With 59% of the US population fully vaccinated against COVID-19, the increased availability of booster shots, and the rise of a new variant, having a highly vaccinated public is incredibly important to the fight against COVID in the months ahead.
In this episode, Talk Policy to Me reporter Noah Cole talks to psychologist and behavioral scientist Philipp Schmid and public health expert and data scientist Crystal Son about the do’s and don’ts of effective vaccine communication.
References
The COVID-19 Vaccine Communication Handbook- A practical guide for improving vaccine communication and fighting misinformation
World Health Organization Best Practices- How to Respond to Vocal Vaccine Deniers in Public
Transcript
Noah: [00:00:00] Hey, Amy.
Amy: [00:00:01] Hey, Noah.
Noah: [00:00:01] Can I tell you a story real quick? Sure. So this summer, I was at one of my favorite bars and I ended up talking to a stranger. The subject of our conversation was the COVID vaccines. This person ended up telling me that they weren’t vaccinated at the time. I pleaded with them to get vaccinated. My go to point was that “getting vaccinated is the only way we’ll get out of this”, I kept saying. And I also talked about people in my life who I knew had become seriously ill from the virus. I repeated these two points over and over again, but each time I raised them, this person seemed to get more and more upset. The conversation became a bit heated, and when we walked away, I know that neither of us came out of the conversation feeling great or productive. I know I definitely didn’t convince them to get their shot.
Amy: [00:00:53] That’s absolutely something I can relate to and a story I feel like I’m hearing over and over again from all of the people in my life.
Noah: [00:01:00] And that’s exactly what I was interested in the topic of our episode today. I earnestly want to learn about how I could improve my persuasive skills and learn about how to have a productive conversation about this topic that’s equally contentious and highly important.
Amy: [00:01:16] Fifty nine percent of the U.S. population is fully vaccinated against COVID 19, with the greater availability of booster shots and the recent detection of a new variant. Having a highly vaccinated public is incredibly important for the months ahead.
Noah: [00:01:29] And while states, localities and corporations have passed vaccine mandates that have compelled people to get vaccinated, there are still holdouts.
Amy: [00:01:38] A core tenet of public policy is storytelling, using narrative evidence and data to persuade others to support your agenda. So although we’ve heard a lot about trying to convince these holdouts to get their vaccines and the fights around the dinner table trying to make that happen, we haven’t heard a lot about the right way to do it. Today, we’re bringing you a workshop with tactical tips on persuading the deniers you’re sharing meals with or even grabbing beers with.
Noah: [00:02:00] We have two guests on our podcast today. First, I spoke with Philipp Schmid. He’s a psychologist and researcher on Science Denialism who authored the COVID 19 Vaccine Communications Handbook. I also spoke with Crystal Son. She’s a public health expert who studies vaccine messaging for Civis Analytics. We had a great conversation on the do’s and don’ts of effective vaccine communication, and I’m sure you’ll find their guidance to be incredibly insightful.
Amy: [00:02:26] Today, we’re talking vaccine deniers, a workshop for persuasive communication.
Philipp : [00:02:36] When you talk to a friend or someone from your own family, then we usually are very angry if that person has a standpoint that we don’t really understand. So just imagine
Noah: [00:02:48] the first tip that Philip provided about having these conversations is to lead with empathy.
Philipp : [00:02:54] So just imagine you have a dad and that dad is a vaccine denier. Turns out at Christmas that he is totally against vaccination. You are very pro vaccine that would potentially lead to the situation where you think what is wrong with my dad? And then you get aggressive and why? Because your dad or your friends does matter is and they are part of your identity. So you can’t really handle that kind of situation. And our first impulse is to get aggressive. But that doesn’t really help because if you are firing aggressive arguments against another person, they will just block. They would just be reacting to whatever you say and not open up. Furthermore, you will not understand why that person is, for example, anti-vax because you don’t give that person enough room and space to actually talk about fears and other aspects of why they did not get vaccinated. So one aspect here is empathy, and empathy starts with giving the other person room to actually explore and explain what the reasons are, why that person is not getting vaccinated. And after that, the next step is also to the knowledge, the reasons and also to respect the person and his arguments. For example, if someone is saying, like, I read this scientific article long ago about how the measles vaccine causes some severe side effects, and you could just say, well, that is a bullshit paper, but that’s very aggressive. A different situation. A better situation would be, are you read that paper? Actually, if I would have only read that specific paper, I probably would not get vaccinated, too. So you would kind of affirm why that person has the specific reason and you actually say, well. I do understand why you have that specific position if you read that paper. Can I give you some more information that I recently read? And then you are offering information rather than confronting the other person with contra arguments, and that is very important to you.
Noah: [00:04:58] OK. And I think similarly, there’s a part of this guidance about you do not question the vaccine deniers motivation. Can you speak a little bit more to that?
Philipp : [00:05:07] Motivations are very personal, and you can have discussions about motives when you got private discussion. There is no problem with that. We are all interested in why people do what they do. But in public, you can’t really assume a motivation behind some specific argumentation without knowing that person. And it would be even an insult if you just assume a specific motivation behind a specific argument without having research that person or without being in personal contact with him or her. So rather than trying to address the person or the speaker, you should focus on the arguments. And by doing that, you also avoid the so-called argument tomato M. that you attack the person rather than his arguments. And that is a false logic because. Being a specific kind of person and being motivated by specific reasons is, in many cases, irrelevant for what we say. And then we if if that’s the case, we should rather focus on what is being said rather than who is saying what
Noah: [00:06:19] part of the strategy of focusing on what is being said rather than who is saying. It depends on understanding the more common arguments against vaccination. Philip’s research falls under the broad public health issue of science denialism. One of the most helpful insights Philip provided was a breakdown of the five most common techniques of science, denialism and the flaws that come with each technique. He summed up the five techniques through the acronym FLICC F-L-I-C-C. Here’s Philipp explaining FLICC– the five techniques of science denialism.
Philipp : [00:06:52] So the F stands for fake experts. Usually, science deniers just cite some random dude that has a Ph.D. in some subject totally unrelated to vaccination. For example, someone who has a Ph.D. in English language and he doesn’t know anything about vaccination or viruses or epidemiology or anything like that. But just because he has a Ph.D., it sounds very good to say Dr. So-and-so says vaccination is bad. That is one technique. You just cite a person that seems or appears to be an expert, but it’s actually not. The L stands for logical fallacies, and we just looked at one of them. But another logical fallacy is that people tend to think that natural things are good and unnatural. Things are bad. For example, vaccines are made by human beings, so they are bad. While some flowers that grow outside in the garden are natural, therefore they are good. But being natural or being unnatural has nothing to do with good or bad. You can run away from a lion and that lion will eat you alive, but he’s very natural, so it doesn’t really make sense to think about natural things as being good things. The other one is I in FLICC, and that is impossible expectation. Some people expect from from vaccination that they should be 100 percent safe. But actually nothing in science and especially also in medical science, is ever 100 per cent safe. You can think about the pain killer or a heart transplant. Nothing is 100 percent safe, so expecting that from vaccination is an impossible expectation. The C stands for cherry picking, and vaccine deniers usually just look at specific data out in the real world that confirms their hypothesis and confirms their argumentation. We probably all know that one argument that goes something like this. I have a friend who has a friend that has a friend that actually experienced severe side effects. And then you are like, Oh, OK, that’s bad. But if you think about the statistics behind that, there may be that one case. But that one case is not relevant on a public health measure compared to all of the other people who actually benefit from vaccination. So that is picking out one specific narrative out of all of the data that is available. Another version of cherry picking is to look at the meta analyzes in science and pick out one study that actually confirms your argument and leave out the rest and leave out the average effect size reported by the meta analyzes and the next see. And the last technique stands for conspiracy theories, and we heard a lot about them during the pandemic. But this technique is basically based on the idea that whenever someone says something, you just say, Well, you are part of the conspiracy theory. I don’t believe what you’re saying, and that is actually quite a rabbit hole. You can’t really get out of that one because whatever you say, even if you say like. But that’s not true. I am a trusted person who has actually experts telling me what what the real data is. They can all say well, but these experts are also part of the conspiracy theory and then there is really no way out of that discussion anymore. So these are the five techniques of science denialism that you can see in all specific areas where science deniers act, or that is climate change denialism to vaccinations than I am to evolution, theory, denialism and so on.
Noah: [00:10:41] A second ago, you referenced misinformation. How do you recommend engaging with misinformation around COVID?
Philipp : [00:10:50] So there is. There are different ways of how you could engage with misinformation, especially also around COVID 19. One way is to just ignore it, and that’s actually the worst you can do. So if you have the chance, go and correct and debunk misinformation as often as you can. And in the best way that you can and do, and there is actually some guidance on how you could design your debunking and corrections. And one simple tip is to write our facts and which is that is your correction should start with a fact rather than a misinformation, then you should use a warning. The misinformation is coming in your text, then you should state the misinformation. Explain why it is wrong and then conclude with the fact again, if you use that, then this is a quite sophisticated way of correcting misinformation without the risk of reinforcing the belief and misinformation.
Noah: [00:11:54] Philip provided a solid foundation for understanding how to debunk misinformation, leading with empathy and being aware of scientific denialism, as I thought about how diverse our community is in the U.S. and especially in the Bay Area. I really wanted to be mindful of how effective messaging may not be one size fits all. This curiosity led me to a report by Civvies Analytics, which tested the effectiveness of eight different vaccine messages in the spring and summer of 2021 across subgroups divided by race, income, age and gender. The findings from this report are fascinating. So for the second part of our vaccine communications workshop, I spoke with Krystal Sun, the director of health care analytics at Civis Analytics, to take a deep dove into the report. First, we discussed the eight messages that were tested. Here’s Krystal.
Crystal (Civis): [00:12:47] One of the messages talked about vaccine safety, and it highlighted the safety of the vaccines, talked about the FDA process, the diversity of clinical trials and the rarity of serious side effects. The second message was something that we just referred to as FOMO shorthand or fear of missing out. And then it talks a lot about how if you are not vaccinated, then you may have to miss out on or delay activities that are considered more off limits to non-vaccinated individuals, like traveling. The third message was what we called scary COVID statistics. So the aim here was just to bombard the reader with a lot of numbers about how dangerous it is. The fourth message was a message called Personal Story, and it’s worth clarifying here because we’ve used this term personal story to describe messages in the past that are actually different here. Personal story referred to the actual copy or actual text from a physician in Alabama who had posted her social media account about how a lot of unvaccinated patients lately who were basically on their deathbed and asking for the vaccine. And she had to tell them, regrettably know that it was too late for them. Patriotism was the next message, and that was one that talks about how the vaccine is an example of American ingenuity, how it’s an ultimate expression of freedom, liberty and country. Next is personal decision in contrast to personal story. So personal decision emphasized that it’s normal to have questions about the vaccine is very more passively encouraging. I would say encourage people to learn more and ask people that they trust for more information. Talked about the vaccination being a personal decision to someone. Next is protecting children, which described the rise in COVID among children and talked about how when adults get vaccinated. This helps protect children, especially those that are younger than 12 years of age. And then the latter, which we tested, was called financial costs. And that talked about how if you get COVID and it’s a severe case of it, it can be expected to have that. Getting vaccinated can help you avoid that financial burden.
Noah: [00:15:02] The service research found that financial costs and protecting children were the most effective messages, but we’ll get to those later. For now, let’s focus on some of the messages that didn’t work well.
Crystal (Civis): [00:15:14] Yeah, I mentioned the overall strategy of using fear based messaging, which is it’s very tempting and it’s very intuitive, right? It’s not supported by the data that we’re seeing. Their results are proceeding. So that’s number one, is to focus on messages that are either neutral or more positive, like focusing on the benefits of vaccination versus the consequences. The second major recommendation that the emphasized yet again, is that talking about the safety of the vaccine is not effective at persuading people at all and in some cases leads to a lot of negative backlash. Using this as a strategy again is very intuitive, because if you ask people, what is the biggest barrier for you? Why, why? Why are you resistant or are you hesitant about getting the vaccine? Concerns about safety are always number one. So when we present a message that should be persuasive, according to the survey, you know, talks about the FDA, talks about how like no corners are cut. We find that people are just not persuaded by that or they kind of like that. I’m not interested. I’m less likely to get vaccinated. And so that’s another gem that we continue to bang. But it is very tempting and we’ve seen that use so many times and continue to be used.
Noah: [00:16:38] Okay. And so I know that you ran this test once or you ran these trials once in the spring of 2021 and you also ran them in the summer. And you know that there were differences in terms of what was effective in the spring versus summer. So what changed over time and which? Judges are more effective now that maybe weren’t so effective in the spring.
Crystal (Civis): [00:16:58] Yeah. So in the spring, what we found to be most persuasive were two messages. One was essentially the formal message talked a lot about the the things that you’d have to miss out on. And then there was another message that was very similar to personal decision. Same theme there we talked about, you know, this is this is your choice to get vaccinated. Of course it’s important, but it’s ultimately up to you. You should get more more information and make the decision yourself. Those two messages were not as persuasive in our more recent test. The two most persuasive this time around were one that talked about protecting children, and the second close runner up was the one that talks about financial costs. We see this kind of change in what’s persuasive and what’s not. Over a period of time, all the time, what’s been really interesting to watch? COVID vaccine messaging has been how fast attitudes and therefore how persuasive certain angles have been for audiences. And so we’re not surprised that between spring and now, especially with so much has changed. You know, in the fall, we started talking about employer and school mandate. That was not a thing in the spring. We had just experienced a summer where there’s a lot of increased comfort around loosening up some of the restrictions and then starting in the late summer or early fall, there’s a lot more concern because of the Delta variant. Just the overall demographic of who is remaining in that unvaccinated population is different now.
Noah: [00:18:43] Was there a message that ended up working well just for maybe any given random vaccine denier that you may come across?
Crystal (Civis): [00:18:51] And so that really leaves like the protecting children and the financial cost message. It doesn’t mean that it’s going to be the most effective for every person across the board. In fact, that’s one of our main conclusions is that now more than ever, we’re starting to see a big difference between what’s persuasive across the board for everyone and what’s persuasive for smaller subgroup. One two three four. But it’s the least likely to do any damage with your campaign or your outreach or even your personal conversation. So, you know, if I do go with two messages, it would be those two that I mentioned.
Noah: [00:19:34] What were some of your findings when you were able to break things down by these subgroups?
Crystal (Civis): [00:19:39] Yeah. So one of our the things that we one of the things that we always bang the drum really loudly about is that what is most effective for everybody across the board may not work. And in some cases, may against you, particularly smaller subgroups. So one example of that is with the Latin X population participants who were in our study. Overall, they were very persuaded by the Protecting Children message, more so than the overall population. It was an average of 11 percentage points increase in their likelihood to say that they would get vaccinated, whereas for everybody across the board was about six percentage point increase. But there was a second message that was really highly effective on this subgroup, which is the patriotism message. You talked about American ingenuity and how this is an expression of liberty for everyone across the board. Patriotism was not one of the persuasive messages. I think it came in fifth place or something like that. But for next respondents, it was in second place and it was the place to get and it was it was an increase of seven percentage points, is what we saw. It tells us that we have this perception and I include myself here too, because I fall into this trap as well of like all unvaccinated people, look like this and they believe this and they’re doing this. And therefore, this is the way that we talk to them to get over this hurdle, to get them vaccinated, right? But when you actually look at the data like this, we find that no, it’s actually a very heterogeneous group. And to to look at them as if they’re they’re not is not helping us make the progress that we want and in a lot of cases may actually be hindering the progress that we want to make.
Noah: [00:21:35] Were there any other messages that stood out in terms of what was more or less effective when you broke things out into subgroups?
Crystal (Civis): [00:21:42] Yeah, there are two other examples I can think of. One was for unvaccinated white Americans and higher income earners. The FOMO message was more. Since then, protecting children, so the other example is unvaccinated white Americans in higher income earners. For them, the FOMO message was more persuasive than protecting children so that that protecting children was not the top ranking message. And then the third noticeable difference we saw was in among the conservative individuals. The personal decision message was more effective than protecting children or financial costs for them. The personal decision where it was like, it’s up to you to get vaccinated. That was the number one was persuasive.
Noah: [00:22:31] How would you recommend, you know, after someone really looks at your findings, how would you recommend applying some of the findings of this report in everyday life?
Crystal (Civis): [00:22:38] I think number one is to really understand the audience that you’re trying to speak to. So beyond just an unvaccinated person, you need to know what are the demographics? It’s sort of like if you’re going to treat a patient, you have to first figure out what is going on with that patient and then tailor how you’re going to approach that patient accordingly.
Noah: [00:22:59] Looking out maybe a year from now, how do you think we’ll be talking about vaccine messaging? And do you think that, you know it will be completely different messages that are effective at that point in time?
Crystal (Civis): [00:23:10] If the past year and a half has shown us anything, is that what’s persuasive has been very volatile. So I think that next year there are going to be different messages that are persuasive. I don’t know exactly what’s going to be persuasive, of course, but I think depending on how the public dialog around mandate and therefore the opinion that shaped by that dialog turns out, depending on what the recommendations are around boosters, I think there’s a lot that we need to do and understand, and a lot that we we need to be able to pivot our strategy to make that effective. There’s a temptation for us to all be bogged down by this and just, you know, this is this is hard slow work in a lot of ways that this is kind of normal with any kind of campaign that you’re running, whether it’s vaccine outreach or it’s raising funds or, you know, fill in the blank. The first phase is always the easiest. Second phase happens. It’s a little bit harder. And then the last phase we’re in right now is difficult and that’s what we would expect. But there are a lot of positive signs. We made a lot of progress over the summer and in certain communities, they seem to be making a lot more progress still. So I think there’s a lot to look forward to.
Noah: [00:24:47] OK, so this may have been a lot to take in, but here are my main takeaways from speaking with Philip and Crystal. First off, lead with empathy and always affirm the argument of the person you’re speaking with before debunking their argument around vaccines, attack what is being said and not who is saying it. Be aware of the five common techniques of science denialism and the ways to debunk them. Fake experts. Logical fallacies. Impossible expectations. Cherry picking and conspiracy theories do not ignore misinformation, but debunk it when you can with the facts sandwich. That means you start with the fact warn that you’re about to discuss misinformation, then state the false claim. Explain why it’s wrong and then state the fact. Again, messaging that has worked well recently includes reminding people about the financial burden brought about by having COVID and emphasizing that getting vaccinated protects children. Negative fear based messaging is less effective and actually may hurt the cause of getting folks vaccinated. Lastly, you have to tailor your messaging to the audience you’re speaking with in order to be effective. So with all that being said, Amy, what do you think?
Amy: [00:26:03] Well, the idea of affirming why someone would believe what they do about vaccines based on what they’ve read really hit home for me. I don’t think I’ve brought nearly enough empathy into my conversations with vaccine deniers, so I’m going to work on that. The other thing I’m thinking about is that for those of us, I guess you could call vaccine acceptors. We accept that the recommendations coming from Fauci and the CDC are always changing based on new science and research. I want to think about my approach to trying to persuade vaccine deniers with that same sense of fluidity. It makes sense that as presidents, the economy, the state of the virus and hospitalizations change, we would need to tailor our messages to that information we have at the time. That’s going to be the most persuasive to get shots in arms. Overall, I think that getting out of negative messaging and into more practical persuasion sounds like the right direction.
Amy: [00:26:51] Talk policy to me is a co-production of UC Berkeley’s Goldman School of Public Policy and the Berkeley Institute for Young Americans.
Noah: [00:26:58] Our executive producers are Bora Lee Reed and Sarah Swanbeck.
Amy: [00:27:01] Noah Cole produced and edited this episode with editing assistance from Elena Neale-Sacks.
Noah: [00:27:07] The music you heard today is by Blue Dot Sessions and Pat Messeti Millier.
Amy: [00:27:11] I’m Amy Benziger.
Noah: [00:27:12] And I’m Noah Cole.
Amy: [00:27:13] Don’t forget to get your shot.
