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Conspiracist Ideation

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.

In general, conspiracy theories tend to become more prominent when people feel threatened or fear a loss of control, because the theories allow people to cope with threatening events by focusing blame on a set of presumed conspirators.

Not everyone who engages in conspiratorial rhetoric is a firm believer in a conspiracy. Sometimes conspiracy theories are used as a rhetorical tool to escape inconvenient conclusions. For example, some people will allude to a conspiracy among scientists to explain away a scientific consensus they oppose, such as climate change, but the same people will not do so when a scientific consensus is of no relevance to their personal attitudes. In general, debunking is easier with individuals who adopt conspiratorial rhetoric only for convenience.

However, some individuals are deeply committed to their conspiratorial beliefs, which may have become part of their identity. Debunking is much more challenging with those committed individuals. People who are committed believers tend to be devoted to more than one conspiracy theory.

Belief in multiple conspiracies (that COVID is a hoax and that the government is hiding people killed by the vaccine) is therefore a good indicator of beliefs that are probably deeply held. In addition, people who are committed believers also tend to exhibit other diagnostic attitudes and attributes. For example, people high on narcissism are more likely to believe in conspiracy theories, as are people who engage in magical thinking (e.g., claim to have experience with the supernatural) and are high in Machiavellianism (and hence low in trust).

The variables that drive belief in conspiracy theories tend to be emotional in nature and revolved around fears and a sense of loss of control.

Targeting marginalised groups

Vaccines are intended to harm disadvantaged groups or poor countries.


Population control

Vaccines are a way to sterilize, depopulate or track the existing population


Made up threat

Vaccine-preventable diseases are exaggerated or do not exist


Government cover-up

Health authorities and companies conspiring to withhold important information from the public


Big Pharma

Pharmaceutical companies conspiring to profit over people or test new drugs