Prof Pete Lunn: Vaccine hesitancy is not a black and white issue

Creating a ‘them-and-us’ story is unlikely to persuade the hesitant minority, it is more important is to understand why they refused in the first place, writes Professor Pete Lunn

Many in the majority can become understandably angry with the minority who refuse to get vaccinated. Picture: Denis Minihane

Ireland’s Covid-19 vaccination programme has been highly successful in persuading people to take a vaccine. This is not an opinion, but a claim backed by data.

The Social Activity Measure (SAM) is a fortnightly study undertaken by the Behavioural Research Unit at the ESRI for the Department for the Taoiseach. Throughout 2021, this measure recorded willingness to take a Covid-19 vaccine, how many doses people have taken it, and satisfaction with the rollout programme.

At the start of 2021, 8% of adults in Ireland told us they would not take a vaccine and 15% said they were unsure.

As the year progressed, vaccine hesitancy fell. Those who were unsure mostly decided to take a vaccine, as did some who initially said they would not, giving Ireland one of the highest vaccination rates in the world.

Meanwhile, public satisfaction with the rollout increased in all age groups.

Yet, despite this success, we once again face rising case numbers and hospitalisations. Those who remain unvaccinated are in the spotlight.

You might think that it can’t make much difference whether 90% or 95% of the population is vaccinated. But it really does.

Consider these numbers from the perspective of the virus. It means twice as many people are substantially easier prey — 10% versus 5%.

Many in the majority can become understandably angry with the minority who refuse to get vaccinated. I say understandably, because taking the vaccine does not just protect the individual, it helps to protect everyone. It irks when people free-ride on the good behaviour of others while not pulling their own weight.

'Them and us'

However, those of us who advocate taking the vaccine need to be careful when it comes to criticising the refuseniks. Creating a “them-and-us” story is unlikely to persuade the minority who are hesitant to come forward for belated jabs. When groups are targeted like this, they can form a stronger bond and dig their heels in harder.

More important is to understand why they refused in the first place. While it is true that a degree of selfishness may contribute to vaccine hesitancy, there are other important factors. My team of behavioural researchers examined this issue and we were surprised by our findings.

What's your view on this issue?

You can tell us here

At the beginning of the year, there was concern that online misinformation spread by anti-vaccination campaigners might cause people to be hesitant about the vaccine.

Many people who refuse a Covid-19 vaccine are adrift from mainstream media and unaware of how the vaccines were developed and how well they work.

While data suggest that concern has some substance, misinformation is perhaps not as important as exposure to good information.

In one of our studies, we gave people a general knowledge quiz about the vaccines. We found that people planning to refuse knew far less about it. They were often unable to answer basic questions about the vaccines, the answers to which had been reported multiple times in the media.

So we decided to look at the relationship between being unwilling to take the vaccine and news consumption. This turned out to be very strong. 

People who were not following the news about Covid-19 in early 2021 were much more likely to be hesitant than those watching, listening to and reading the news. 

This difference persisted all year and is bigger than the (often-highlighted) difference in willingness to take the vaccine between younger and older adults.

We also asked people to write down the benefits and risks that come to mind when they consider whether to take a vaccine. As well as being unable to answer general knowledge questions, vaccine-hesitant people were far less likely to list benefits — any benefits at all. Furthermore, when listing risks, they were more concerned by how quickly the vaccine had been developed than by any side-effects.

Overall, the picture our research paints is not one of people persuaded by misinformation or selfishly wanting to free-ride on the good behaviour of others.

Adrift from mainstream media

Instead, we find that many people who refuse a Covid-19 vaccine are adrift from mainstream media and unaware of how the vaccines were developed and how well they work.

Continued reliance on vaccines looks likely in the fight against this virus. Our research suggests we need to keep reaching out beyond mainstream media, through local organisations, services and face-to-face contact, to get across how well the vaccines are protecting people.

The success of the vaccine programme makes this easier. We can demonstrate how a disproportionate number of unvaccinated people end up very sick. We can explain that multiple trials in many countries now show the vaccines to be very safe over extended periods and different groups of people. We can point to millions of vaccinated people who have suffered no side-effects beyond an achy arm, a bit of tiredness, or mild post-jab sickness.

The Covid-19 vaccines work very well. We need to keep demonstrating this as widely as possible.

The HSE’s online registration system remains open for business.

• Professor Pete Lunn is the head of the Behavioural Research Unit at the ESRI