Combat Vaccine Hesitancy, Or They Will Kill Us All

Source: Butler R. (2017) Vaccine Hesitancy, Acceptance, and Demand. In: Vesikari T., Van Damme P. (eds) Pediatric Vaccines and Vaccinations. Springer, Cham.

Earlier this evening I was chatting with some good friends, and as is often the case we end up discussing politics. At some point the topic of Khairy Jamaluddin came up, where I expressed an opinion that he’s handling the vaccine rollout and the public communication of the programme rather well, and that hypothetically I could vote for him in an election. This angered my friends, because they considered him untrustworthy—a snake. They insist that the vaccine rollout had been problematic at best — ‘why was the vaccination programme information released just weeks ago, when they already knew the vaccines were coming for months? ’ And, just because the bar for what passes for a competent Minister has been dug so far below ground by the PN administration, that doesn’t mean we should praise the Science Minister for merely being better than the rest of the Cabinet. I then try to put in an argument that we have to be mindful between what things ought to be (ideal) and the way things actually are (reality). But my friends fired back, saying that I was giving excuses for bad politicians, and that’s exactly the kind of fatalistic attitude that has been holding Malaysia back.

I was just being “a tool for Khairy”, said one. I resented being called that, I told them dispiritedly.

By now the mood had gone sour. The thing is, I actually agree with almost everything my friends were saying. But I didn’t feel like they understood what I was trying to say, and I felt very attacked, especially with that “tool” remark. I went quiet.

But these are good friends. Clearly this topic was spoiling the mood, so we moved on to other things and caught up with gossip and personal updates instead.

If that was what it looks like when you argue with good friends — people you’ve known for years and like very much — what does it look like if you had to argue with … these comments?

The nature of social media is that it is socially acceptable for complete strangers who don’t know a thing about each other to discuss politically sensitive issues, even get into vicious arguments about it. Its effect at the wider societal level can sometimes be dramatic (its seriousness underscored no less by the infamous Jan. 6 insurrection at the U.S. Capitol). At a personal level, however, it often leaves its users (that’s us) feeling terrible, anxious, alienated, humiliated, and often angry.

No point engaging in it, right? Better to switch off that smartphone. Seal off the doorway into that cacophonous labyrinth populated by trolls, pedants, gaslighters, and other such disagreeable entities. Save your emotional energy for more productive endeavours in your life.

And yet the challenge of an unprecedented, emergency nationwide vaccination is such that we ignore the turbid swamp of social media misinformation at our peril.

For that challenge is this: governments understood from scientists that it will be necessary to vaccinate 75–80% of the population in order to achieve herd immunity, and until that happens, a country will not be a safe harbour for unimpeded social and economic activities to resume.

If not enough of us are vaccinated, then it’s as if none of us are vaccinated.

This is because the virus will continue to circulate around the community, giving it more opportunities to mutate into variants that could escape the efficacy of existing vaccines, in effect tearing down the barrier wall of community immunity. We would be back to square one. This will mean more MCOs, prolonged SOPs, accelerating economic damage, pushing some into abject desperation that could lead to out-of-control crimes and even riots. This is the future we are staring at, and our zombie government has all but indicated that it will be incapable (nor see it as its responsibility) to prevent this scenario from happening.

For those reasons, we cannot have a significant minority of Malaysians casually deciding that they do not want to vaccinate. Already, under-18s, immuno-compromised persons, and a few other minor groups of people are to be left out of the vaccination programme, for reasons of safety and prioritisation. I don’t know how much margin that leaves us to play with in terms of population percentage that we can afford to not vaccinate, but it cannot be more than a few percent (if we want to achieve 80%).

Fellow Malaysians, this significant minority is not theoretical. (Health Ministry survey shows a third of Malaysians still fear, doubt Covid-19 vaccine—Malay Mail.)

These anti-vaxxers and vaccine-hesitants are, for whatever reason, mostly on Facebook. Wade into KKM announcements, news report posts (Malay Mail, Berita Harian, etc), and videos such as that infamously misguided one from Roland Victor (which rather alarmingly made it into my neighbourhood Whatsapp chatgroup as something that’s “good for us all to know”), and you will see comment after comment after comment from people who are certain, so absolutely certain, that there’s something wrong about vaccines generally or Covid-19 vaccines specifically, that they either refuse to or are suspicious about taking it. Some disseminate overblown fears about ‘side effects’. Some cite the government’s incompetent bungling of every policy from school openings to immigrant workers as proof that the vaccination programme is dooming the country. According to the stand-up comedian Dr Jason Leong, some of them are actually KKM staff.

We’re in trouble, guys.

Unless we (that means you and I!) can minimise the number of people who plan to abstain from vaccination, from the millions to hundreds of thousands.

Think of it as national service.

Dear reader, if you have the time to spare, I implore you to trawl through the relevant Facebook sites, go through the comments, and gently rebut the comments that profess suspicion or fears towards taking the Covid-19 vaccine, and encourage them to take it when their turn comes. I’ve been doing this myself. (It’s mentally and emotionally tiring. I can only do a dozen of this a day.)

Syahredzan Johan (aide to DAP supremo Lim Kit Siang) suggested this typology:

(1) people who are merely hesitant or suspicious towards the Covid-19 vaccine specifically, suggesting that they could be persuadable;

(2) all-out anti-vaxxers.

Engaging with the latter group is probably a waste of your time. Many of them have formed impenetrable bubbles, both in the sense that they operate in closed Facebook groups or Whatsapp chatgroups, and also that most of them have developed a cult-like philosophy that functions like a black hole: facts and opinions that agree with them will be sucked in strongly, whereas counter-arguments will be distorted into spacetime pathways that can circle around the hole but never enter it.

The only anti-vaxxers you should try to persuade, if it’s within your ability to do so, are family members, and maybe close friends. These are people who know you, and that familiarity is one mighty advantage no stranger (even one with the authority of expertise and experience) will have over you.

Convincing the first group, the vaccine-hesitants, are a more likely prospect.

Some just have questions.

Some just have an odd logic, perhaps missing just pieces of knowledge about vaccines and vaccination programmes that make them think this way.

Some are trolls. Ignore trolls, don’t engage. Report them if appropriate. You want to deal with real people, and change actual minds.

How should one answer them? Here’s one example of how I did it.

Be gentle. Keep a neutral tone. Stay matter-of-fact in your descriptions. Assume good faith. Don’t be afraid or cynical about sincerity. Check your ego on the doorway — you have it, I have it, it’s okay, just watch out that it doesn’t seep into your comment. That means, don’t be sarcastic, don’t antagonise them, don’t bait them to attack you.

I highly recommend reading this Guardian article: ‘How to have better arguments online’. It is very illuminating about what motivates us or triggers us, and how to avoid antagonising the other party so that you achieve your objective of persuasion. Here are some choice excerpts:

‘Disagreement floods our brain with chemical signals that make it hard to focus on the issue at hand. The signals tell us that this an attack on me. “I disagree with you” becomes “I don’t like you”.’

‘One of the most powerful social skills is the ability to give face; to confirm the public image that the other person wishes to project. In any conversation, when the other person feels their desired face is being accepted and confirmed, they’re going to be a lot easier to deal with, and more likely to listen to what you have to say.’

‘Why were these people, many of them smart and highly educated, ignoring mainstream medical advice that was based on sound science? Elisa Sobo [a professor of anthropology] concluded that for these individuals opposition to vaccines is not just a belief, but an “act of identification” — that is, it’s more about opting in to a group than opting out of a treatment, like “getting a gang tattoo, slipping on a wedding ring, or binge-watching a popular streamed TV show”. The refusal is “more about who one is and with whom one identifies than who one isn’t or whom one opposes”. Sobo points out that this is also true of those who opt in to vaccines: our desire to be associated with mainstream views on medicine is also a way of signalling who we are. That’s why arguments between the two sides quickly become clashes of identity.’

Remember, our goal here is to persuade people who are vaccine-hesitant to agree to take the vaccine, in order to achieve the ultimate goal of herd immunity. Not to stroke your ego, not to hit back at people you reflexively consider to be idiots. These emotional impulses are very human, you don’t have to feel terrible about having them — it’s like that mindfulness credo, just watch these emotions happen without judgment, and let them pass.

The great advantage of written replies, as compared to verbal arguments, is that you can check your impulses and revise your comments, purifying it from unhelpful emotions, before clicking that Send button.

If enough of us are participating in this little project of mitigating vaccine misinformation, changing a few minds at a time and empowering them with the right information and attitude, then we can help accelerate Malaysia’s pathway to herd immunity, and get us quicker to a life without the Damocles of MCOs over our heads, or the niggling inconvenience of SOPs, or the alienating disconnection from loved ones. If nothing else, think of the sacrifices, the great sacrifices our frontliners have made this past 12 months.

Please do help.

If you feel you need more information in order to beef up your arsenal of knowledge to redirect vaccine-hesitants to take the vaccine, here are some resources:

On reports that vaccines are, in fact, working globally:

On side effects:

On why children will not be vaccinated anytime soon, and steps to protect them:

On specifically Malaysia’s vaccination programme (JKJAV):

On a comprehensive understanding of the history and effectiveness of vaccination (very clear and easy to follow):

Renaissance Man aspirant: failed economist, career filmmaker, award-winning playwright, medieval historian.