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How the pandemic ends depends on us

Since not everyone is on board with being vaccinated, it’s become necessary to find ways to reach recalcitrant Americans.

State officials say an easy way to get connected with a dose is through their Vaccine Connector website.
State officials say an easy way to get connected with a dose is through their Vaccine Connector website.
REUTERS/Dado Ruvic/Illustration

Now that more and eventually sufficient COVID-19 vaccine is becoming available as a result of a worldwide medical Manhattan Project, we are turning attention to the underlying obstacle to coping with this virus: the crooked timber of humanity.

Receiving a protective injection, whether Pfizer, Moderna, J&J or the new Oxford formula, is easy, effective and free of cost for most people. Since not everyone is on board with being vaccinated, it’s become necessary to find ways to reach recalcitrant Americans. Objections to getting jabbed range from reasonable concern regarding health issues to possible DNA damage and conspiratorial notions of government takeovers.

It’s a fair assumption that vaccine resisters overlap considerably with those who refuse to mask up or do so reluctantly. The two groups are alike in some ways — personal freedom, downplaying the danger of COVID — but also have different concerns. Vaccine skeptics may worry about long-term health effects versus non-maskers who don’t like to be told what to do. Both attitudes combine to account for too many Americans who represent serious public health obstacles to overcoming the pandemic, which can linger for years.

A greater emphasis on messaging

What to do? If health authorities and political leaders hope to bring this pandemic under control, then certain actions are necessary. According to a recent study, national surveys show that a large segment of Americans may continue to be unwilling to receive a COVID-19 vaccine. Even if that segment shrinks over time, it is still disturbing. So the experts recommend that more attention be given to public communication: spread the message about masking, physical distancing and the importance of vaccination. This research, which was co-authored by the new head of the Centers for Disease Control and Prevention, Dr. Rochelle Walensky, finds that the success of the country’s vaccination effort hinges on Americans’ willingness to be inoculated.

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Walensky, formerly chief of Massachusetts General Hospital’s infectious disease division, said, “We’ll get out of this faster if you give the vaccine less work to do.” In other words, the vaccine itself works fine, but people need to accept it. That’s the difference between vaccine efficacy, its proven biological/medical impact, versus vaccine effectiveness, which takes into account how much of the overall population receives and benefits from the vaccine. Just because we have a great vaccine doesn’t mean that the pandemic is under control unless people actually get that shot in the arm.

Making this happen means greater emphasis on messaging and communication. So we can expect to see more articles and features in the media like “How to Debunk Misinformation about COVID, Vaccines, and Masks” and “How ‘Vaccine Day’ Could Boost Inoculations.” The idea is to encourage laggards to step up and do the right public health thing by being vaccinated. Finding ways to bring the vaccine into diverse neighborhoods and workplaces will also be important.

There are interviews with formerly hardcore skeptics who appear thoughtful by considering whether to be vaccinated, an apparently difficult choice for the anti-science crowd. It remains to be seen how well better communication methods will change attitudes about lockdown restrictions or affect what looks like a strain of herd immunity to reason.

Persuasion research

Research from heavy academic guns is being brought to bear in the vaccination battle. “How to Persuade People to Change Their Behavior” from the Harvard Business Review suggests that telling people what to do doesn’t work as well as encouraging them to convince themselves, e.g. “What would you want your grandparent or sister to do?”

Over at the University of Pennsylvania Wharton School a team of behavioral scientists are looking into the best ways of persuading people to accept vaccination. In a partnership funded by Walmart, The Behavior Change for Good Initiative has created a tournament asking leading scholars of human behavior to submit their best ideas. An example of a winning entry suggests that employers wanting their workforce vaccinated should not invite employees to sign up but instead go ahead and make an appointment for them. Not offering the shot as a choice but making it a done deal leads to better compliance.

Meanwhile a research group at Duke University with an appealing name, The Center for Advanced Hindsight, is working to understand and apply habit formation as it relates to mask compliance, vaccine adoption and combatting misinformation. One of their pilot projects focuses on religious communities in North Carolina. It’s suggested that health messages be related to scriptural lessons and incorporated in Sunday sermons. While it may be effective to hear a parable from a respected reverend or faith leader, there will probably be congregants who won’t enjoy being preached at about COVID in church.

Larry Struck
Larry Struck
These behavioral approaches to public health are descended from the broader discipline of behavioral economics, which melds traditional economics with psychological motivation. Practices such as “nudging” and “opting out” versus “opting in” have become common tools in business, government and wherever there is a need to influence people’s judgment or choice.  The main idea is to reframe how we understand an issue or situation to arrive at a preferred decision. Preferred by whom, though? Despite its achievements, critics of this behavioral science complain that we are being manipulated or treated like lab rats.

Maybe we should be allowed our irrational side and have permission to act in “suboptimal” ways. But when dysfunctional behavior threatens everyone else’s good life then I won’t mind being led through a maze with a jab at the end. It’s just part of dealing with “the crooked timber of humanity from which nothing quite straight can be made,” or as that 20th-century philosopher Pogo pointed out, the enemy is us.

Larry Struck is a writer based in Edina.

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