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Perceived Self-Interest

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.

Getting vaccinated is a prosocial act because it protects not just the person who got vaccinated, but also their community as a whole (through herd immunity). If nearly everyone gets vaccinated so that herd immunity is achieved, it would be possible for one individual to “free ride” on others in the community.

People may perceive that they can benefit from others’ willingness to be vaccinated while not incurring the inconvenience or small risk of side effects themselves. Experimental and observational studies have documented the presence of this type of free-riding behaviour.

People may justify looking out for their (and their children’s) interests if they perceive that the world is individualistic and competitive, where everyone only looks out for themselves.

Luxury measures

Other people should take the measures that I can afford (e.g., quarantine and social distance)



Preference for taking advantage of herd immunity rather than taking the vaccine