← Quick Find

Fear and Phobias

Dialogue between patients and healthcare professionals can be a good way to answer questions and clear up misconceptions for vaccine-hesitant patients. In this dialogue, it can be helpful to understand the underlying reason why a patient might be reluctant to get a vaccine. We call this underlying reason the ‘attitude root’. Attitude roots refer to deep psychological factors, such as a person’s level of trust or distrust, that shape and constrain people’s beliefs and attitudes.

This tool explains some of the most common attitude roots and how they may show up as arguments expressed by a vaccine-hesitant patient. It also identifies some of the most common themes related to each attitude root, so that we can address them.

Understanding the attitude roots of hesitancy also helps us guide our empathy with a patient. Empathy is an important component of communication, and one way in which we can show empathy is by affirming the reasons for a patient’s concerns. For example, we can acknowledge that there have been cases in which governments have shown themselves to be untrustworthy. This tool gives some examples of affirmations for each attitude root. We can use those examples to understand and empathise with how the patient is feeling about vaccination.

Finally, the tool provides refutations for common arguments and misconceptions that a patient may have. These refutations take into account the likely attitude root and try to correct misconceptions while still affirming the patient’s psychological predispositions.

There are usually two types of vaccination fears, which tend to be much greater than the actual risks involved. Both types of fear have been shown to influence vaccine hesitancy.

1) Fears related to suffering side effects (whether plausible or not). For example:

  • Autism.
  • Cancer.
  • Autoimmune diseases.
  • Neurodevelopmental conditions.
  • Death.

These fears can stem from or be magnified if individuals perceive vaccines to have toxic ingredients. Some commonly mentioned ones are:

  • Formaldehyde.
  • Glycerin.
  • Thimerosal.
  • Aluminium.

2) Fear of the vaccination procedure itself, such as fear of needles.


Arguments reflecting extreme fear of injections or hypodermic needles


Toxicity hazard

Vaccines contaminate the human body with toxins, heavy metals and viruses, or alter DNA


Side effects

Fear to side effects that are known to be caused by vaccines (e.g., fever, sore arm and fatigue)


Safety concern

Fear is induced by portraying vaccines as a general safety concern (e.g., hot lots)


Immune compromise

Fear that one's immune system will be compromised or overwhelmed by vaccination


Dreadful injuries

Severe pathological conditions believed to be caused by vaccines (e.g., autism and infertility)



Rejection due to pre-existing conditions (e.g., allergies, pregnancy and young age)