Converting Anti-Vaxxers: The Power of Fear & Stories

The country’s economic and social well-being, as well as the mental health and lifestyle of its people, is dependent on cooperation from those who are skeptical of or refuse vaccination. And that cooperation is being withheld by many people. In a recent Kaiser Family Foundation survey, 17% have a wait-and-see approach and another 20% say they will never have the vaccine unless required. An NPR/Marist poll found 25% would refuse the coronavirus vaccine and another 5% are “undecided.” According to these statistics, around 20% of the population is made up of committed anti-vaxxers. Current projections indicate that herd immunity may not happen, and that would be a disaster—unless some of these people get motivated to change their minds. So, what should be done? 

Those that are reluctant or undecided may be influenced by the right medical authorities, such as the family doctor or the hospital consortium led by Mayo Clinic and Cleveland Hospital who can reassure them the vaccine is safe. Other reluctant individuals may be open to incentives. A $100 reward for vaccination has been shown to work on some. Still, others admit that their opposition will only be affected by needing a vaccine to gain admission to activities, such as going to work, traveling or attending a sporting event. The Ad Council’s “It’s Up To You” campaign highlights the “treasured moments” that will be missed and has tested well. But these efforts will still leave many of the people on the sidelines and will not impact those fixated on not vaccinating. 

Some leaders have made the judgment that the committed anti-vaxxers, those who have hardened views based in part on political, religious or ethnic views, are a “lost cause.” In my view, that position is misguided for two reasons. First, however difficult, it is crucial to convert at least a part of this group (and more of the skeptical whose reluctance persists), because achieving herd immunity may depend on it. Second, there is evidence that entrenched positions can be changed with the right appeal. We do know that framing the discussion around safety, incentives or lost special moments will not be effective enough. Research on similar contexts has shown that it will only elicit coping strategies. They will ignore, distort, forget, counterargue and actually be reminded of why they oppose vaccination in the first place. But what can work is framing messaging around tragic coronavirus outcomes using powerful first-hand stories.    

Vivid Stories of Death and Long COVID-19 Suffering Can Work

The role model is the “Stop Cigarette Smoking” experience campaigns. The government and other institutions challenged long-term smoking habits with campaigns that featured highly emotional personal stories about people struggling with smoking-related health issues, including cancer, gum disease, premature birth and stroke. The stories, often graphic, showed suffering people who told of or implied how regretful they were about cigarette use—some when the end was clearly near. Studies showed they were effective. For example, the CDC ran two short bursts of anti-cigarette advertising in 2012 and 2014. By 2016, over 400,000 people had quit smoking for good and millions more attempted to stop. In contrast, arguing whether smoking caused lung cancer or other diseases was not effective. The fear appeal worked then, and it can work again.   

“The effort needs to involve vivid, emotional, personal stories that dramatically show the unbearable grief over a virus-caused death or the destructive effects of lingering symptoms.”

The urgent task at hand is to create a communication effort that reframes the discussion around the “long COVID-19” outcomes that degrade or destroy life, outcomes that can be prevented by vaccination. And communicate the messages relentlessly. Watching from a distance as a beloved family member takes their last breath. Seeing a real person living with debilitating long-haul COVID-19 effects, such as the lack of energy to even function, brain fog, dizziness, memory issues, breathing problems, the loss of taste and smell, or the need for a lung transplant. That is the frame in which those opposing vaccination will become uncomfortable and a change in beliefs or behavior will become possible.   

The effort needs to involve vivid, emotional, personal stories that dramatically show the unbearable grief over a virus-caused death or the destructive effects of lingering symptoms. Stories are powerful. An enormous body of research shows that involving stories attract attention, distract from counterarguing, are more memorable, and are much more likely to persuade than facts and logic.  

Facts can still be presented, but they need to be motivated by or embedded in a story to penetrate and make a difference. For example, a vivid story featuring a person living with long-term COVID-19 effects compounded by the fact that 500,000 people in the U.K. are sharing that fate will be processed, whereas, without the story, it would fall on deaf ears. Such facts or logic by themselves just will not breakthrough. 

These stories need to be part of a professionally produced communication effort that is strategically targeted and given enough time, enough stories and adequate resources to complete the job. Repetition and story variety will be needed for the campaign to maintain energy and create a change in mindsets. Powerful videos that are graphic, emotional, personal and memorable with visible and credible spokespeople telling their personal stories will be effective in part by gaining exposure through news, commentaries and interviews on various media platforms.