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Sunday, September 26, 2021

What can lead to vaccine hesitancy and how can it be addressed?

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TORONTO — Change has been a constant throughout the pandemic, whether it be our habits or the guidance from public health officials, Canadians have had to adapt and learn over the last 18 months, but changing information has pushed some people to mistrust what they hear.

The COVID-19 pandemic has put a spotlight on the scientific process, and while guidance and recommendations have been continuously updated along the way, some Canadians were left behind and sidetracked by misinformation.

“Usually, citizens don’t actually see how science is not definitive facts, but it’s a process by which over time and through increasing levels of certainty, we’re able to land on facts that we can then make use of,” Steven Hoffman, director of the Global Strategy Lab and a professor of global health, law, and political science at York University, told CTVNews.ca in a phone interview on Wednesday.

With so many studies on COVID-19 being conducted around the world, there’s a plethora of information that can then be difficult to put into simplified public health messages.

“It can be difficult to integrate all this knowledge together and communicate it in clear and crisp ways to the public, because everyone wants a very clear statement of facts,” he said.

Celia Du, a science communications expert, says that communicating the dangers of COVID-19 is a fine balance.

“It’s not easy because this is really all about risk communication, being able to communicate something that’s affecting a lot of people negatively, and walking that line. You don’t want to fearmonger, but we also want to make sure that everyone understands the level of consideration that they should have about this issue,” Du told CTVNews.ca in a phone interview on Wednesday.

Those types of communication strategies take time, which was something we weren’t really afforded during the quickly spreading pandemic.

“That’s really hard and that takes time to strategize. We don’t really have the benefit of time during the pandemic,” she said.

The changing guidance and information that has played out in Canada throughout the pandemic is knowledge evolving in real time, which is something many Canadians aren’t usually able to witness so easily.

“What public health officials are trying to do is to be truthful and honest with everyone about what we currently know, while simultaneously recognizing people have to make decisions in the absence of full evidence. So they’re providing the best available evidence and advice,” said Hoffman.

COVID-19 guidelines and vaccine rollouts have been political from early on in the pandemic. Anti-mask and anti-vaccine groups continue to march and hold rallies in Canadian cities to this day, but for Hoffman, this isn’t overly surprising.

“Public health has always been political,” he said.

This isn’t necessarily a bad thing, he added, public health is how the government works to protect its citizens.

“Where it’s bad is when political actors can sometimes become incentivized to make statements that might win them political points, but at the expense of people’s health.”

Canadian officials have been good, said Hoffman, but the bigger issue lies in social media where misinformation and disinformation can spread quickly with little control.

“I think that social media and the internet enabled misinformation to spread faster and broader than ever before,” he said. “The phenomenon itself is not new, think of a snake oil salesman.”


Some doctors and experts have taken to social media to share their advice and guidance and as a result have become household names in Canada, garnering thousands of followers, but Du cautions against having a favourite doctor and hopes that people will broaden their scope.

“I think the whole downfall of celebrities and influencers is that we like to follow the individual, but the thing is that even though these individuals have a lot of expertise, they are still one individual. No one individual is going to get all of the information right,” she said.

While being able to access a doctor’s or expert’s quick opinion on Twitter might be helpful to some, it has also led to some analogies that don’t quite fit the bill, or even downplay the seriousness of some people’s concerns with vaccine hesitancy.

“Vaccination hesitancy is different among different communities, even different age groups, different ethnicities, different languages, they all have their different reasons,” said Du.

One common analogy used by a few experts on Twitter to combat concerns around vaccine interchangeability was that they are like Coke and Pepsi, that is to say, they are the same. But, if you ask any Pepsi or Coke lover, the two beverages couldn’t be more different, and some won’t drink the other.

“This is why we really need to target with this messaging because It’s going to be hard to get an analogy that works for literally everybody,” she said.

Social media also acts as a sort of echo chamber. As the various platforms’ algorithms get to know us based on what we like and share, it presents us with more and more similar posts.

“The algorithms know us quite well and almost too well,” said Du. “If you’re looking for, and liking and sharing very specific types of posts, the algorithm is only going to show you more.”

And even when experts do go viral for the pithy posts, they are usually only reaching and convincing those accounts who have similar interests and beliefs.

“Social media has these bubbles,” she said. “That’s the thing with medical experts on social media, they often go viral, but how many people are they really reaching that aren’t already on board. Social media can be a little bit of preaching to the choir situation.”

Some experts and officials who were once sharing their expertise behind closed doors suddenly found themselves on TVs and quoted in digital and print news while trying to learn about the novel coronavirus.

“It’s a process of learning and sometimes we get it wrong,” said Du. “Usually we’re on the right track, but we have to acknowledge that we are working in an area of uncertainty.”


Canada’s vaccine rollout communication hasn’t exactly been perfect, there have been setbacks, and changes to dosing schedules, mixing and matching and which vaccines are highly recommended, and Hoffman says now is the time to focus on the vaccine hesitant.

“Let’s focus on the Canadians who are either accepting of vaccines, or would be after a respectful conversation with their health-care professionals,” he said.

Du agrees that the vaccine hesitant should be a priority.

“You’re really more concerned about people sort of on the fence, because they can become more anti-vax,” said Du.

Making the vaccines easier to access, and having respectful conversations with a health-care provider could help give people who are vaccine hesitant the final push they need to get their shot, said Hoffman.

“I don’t think the energy should be focused on the 3 per cent of Canadians who are ardent anti-vaxxers,” he added. “There is little that governments and public health officials will be able to do to convince them otherwise.”

Incentives could be one way to get people to take the final step and get their first dose, but the jury is still out on how effective they are.

“There isn’t a definitive answer, whether it’s good or bad, but on the good side it’s like providing that extra little nudge, which helps not only the person being vaccinated, but everyone they come into contact with. But on the other hand, may accidentally, unintentionally raise questions about why is it that the government feels that it needs to incentivize.”

It can also make people feel like they’ve been coerced or tricked into getting the vaccine, and Du says the effort should be made to allow people to give their full consent and come to the decision on their own.

“It’s a more effective way for someone to actually fully support a decision that they’ve made when they feel like they’ve come to the conclusion themselves.” 

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