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Engaging Vaccine-Hesitant Loved Ones with Empathy

Emotionally fraught conversations are best navigated by listening actively, understanding people’s concerns and avoiding divisive side topics.
Members of the Alliance for Vaccine Literacy group started by Purnima Madhivanan, PhD, MBBS, MPH, (center arms crossed) flex their muscles in supporting the UArizona Health Sciences community in effectively talking with vaccine hesitant friends and family. (From left) Students Wesley Chiu, Himanashi Kapoor, Dametreea Carr McCuin, Dr. Madhivanan, Maiya Block, MPH, and Riley Sena.

Engaging Vaccine-Hesitant Loved Ones with Empathy

As flu season collides with the holidays and Arizona’s continuing COVID-19 incidence, many people are taking steps to reduce their risk for illnesses. But with so much misinformation and apprehension about vaccines flying around, rifts can appear among friends and families when not everyone shares the same perspective.

In response, University of Arizona Health Sciences students and faculty are working to figure out how to reach vaccine-hesitant individuals and communicate more effectively. Mel and Enid Zuckerman College of Public Health doctoral student Maiya Block, MPH, has spearheaded a series of virtual workshops to help people navigate these challenging conversations, giving participants the opportunity to learn communication techniques and practice using them in role-playing scenarios.

“Personally, I’ve been struggling, and a lot of people on our research team have family members or friends who are not getting vaccinated,” Block said. “They were not sure how to talk about it in an effective manner. People get their feelings invested, and it’s difficult to see eye to eye.”

Spotlight on the Alliance for Vaccine Literacy

The continuum of hesitancy

Being unvaccinated doesn’t mean someone is “anti-vax,” or categorically opposed to getting a vaccine. Assuming they have access to the shot, it often means they have concerns that aren’t being adequately addressed. This phenomenon is called vaccine hesitancy.

Dr. Madhivanan started the vaccine hesitancy research in collaboration with the Pima County Health Department in late 2019 at the Mel and Enid Zuckerman College of Public Health.“Vaccine hesitancy is on a continuum, from not getting a recommended vaccine immediately, to delaying it for months, sometimes years, to maybe never,” said Purnima Madhivanan, PhD, MBBS, MPH, associate professor in health promotion sciences and director of the Global Health Training Program. “Anti-vax refers to a person who may be against all vaccines or are suspicious about one specific vaccine, like the COVID vaccine.”

According to the Arizona Department of Health Services, 61% of Arizonans are vaccinated against COVID-19 – too low to provide community-wide protection. The most vulnerable remain at risk; breakthrough infections and new viral variants are looming threats; and social, emotional and economic suffering endures. As lawmakers debate policy, many individuals feel disempowered. Block and her fellow students, however, believe the individual can be a powerful force for change within their own social networks.

Tips and tricks

Over the summer, Block and other students involved in the Alliance for Vaccine Literacy organized virtual workshops providing guidance for approaching vaccine-hesitant loved ones. Interest remains steady and the workshops have continued into the fall semester.

“We talk about tips and tricks that help us engage in a conversation and not just talk ‘at’ each other, creating opportunity for people to engage in dialogue and ask questions openly without feeling judged,” Block said. “That’s difficult with these kinds of sensitive topics.”

Maiya Block, MPH, a doctoral student in the Mel and Enid Zuckerman College of Public Health, has spearheaded a series of virtual workshops to help people navigate challenging conversations around vaccine hesitancy, giving participants the opportunity to learn communication techniques and practice using them in role-playing scenarios.The first step is to listen actively. Don’t wait for someone to stop speaking so you can jump in with your argument. Listen with empathy, trying to understand the root of their concerns.

“It’s important to tailor our conversations to the specific issue the person is concerned about,” Dr. Madhivanan said. “A one-size-fits-all approach is not going to work.”

“Understand the other person’s point of view and where they’re coming from. Reflect back what they’re saying and request clarification to verify what you’re understanding,” Block added. “Then, with their permission, you can share good information from sources they trust. Identify what those sources are, and find information from those sources that might support your cause.”

Dr. Madhivanan and Block suggest aligning your approach with the other person’s values, such as being healthy or spending time with loved ones.

“It’s important to focus on commonalities,” Block said. “The first conversation has to be centered on setting the tone where you and the other person are on the same side, not arguing against each other. Once you start talking too much about your differences, it turns into a debate rather than a conversation.”

Block says it’s important not to spread misinformation yourself.

“It’s OK to say, ‘I don’t know.’ If you’re not sure about something, come back to them at a better time,” Block said.

One topic that has come up repeatedly in the workshops is that the issue is so emotionally charged that conversations can quickly be derailed.

“It’s easy to say, ‘Yeah, I’m going to listen,’ but to actually do it in the moment, especially when you’re feeling all these emotions, is difficult,” Block said. “Finding the right moment to have the conversation is key. If you’re not in the right place emotionally, that probably isn’t a great time.”

Dr. Madhivanan adds that empathy, kindness and civility are paramount in effective communication.

“If they think you’re talking down to them, they’re going to shut you off, and you missed out on a unique opportunity,” Dr. Madhivanan said, adding that this is not a one-and-done conversation. “These things take time. It can’t be done in one sitting. It has to be over a period of time.”

One conversation at a time

The Alliance for Vaccine Literacy is composed of UArizona Health Sciences and UArizona undergraduate students, graduate students and faculty. The group’s overarching goal is to improve communication about the safety and efficacy of vaccination with the general public. The workshops are one of many endeavors they oversee.

“The Alliance for Vaccine Literacy is an important project founded by Health Sciences faculty and fueled by the enthusiasm and talents of our incredible students. For them, education isn’t just about training for tomorrow – it’s about making a healthier world today,” said Michael D. Dake, MD, senior vice president for Health Sciences. “The contributions of these students are helping to mitigate the effects of the pandemic one conversation at a time.”

For Dr. Madhivanan, the one-conversation-at-a-time approach gives everyone, not just lawmakers and media figures, a place in the public discourse. She optimistically points out that most people are persuadable, referencing ongoing research by the Kaiser Family Foundation showing that only 16% of U.S. adults say they will “definitely not” get a COVID-19 vaccine.

“Many will do it, because they appreciate being able to visit their aging parents, young children, and relatives who are at very high risk of hospitalization and even death,” Dr. Madhivanan said. “Get vaccinated, and get vaccinated soon, both for flu as well as COVID.”

Register for the next workshop, scheduled for Saturday, Dec. 11, 2021, from 10:30 a.m. to noon.

The Alliance for Vaccine Literacy’s workshops for engaging vaccine-hesitant individuals are run by University of Arizona students and staff, including:

  • Maiya Block, MPH (College of Public Health doctoral student)
  • Dametreea Carr (College of Public Health research program administration officer)
  • Riley Sena (psychology undergraduate)
  • Wesley Chiu (biochemistry and systems engineering undergraduate)
  • Himanshi Kapoor (neuroscience undergraduate)
  • Veena Raghuraman (physiology undergraduate)
  • Lidia Azurdia, MPH (College of Public Health doctoral student)
  • Kerry Johnson (College of Public Health master’s student)
  • Nga Tuyet Kim (College of Public Health master’s student)
  • Emily Waldron, MPH (former College of Public Health internship coordinator)