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Distorted Risk Perception

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.

People often have a distorted perception of the risk that they or others face from a disease. Specifically, people may perceive that the risk from a disease is low or inconsequential. This can motivate their belief that they don’t need a vaccine or that the drawbacks outweigh the benefits of vaccination. A misperception of disease risk has been found to be related to hesitant attitudes towards vaccination.

One of the reasons that people underestimate the risk from diseases is that vaccines have been so successful. It’s easy to misperceive that the risk from a preventable disease is low when few people, if any, suffer from that disease.

Vaccination is unnecessary

General arguments portraying vaccination as unnecessary, redundant or unimportant


Vaccination is not for me

Lifestyle, religion, good health or natural immunity would be enough to avoid disease


Misperception of risk

Dismissal of the risk of getting the disease, considering its incidence to be irrelevant


Disease is not serious

Diseases are perceived as mild or even positive for child development and the immune system


Cost-benefit analysis

Vaccinations are perceived as being riskier than the diseases themselves