What to Say to People Who Still Want to 'Wait and See' Before Getting the COVID-19 Vaccine

When the US started rolling out COVID-19 vaccines, I knew I'd sign up for mine as soon as it became available to me. After seeing how the virus ravaged communities throughout the world—and having to wear a mask around and social distance from people I care about—I knew I had to play my part in helping the country regain a sense of normalcy.

Some of my friends, however, weren't quite as excited. After I voiced my own excitement for getting the vaccine, several told me they want to wait a year before getting it. Their reasoning? To see whether any to-be-determined long-term health issues crop up in people who got the jab.

And they're not alone: According to the most recent round of polling conducted by the Kaiser Family Foundation, 17% of the public want to take a "wait and see" approach—meaning they'd like to "wait until [the COVID-19 vaccine] has been available for a while to see how it is working for other people" before getting vaccinated themselves. Though that number has dropped from 31% of people who wanted to take the "wait and see" approach in January 2021, experts say that the US may reach a "tipping point" soon, as the supply for COVID-19 vaccines beings to outpace the demand—which will then threaten the country's chances of herd immunity against the virus.

There are a few explanations as to why someone might be more likely to take the "wait and see" approach regarding the vaccine. For example, they may not trust in the vaccine's safety, Wändi Bruine de Bruin, PhD, provost professor of public policy, psychology, and behavioral science at the University of Southern California, tells Health. Or some may view the vaccine as more of a gamble—seeing equal or greater risks versus rewards—which leads them to hold the belief that more data are still needed and choose to wait it out, Jennifer Trueblood, Ph.D, associate professor of psychology at Vanderbilt University, tells Health.

However, these ideas are all in contrast to what experts from around the world have told the public about the COVID-19 vaccines: That they are safe, effective, and (despite an expedited process) made using the same methods and precautions for other vaccines—from development, to clinical trials, to emergency use authorizations granted by the US Food and Drug Administration.

Still, the fear is there. So what can you do when faced with a loved one who is open to the vaccine but wants to "wait and see"? Here's what to know.

Do health experts say delaying the COVID-19 vaccination is ever OK?

The short answer is no. Once you are eligible, it is advised to get vaccinated as soon as possible.

Why? Vaccination is really about controlling the pandemic at a population level through reaching herd immunity, says Dr. Deborah Fuller, Ph.D, professor in the Department of Microbiology at the University of Washington, "This requires a community effort, everybody to step forward in and get their vaccines, so we can build up sufficient immunity of the population, so that the virus runs out of hosts to infect." Dr. Fuller says when the virus still has many hosts left to replicate in, it has more opportunity to randomly develop new variants, And some of these variants may reduce the efficacy of the current vaccine.

Also, if you consider the groups of people who aren't able to get vaccinated because of underlying health conditions, delaying vaccination for a year after you're deemed eligible means these individuals will continue to be at risk of contracting COVID-19, says Dr. Fuller.

And since extensive development and clinical trials have already taken place, waiting a year to get the vaccine is also just unnecessary. The longest you need to observe any ill effects from vaccines is around eight weeks, according to the Centers for Disease Control and Prevention—that's because it's highly unusual to experience side effects past that.

Any side effects would be related to your immune response to the vaccine. So, if a vaccine was going to cause any long term side effects, it would usually occur within six to eight weeks post vaccination, Colleen Kelley, Ph.D, associate professor of infectious diseases at Emory University School of Medicine and principal investigator for the Moderna and Novavax Phase 3 vaccine clinical trials at the Ponce de Leon clinical research site, tells Health. "We don't have to wait for years to figure out whether any health outcomes are going to pop up."

What can you say when someone fears the vaccine was made too fast?

Besides the fact that concentrated efforts and resources went into developing the COVID-19 vaccine, there is another explanation for why a viable vaccine was able to be developed quickly.

"RNA vaccines and adenovirus based vaccines [the vaccine technologies used in the current vaccines against COVID-19] were in what we call 'phase two human trials' for other infectious diseases like influenza and a different coronavirus called MERS," says Dr. Fuller. They had already gone through at least four years of development, "so scientists already had safety data, immunogenicity data, and the manufacturing worked out." According to Fuller, these vaccines were already far enough along in their development come 2020, so when the time came for scientists to brainstorm how to produce a vaccine in response to the pandemic, all they had to do was tailor these vaccines to target COVID-19.

Once they replaced the virus gene in the vaccine with the SARS-CoV-2 gene, the COVID-19 vaccine began entering formal testing phases. But instead of doing these sequentially, where they execute the phase one human trial to confirm safety, then waiting six to nine months before analyzing the immune response data and moving to phase two, Dr. Fuller says scientists aimed to shorten the amount of time by overlapping the phases. After they got the safety data from phase one human trials, they started phase two as they continued analyzing the immune response in phase one. "Through all of those overlapping phases, every safety test is done," emphasizes Dr Fuller.

So how should you respond to loved ones who tell you they plan to delay getting vaccinated?

First things first: Don't get angry. If that happens, the person may shut down and not want to listen to you, says Bruine de Bruin. Instead, try to patiently address their questions and fears, and show that you understand why they might be concerned. You can ask them to share their vaccine doubts with you, and spend the time answering their questions the best you can, says Dr. Kelley. You may want to use some of the vaccine information in this article if the person brings up doubts about its safety. Here are some other key points to address.

Emphasize the vaccine’s role in benefitting the community

In a research article published in the journal Social Psychological and Personality Science in March 20201, Dr. Trueblood and her colleagues analyzed survey data from 34 000 Americans between June and December 2020, on their openness to take a (then-anticipated) COVID-19 vaccine.

Researchers found that when you described the prosocial benefits of the vaccine (like how it can help lead to herd immunity), people appeared to be more willing to take the vaccine sooner. "One of the things we hypothesized in the paper was the fact that prosocial messaging helps redirect people's attention onto the rewards of the vaccine," says Dr. Trueblood. "We know from work in cognitive psychology and neuroscience that people's decisions are influenced by what they're attending to. So we hypothesized that if you help people attend to the rewards of an action more than the risk, that might increase the likelihood that they would want to engage in a certain action."

Share about your own vaccine experience with them

"Facts alone may not change people's behavior," says Dr. Bruine de Bruin. "But people tend to be convinced by what others do." If you've gotten the COVID-19 vaccine, be honest about your experience, not leaving out details like feeling under the weather for a while after receiving it. If you haven't gotten the vaccine yet, explain your intentions to do so, demonstrating your belief that the safety risks associated with it is low.

Remember, it is ultimately the person’s choice

Your loved one may be reassured by you, or they may remain staunch. "If you've tried your best to listen to them, help them understand, and help make it easier for them, and they're still not willing to get vaccinated, accept that you've done your job and respect the person's own decision making," advises Dr. Bruine de Bruin. They may come around to the vaccine in the future—possibly even after waiting a year as they originally planned. And even that is better than the alternative of never getting vaccinated at all.

The information in this story is accurate as of press time. However, as the situation surrounding COVID-19 continues to evolve, it's possible that some data have changed since publication. While Health is trying to keep our stories as up-to-date as possible, we also encourage readers to stay informed on news and recommendations for their own communities by using the CDC, WHO, and their local public health department as resources.

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