entrenched in their belief systems for so long. But persuasion requires certainty and conviction of beliefs.
COVID-19 has taught us many lessons, including the need for a systemic communication approach to drive difficult messages, including vaccination, climate change and mental health.
This must come in the form of a total defence communication approach that reaches out to everyone because no one is safe until everyone is safe – not just those in the most established and visible organisations, but also those in less visible subcultures and countercultures.
Dr Omer Ali Saifudeen is Senior Lecturer at the School of Humanities and Behavioural Sciences, Singapore University of Social Sciences. Valerie Ng is a corporate communication practitioner and Associate Faculty in the same university.
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