On this blog, we had more than our fair share of comments from the anti-vax clan. This article asked a question that I have often been pondering:

How to convince the unvaccinated proportion of the population of the benefits of a vaccination?

Designing more successful communication strategies, both in retrospect and looking ahead, requires a differentiated understanding of the concerns of those that remain unvaccinated. Guided by the elaboration likelihood model, this paper has two objectives: First, it explores by means of a latent class analysis how unvaccinated individuals might be characterized by their attitudes towards COVID-19 vaccination. Second, the researchers investigate to what extent (i) varying types of evidence (none/anecdotal/statistical) can be employed by (ii) different types of communicators (scientists/politicians) to improve vaccination intentions across these subgroups. To address these questions, the authors conducted an original online survey experiment among 2145 unvaccinated respondents from Germany where a substantial population share remains unvaccinated.

The results suggest three different subgroups, which differ regarding their openness towards a COVID-19 vaccination:

  • vaccination opponents (N = 1184),
  • sceptics (N = 572)
  • those in principle receptive (N = 389) to be vaccinated.

On average, neither the provision of statistical nor anecdotal evidence increased the persuasiveness of information regarding the efficacy of a COVID-19 vaccine. However, scientists were, on average, more persuasive than politicians (relatively increase vaccination intentions by 0.184 standard deviations). With respect to heterogeneous treatment effects among the three subgroups, vaccination opponents seem largely unreachable, while sceptics value information by scientists, particularly if supported by anecdotal evidence (relatively increases intentions by 0.45 standard deviations). Receptives seem much more responsive to statistical evidence from politicians (relatively increases intentions by 0.38 standard deviations).

According to the authors, these insights suggest that, in the short term, receptives and sceptics are the most promising target groups for vaccination campaigns. Yet, in the medium term, opponents need not be forgotten. While mandatory vaccinations may appear as the only strategy to target strict vaccination opponents, politicians and researchers are advised to focus on ways how to rebuild trust and address beliefs in misinformation within this population group. The inconsistency in vaccine related communication has led to a loss of trust in political and scientific decision-makers. It is therefore important to rebuild this trust through evidence-based communication. The way we understand and perceive the credibility of a source significantly impacts our processing of messages and can also significantly affect related behaviours. Using evidence to validate relevant and reliable information can therefore also be vital to build trust and credibility in the vaccines themselves and their safety.

The authors concluded that our study employed sociopsychological theory to challenge the view of the existence of a single homogeneous group of unvaccinated citizens. By drawing on a large sample of unvaccinated citizens and combining latent class analysis with experimental methods, we encourage decision-makers to carefully consider heterogeneities in the effectiveness of their communication strategies, especially regarding their communicator and employed evidence type.

32 Responses to How to reduce vaccination hesitancy?

  • I’m not sure much can be done to change the minds of the opposers, and compulsion risks making martyrs of them. However they have to be constantly challenged in order to prevent them converting sceptics and receptives into outright opponents.

    The opponents are very vocal and come armed with reams of ‘evidence’ which can seem very persuasive, never mind that it is usually false or doesn’t mean what they claim. But certainty can seem attractive when set against official advice which may be lukewarm and qualified. Evidence is unlikely to affect the opposers – they will just invent new facts or even dismiss the very concept of evidence as part of an outmoded scientific paradigm. At least by challenging them and luring them into revealing their more absurd and extreme positions we may reduce their recruiting effectiveness.

  • Hello Socrates (whoever you really are); you and others are determined to discredit anyone that doesn’t agree with your point of view. Criticising folks (including highly qualified and experienced physicians) who prefer to conduct due diligence before being injected with a cocktail of synthetic chemicals that their immune system has never previously experienced is rather ignorant.
    In any event, why not use use a more sensible expression for these ‘sceptics’ by labelling them VACCINE CAUTIOUS rather than VACCINE HESITANT – it’s more grown up wouldn’t you say?
    I’m sure some of you will dismiss my opinions but I can live with that.
    Here is just one of numerous reports that demonstrate the potential risk of being jabbed with a vaccine:

    • @Mike Grant

      you and others are determined to discredit anyone that doesn’t agree with your point of view.

      This is not true. We simply debunk and criticize the lies and nonsense from antivaxxers who are endangering the lives of people who listen to this FUD (fear, uncertainty and doubt).

      Criticising folks (including highly qualified and experienced physicians)…

      Those ‘highly qualified and experienced physicians’ that you refer to are also antivaxxers, unworthy of their title, because they are spreading the same antivaxx nonsense that you are spreading. These people deserve all the scorn and derision that is coming to them, and should at the very least lose their medical license for endangering people’s health by scaring them away from vaccines – vaccines that may prevent them from getting seriously ill and even save their lives.
      Especially during the later half of the COVID pandemic, we could daily dear the sad stories from people who listened to antivaxxers like you and declined vaccination – only to get seriously ill and sometimes even die from COVID, often expressing their regret on their death bed. You are contributing to the death of people.

      … who prefer to conduct due diligence …

      Due diligence has taken place, and in any case, you are certainly not qualified by far to judge whether due diligence has been observed. All vaccines on the market today have been tested for safety and efficacy in the same, rigorous way.

      … before being injected with a cocktail of synthetic chemicals that their immune system has never previously experienced is rather ignorant.

      What this tells us that you are the one who is utterly ignorant – about vaccines as well as our immune system.

      Here is just one of numerous reports that demonstrate the potential risk of being jabbed with a vaccine: [death caused by AstraZeneca vaccine]

      Yes, the AZ vaccine could cause lethal blood clots as a side effects. This happened to approximately 1 in every 200,000 recipients of the vaccine. Nevertheless, use of this vaccine was immediately halted when scientists (of course not antivaxxers like you) noticed this side effect.
      However, given that the Delta variant of COVID-19 itself killed 1 in every 100 people, taking even this vaccine was still a no-brainer. The risk of dying from this vaccine was several thousand times lower than the risk of dying from COVID-19.

      No, you are not ‘vaccine-cautious’, but rather ‘vaccine-caustic’. You are a rather unintelligent full-blown antivaxxer who tries to scare people away from life-saving vaccines with your lies and FUD (“cocktail of synthetic chemicals”), instead of letting people make up their own mind and make a well-informed choice. An honest, truly ‘vaccine-cautious’ person would not use the extremely charged, scary language that you use.

      • Richard – you said “antivaxxers like you” – but you are mistaken! You don’t know me personally, and I have been vaccinated on a number of occasions throughout my life. May I respectfully suggest you desist from making untrue claims on this forum or anywhere else. If you are saying it is wrong to conduct due diligence before agreeing to a medical procedure, then I suggest you think next time before spouting silly generalisations.

        • Mike

          Spare us your high-handed and pompous posturing.

          You’re an antivaxer. Embrace it.

        • @Mike Grant

          May I respectfully suggest you desist from making untrue claims on this forum or anywhere else.

          Fine, as soon as you stop scaremongering by using highly contentious language such as “cocktail of synthetic chemicals”.

          If you are saying it is wrong to conduct due diligence before agreeing to a medical procedure …

          Due diligence is not the same as listening to misinformation, FUD and lies from antivaxxers, including the handful of antivaxxers with scientific and medical degrees.
          Due diligence is considering and weighing ALL evidence and information, with more weight for information from experts in the field – virologists, immunologists, epidemiologists. The overwhelming majority of these people will attest to the fact that COVID vaccines are safe(*) and effective, and that any potentially serious side effects are signalled and acted upon, as happened with the AstraZeneca vaccine.

          If you want to be treated with respect, just lay off the antivaxx rhetoric and start discussing facts – then you will see that we can actually agree on a lot of things. But people who keep fearmongering about vaccines while showing their ignorance on the subject are indeed discredited, especially if they keep rejecting evidence that they are wrong.

          *: Also note that safety is never absolute. Nothing is 100.00% safe, but getting a vaccine is one of the safest things we humans can do. Just going out the door and taking part in traffic is hugely more risky than getting vaccinated, yet you almost never hear people refer to cars as “energy-guzzling people-maiming machines foisted upon us by a greedy industry”, even though there is a kernel of truth in this: the automotive industry mostly ignored the safety aspect of their products until well into the 1970’s, because safety measures not only cost money, but also confronted consumers with the unpleasant fact that cars are indeed pretty dangerous machines, and this connotation with death and harm would put buyers off. Only after governments around the world made several safety measures compulsory did the industry turn around and started touting safety as a feature, instead of something that should not be mentioned.
          Interestingly, this increased attention to consumer safety also gave rise to far better product testing and surveillance procedures in the medical/pharmaceutical industries – of course also prompted by things such as the thalidomide scandal.
          But, as said, 100% safety can never be achieved, and problems, errors and even fraud can always happen. Pharmaceutical products can turn out the be more harmful than initially thought, and are then pulled from the market. The same way that new cars can also turn out to have an unexpected safety issue, and are recalled for a fix. And in cases of fraud, fines are the highest by far for pharmaceutical companies, sometimes up into the billions of dollars. This is exactly because especially here, many people can be seriously harmed by a dodgy product.

          The above may also be seen as a start for a respectful, fact-based discussion about vaccine safety. No emotionally charged or condemning language, but just facts, and how we can deal with those facts – even the less pleasant ones.

    • If you want to use ‘vaccine cautious’ rather than ‘vaccine hesitant’ I have no objection. Of course I understand that many people faced with claims and counter claims don’t know which way to turn. And the appeal of ‘trust nature’ works for many.

      So my concern is with those who knowingly spread lies and misinformation to sway the wavering into the opposition camp. And it goes way beyond the question of pro or anti vaccination. Scratch the surface of an anti vaxxer and you will almost always find a host of other anti science conspiracy theories.

  • Prof. Ernst. According to Britanica, “A vaccine can confer active immunity against a specific harmful agent by stimulating the immune system to attack the agent”. However, the covid “vaccine” does not confer an immunity, but reduces the probability of severe symptoms, not catching the virus itself. Possibly the covid “vaccine” is misnamed a vaccine as it does not provide an immunity. This is arguing semantics, but I would appreciate the comments from some of the viewers of this blog.

    • Yes, I agree with your comment. No vaccine can guarantee ‘IMMUNITY’ from anything – that should be obvious to even the most pro-vaxx person. Ultimately, the subjects own natural immune system will influence their ability to rid the body of an invading pathogen. Vaccines may or may not make a significant difference as we are all different and each of us will react differently when our body is jabbed with a chemical cocktail.

    • @GibleyGibley

      However, the covid “vaccine” does not confer an immunity …

      The COVID vaccine absolutely confers immunity. It’s just that this immunity is not 100% watertight and wanes relatively quickly (4-6 months half-life). If it didn’t confer immunity at all, it would indeed not be a vaccine.

    • Brittanica is correct: all vaccines, including all of those approved to prevent infection, severe disease, hospitalization and death from COVID-19, provide immunity.

      No one ever said it was of the sterilizing immunity type. You claim that the COVID-19 vaccine is not a vaccine because it doesn’t provide sterilizing immunity. What do you then call the immune response post-infection, since that, too, wanes quickly and never has provided sterilizing immunity?

  • There is evidence that the 4th Covid vaccine confers immunity. The large study below confirmed this for a 3 month period. This is not surprising. What needs to be explained though is why there was a reversal of this effect after 6 months.

  • Put the blame for vaccine hesitancy where it belongs… on the vaccines.

    This is a nationwide retrospective observational study. We calculated age and gender adjusted Cox proportional hazard ratios (HRs) of COVID-19 deaths (primary outcome) and SARS-CoV-2 infections (secondary outcome) from 1 November to 31 December 2022, primarily comparing individuals with four versus three vaccine doses. Relative vaccine effectiveness (rVE) was calculated as (1-HR) X 100.

    Among 3,986,312 previously infected individuals, 281,291 (7,1%) had four and 1,545,242 (38.8%) had three vaccinations at baseline. We recorded 69 COVID-19 deaths and 89,056 SARS-CoV-2 infections. rVE for four versus three vaccine doses was −24% (95% CI: −120 to 30) against COVID-19 deaths, and 17% (95% CI: 14–19) against SARS-CoV-2 infections. This latter effect rapidly diminished over time and infection risk with four vaccinations was higher compared to less vaccinated individuals during extended follow-up until June 2023. Adjusted HR (95% CI) for all-cause mortality for four versus three vaccinations was 0.79 (0.74–0.85).

    The actual efficacy to prevent infection waned to about 35% after three months.

    • Conclusion:
      In previously infected individuals, a fourth vaccination was not associated with COVID-19 death risk, but with transiently reduced risk of SARS-CoV-2 infections and reversal of this effect in longer follow-up. All-cause mortality data suggest healthy vaccinee bias.

      • You are focused on what you want to use to distract.

        I never mentioned the death risk. However, if you choose to focus on that then do so, just admit that the death risk proved to be significantly negative or positive.

    • John,

      Congratulations on your successful foray into scientific literature. It is a daunting task to copy past a part of the abstract to prove your point, which you managed to do with ease. Accept my sincere commendations on a job well-done!

      I have been saying all along that the best way to “vaccinate” against COVID is to acquire natural immunity. The best way to acquire natural immunity is to lick door handles of toilets at a shopping mall or if you want a more targeted immunity, find a COVID patient and have them cough on your face. You humans come up with complicated mental gymnastics to avoid following the best advice. There is no future you big brained yet dumb bipedal apes on this planet.

      • The study referenced was not a study that focused on boosters rather than initial vaccine acceptance. You are off point again.

        • How likely is one to have gotten a vaccine booster if one went and licked doorknobs instead of initial vaccines? Not very likely, Einstein! One would have continued to lick doorknobs in place of getting an actual booster. Because a doorknob “booster” would have been more efficacious than a vaccine booster. Despite your big human brain, you fail to grasp even the basic premise of the argument. You better go back to mindlessly quoting abstracts from scientific literature to feel intellectually superior.

  • lol… haha
    You’re no more than a knob-licking ape.
    What do you know.

    • impressive argument!

      • Your comments sir are some of the least impressive of all here.
        Most are just tasteless Ad hominem BS

        • really?
          Let’s have a look:
          1) Conclusion:
          In previously infected individuals, a fourth vaccination was not associated with COVID-19 death risk, but with transiently reduced risk of SARS-CoV-2 infections and reversal of this effect in longer follow-up. All-cause mortality data suggest healthy vaccinee bias.
          2) I did not focus on anything – but omitting the conclusions seems less than honest.
          3) impressive argument!

          AND YOU:
          lol… haha
          You’re no more than a knob-licking ape.
          What do you know.

    • I suppose I can call you a conspiracy theory peddling nut job. But I won’t! Because I am better than you, Johnny John John!

      We both know that “natural” immunity is the best there is and vaccine-induced immunity is no match. Yet, you choose to continuously bleat about vaccines. Do you think that is productive? I, on the other hand chose to spread the gospel of the “natural” immunity and how to acquire it effectively. Apparently, my message went way over your head, as usual.

      • LMAO at you Ape

        This antivaxxer just took a jab in the arm yesterday, Yes, I stepped on a nail and could not recall my last Tetanus vaccine date. We all know that with Tetanus, the disease is worse than the cure. Furthermore, having been fully tested over many years, I can be fairly confident that I won’t have an adverse reaction to the jab other than some arm pain.
        Please don’t call me anti-vax. You are mistaken… repeatedly.

        • News flash for you Johnny Boy! You get judged as an antivaxxer by what comes out of your mouth and not by what goes into your body. I know it’s unfair but that is the world we live in. I run a support group for fellow antivaxxers like you who have a hard time grappling with the fact that this cruel world labels them as antivaxxers. You are welcome to attend our meetings anytime, no appointment needed. You have coffee and light snacks. Oh, did I mention that we end the meeting with two minutes of hate towards Dr. Fauci?

          • Wrong again Ape

            People in this world are judged on the basis of what they do, not what they say.

          • LMHAAO @John

            Who said a human is judging you? Ape is judging you and apes judge others by what they say. I pity your intellectual acumen, Johnny, the antivaxxer!

          • Who you are, or what you are matters not to me.
            Yes, the person (or ape) behind this moniker passed judgement on me as an antivaxxer.

            I pity your lack of intelligence; you don’t even realize what you are saying.

          • I pity your lack of intelligence; you don’t even realize what you are saying.

            Kudos to you John! You have proven yourself to be a person with abundance of intelligence, by diligently engaging for the past couple of days with me, a doorknob-licking antivaxxer ape.

            I admit my defeat and I am proud to have been defeated by a fellow antivaxxer. It is time for me to climb back up my tree to lick my wounds and brood over my defat. Until we meet again, adios amigo!

  • Hesitating was a good idea e.g. from the Daily Telegraph:

    [quote, Telegraph, 6th Dec, 2023,]

    It was thought the minor tweak to uridine caused no problems in cells, but a team of researchers at the University of Cambridge’s Medical Research Council (MRC) Toxicology Unit have now found when this partially synthetic code is read, the protein-making machine in the body sometimes struggles with the uridine analogues.

    Because it is not a perfect fit for what is expected, there can be a momentary pause which causes the process to stutter and a letter in the code can get skipped, much like a bike slipping a gear.

    This process, called frameshifting, throws out the way the code is interpreted as it relies on groups of three bases, known as codons, being read in the right order.

    This issue, caused by the jab’s code, throws the process completely out of sync and the entire subsequent code becomes garbled.

    In the case of the Covid jabs, the end result is a nonsensical and harmless protein, the team found, which the body attacks and leads to an immune system flare-up. The new study, published in Nature, found this occurred in around 25-30 percent of people.

    [end of quote]

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