Parents are leery of the C19 vaccine. Help.
April 27, 2021 10:25 AM   Subscribe

My parents are wary of getting vaccinated for various reasons. I'm looking for how to present it as a reasonable decision.

I was talking to my parents yesterday, and it doesn’t seem like they’re planning to get vaccinated. What they seem to be latching onto is that there’s no info about the long-term effects. Which, y’know, fair enough. Someone who worked as a nurse for forty-plus years has also shared some anecdata that casts doubt on the wisdom of getting the vaccine. Finally, they seem to be reacting strongly to the public uptake of the vaccine in such a way that almost feels contrarian. They suggested I do my own research to conclude whether it’s worth getting or not.

So here’s the thing: I definitely have some sympathy for being skeptical, that we as members of the public rarely get the full story on anything. I believe it’s worth doing due diligence. And being a little worried about the long-term effects for something that was recently released makes sense to me. Heck, I’d be lying if I said I wasn’t at least a little worried myself.

My question, though, isn’t whether I should get the vaccine. I’m going to. Can you help me explain why it’s a good idea, despite their objections (some of which seem sensible and others don’t)? Research that expresses skepticism but still comes out in favor of getting it would be terrific! Comparisons with previous vaccination roll-outs would be welcome too. If you’ve navigated a similar situation with people in your life, I’d very much like to hear about it.
posted by Definitely Not A Robot to Health & Fitness (39 answers total) 6 users marked this as a favorite
Best answer: I personally had the same concern since even trial participants have not had a chance to experience any potential long term effects but ultimately decided to get the vaccine. My reasoning was that if there are terrible side effects down the road, millions of other people across the globe will have the same issue, so there will have to be some kind of cure devised for it. Also, certain venues are opening up to only vaccine holders - do they want to miss out?
posted by lovelygirl at 10:31 AM on April 27, 2021 [5 favorites]

I had an older relative who was bizarrely skeptical about the vaccine, for reasons which made no sense to me at all. Whatever propaganda algorithm is working on these people is doing a hell of a job because they're changing peoples' minds who have been pro-vaccine for their entire lives. I guess because one child was saying the vaccine isn't trustworthy & the other child was saying hey that guy's an idiot, just take the vaccine, they decided we were both stupid. The only thing that ultimately convinced them was to see an infection control doctor and get them to personally declare the vaccine as being safe. It caused a delay because yknow, they're busy right now, but it worked.
posted by bleep at 10:33 AM on April 27, 2021 [3 favorites]

This is pure layperson conjecture but (for the non-mrna ones, at least) it's a vaccine. I think it's a pretty standard mix of, y'know, stuff, just with a new special ingredient that teaches your immune system to create antibodies against COVID 19, instead of the flu or chicken pox or whatever.

This seems to bear out my conjecture.
posted by rhooke at 10:46 AM on April 27, 2021 [1 favorite]

Best answer: Regarding long term vaccine effects - while those remain uncertain, long term effects from contracting COVID are prevalent and real. You're balancing one set of risks that are well-documented and potentially life-altering, for ones that are unknown and scientifically unlikely (but yes, not a 0% risk).
posted by blueberrypuffin at 10:46 AM on April 27, 2021 [53 favorites]

You could look into the work of the Turkish "persuasion teams" they're deploying to convince older folks in the southeast with a pretty decent success rate.
posted by aramaic at 10:48 AM on April 27, 2021 [1 favorite]

Best answer: I don't know how to convince your parents about this, but in general the chance of long-term adverse effects from vaccines is very low. There's no particular reason to think that these new vaccines will be any more likely to cause long-term existing effect than any of the half-dozen or more vaccines your parents have probably been getting their whole lives (if your parents are general antivaxxers, obviously this tack does not apply).

I guess if your parents were my parents, I would want to talk about, like, what their plan is? Are they planning to keep isolating? Do they just figure they'll get COVID at some point and it won't be so bad (in which case you can talk about how there are frequent, well-documented long-term effects from COVID infection!)? Do they figure COVID's just going to go away and they'll never need to get a new vaccine?
posted by mskyle at 10:50 AM on April 27, 2021 [19 favorites]

I think you're taking the right tack: accept the validity of their concerns, don't try to shame them for being hesitant to get the vaccine, and explain your own logic for deciding to go ahead with it. Another thing that I would point out is that we really don't know the longterm effects of even mild COVID, but the evidence looks pretty grim. A lot of people with mild COVID have longterm neurological effects, and I read yesterday that people who have COVID and aren't hospitalized are 60% more likely to die in the next six months than people who don't have COVID. There's no such thing as a risk-free life, because we can't predict the future. But at this point, the possibility of longterm effects from the vaccine is totally hypothetical, and the possibility of longterm effects from COVID is not.

I guess another thing you could try is to see if they'd be more comfortable getting the J&J vaccine. All of the blood clots have been in young women, so they presumably don't fit the profile. And it's a more-typical vaccine technology, so you might be able to sidestep some of the concerns about the novelty of mRNA vaccines.
posted by ArbitraryAndCapricious at 10:52 AM on April 27, 2021 [8 favorites]

I would also point out that yes, it's true, we don't know if there are long-term issues with the vaccines, but in general, issues tend to occur within two months of injection, and we're not really seeing those other than rare cases of cerebral venous sinus thrombosis with J&J and AstroZeneca.

On the other hand, we also don't know the long term issues that may occur with COVID infection. Here's a pre-print (not yet peer reviewed) from a team in the Netherlands that claims that rhesus macaques infected with COVID-19 develop Lewy bodies, and that's kind of concerning because that could lead to Parkinson's.
posted by Comrade_robot at 10:55 AM on April 27, 2021 [5 favorites]

The Sawbones podcast did a pretty good episode on vaccine hesitancy and how to discuss it with people by pairing the actual science with empathy for the very real (if unfounded or disproportionate-to-real-risk) fears people might have. There's also a transcript for the episode.
posted by mandolin conspiracy at 10:59 AM on April 27, 2021 [6 favorites]

This week's episode of This American Life has a segment on overcoming vaccine hesitancy that you might want to listen to. It's here. Start at act two, The Elephant in the Zoom.
posted by BlahLaLa at 11:11 AM on April 27, 2021 [3 favorites]

Best answer: We don't know the long-term effects of these vaccines, but we do know:

- The long-term effects of other vaccines, which are generally agreed to be negligible by people who aren't being misled by junk science about autism or Guillain-Barre

- The slightly longer-term effects of other mRNA vaccines, like the Zika one which has been in human trials since 2019; I believe they're finding it less protective for Zika than attenuated virus vaccines, but there haven't been major side effects

- The long-term effects of Covid, which we already know to be very bad and which may well prove to be worse over a longer term.

Skepticism is a good instinct! But a skeptic who demands certainty isn't a very good skeptic. It makes sense to gather all available information and to take unknowns seriously. But we actually do know a fair amount here, and all of it points to the vaccine likely being safe and not taking the vaccine likely being unsafe.
posted by babelfish at 11:17 AM on April 27, 2021 [6 favorites]

Best answer: We do know that the long-term effects of this virus are lousy; there are already specialty medical facilities and programs for that population. [I made an FPP last month about long-haul COVID (PASC); getting vaccinated may help some long-haulers 'reset' their immune systems.]

It's great that for many people a COVID infection has become less immediately lethal, but it's still best to avoiding contracting it -- which means getting vaccinated, if possible, for self-protection and to protect others. More on that protection in the Lancet study published last week, involving 23K+ nurses, Population immunity and vaccine protection against infection. (Speaking of nurses, who is this possibly-retired nurse giving them poor advice, and why are they prizing it above the advice of their current medical providers?)

A senior in my own family seemed really attuned to weird Fox/FaceBook fringe-y talking points, in spite of their doctors' recommendations to get vaccinated. At this person's request, I did do a ton of research, but I think the tipping point was a frank appeal to their self interest? They resented lockdown protocols, and wanted to return to regularly gadding about town and having company over. So, things to think about and maybe discuss with your parents: Going forward, how comfortable are you and others going to be around known unvaccinated people? Will avoiding the vaccine now limit opportunities to mingle with family and friends, or travel, or attend public events, or enjoy other activities they've had to severely curtail in the last year and change?
posted by Iris Gambol at 11:20 AM on April 27, 2021 [4 favorites]

What worked with my ex who is very susceptible to any kind of conspiracy theory and did Not want to get vaccinated, is focus on the angle that by both getting vaccinated we do the best we can to alleviate our son's fears that his parents contract covid / die of covid. Our son ist 12 and is truly scared.
Perhaps If there are grand children they might do it for them? Or for your sake?
posted by 15L06 at 11:26 AM on April 27, 2021 [3 favorites]

"Every choice is always between options with risks attached. Remaining unvaccinated is an option carrying a moderate risk of becoming infected with a disease whose consequences are well understood to be anywhere from horribly unpleasant to genuinely life threatening. Getting vaccinated is an option carrying a very low risk of bad consequences; lower, in fact than that associated with many of the choices you're already making daily without worrying about them. So what I completely don't understand is why you'd lean toward the option with orders of magnitude more risk attached, a risk that's higher both for you and for all your children and all your friends. That just doesn't make sense to me. Could you explain?"
posted by flabdablet at 11:46 AM on April 27, 2021 [2 favorites]

There is already talk that covid could be with us for decades, even if everyone is vaccinated none of the current vaccines provide Sterilising immunity.

Sterilising immunity means that the immune system is able to completely prevent a virus from replicating in your body.
For people who have been vaccinated this doesnt really matter, you pick up some covid particles, your body spends a day or two fighting it off and you carry on with your day, the important thing is that you don't get ill.
For people who haven't been vaccinated it means that every social interaction will remain a game of Russian roulette even if everyone around you has been vaccinated.

When booster jabs become available to cover new variants, it seems likely these will only be tested on patients who have already had the first vaccine.
Basically FOMO can be a good motivator.
posted by Lanark at 11:48 AM on April 27, 2021 [4 favorites]

Best answer: I can't say this often in my day job as a toxicologist-epidemiologist in the drug development field, but I do say this often to people in my personal life who ask these kinds of questions about this specific vaccine at this point in a pandemic that has killed masses of people: have you done the kind of research you think is missing here for *every other* drug, supplement, surgery, engineered food product, multivitamin, contact lens, nutritional supplement, medical device (including apple watches and lube and so on) that you put on/in/near your body?

At some point, the burden of investigation isn't something that you can outsource. If people want to stay in that skeptical space forever, they can. In general terms, though, there's usually a trigger for that kind of thinking that's so-hot-right-now for any given moment. Isn't that what this is?

This is a long-winded way of saying, if you're trying to convince someone who is unwilling to dive into the material between themselves and their doctors (or any of the public experts who are available for free consultations on this specific question), I think the questions to ask in a group setting is less related to the technical details and more about the willingness to apply a newfound sense of hyperskepticism to this particular situation.
posted by late afternoon dreaming hotel at 11:51 AM on April 27, 2021 [28 favorites]

How do they feel about Benjamin Franklin? Maybe an appeal to authority would help.

“In 1736 I lost one of my sons, a fine boy of four years old, by the smallpox taken in the common way. I long regretted bitterly and still regret that I had not given it to him by inoculation. This I mention for the sake of the parents who omit that operation, on the supposition that they should never forgive themselves if a child died under it; my example showing that the regret may be the same either way, and that, therefore, the safer should be chosen.”
posted by bq at 11:59 AM on April 27, 2021 [15 favorites]

Have you tried asking one of your parents' friends or peers to present your arguments?

Parents often have a huge blind spot for listening to their children, because they're used to being the ones that are always right and not vice versa.
posted by meowzilla at 12:01 PM on April 27, 2021 [6 favorites]

One thing you can push back on is their assumption that you haven't "done the research," which is a popular Qanon phrase along with being extremely insulting to say to somebody. Ask them to quantify how stupid they think you are.

Also, how old are they? How long-term are they worried about? Are they over 60, when COVID starts getting real dangerous?

Maybe get them to be specific about their fears. What other vaccines' "long-term" effects are they aware of? Like, we don't actually know of any documented "long term" vaccine effects beyond protection from the thing they're vaccinating against, because if they exist they blend into the millions of other risk factors in people's lives. It's possible that all of us who got MMR vaccinations (or a certain era or batch or whatever) are 1% more or less* likely to get some common disorder of old age, at a rate that is indistinguishable from it being caused by bad diet or mercury fillings or too much sun exposure or air pollution.

*It's also entirely possible that the unanticipated "long term" effects are positive! We know that not getting covid is definitely a positive long-term, but just like there may be some slight negative repercussions to the vaccine, there could just as easily be a tiny percent less susceptibility to something bad. People who got the chicken pox vaccine are so far significantly less likely to get shingles than those of us who got antibodies the old fashioned way! We're about to find out how much so in a big way, as the first consistently-vaccinated kids are about to hit middle age.

There is a very, very slim chance with the technologies being used here that 20 years from now a huge percentage of the population is going to drop dead or grow a third arm or turn green. And most of the things that could happen are going to be manageable. Ask them to define the difference between acceptable and non-acceptable risks, out loud, where they can hear themselves.

You might also let them know that as their next of kin, if this is their position then you will make sure they aren't given other potentially life-threatening/long-term-effects treatments like antibiotics or chemotherapy, if that's the hill they want to die on. This is an unsympathetic frustrated response from me, but probably you should rephrase it slightly more politely and see if they're ready to draw the same line. In chemotherapy in particular, people survive stuff for years now that was a quick death sentence 10-20 years ago, often on the backs of very fresh iterations of treatments that have not - in their specific formulas and in some cases overall technologies - been testable long-term because they haven't existed long term. Is that a line for them? How many years would be sufficient? Some of those treatments are very hard on the body, with repercussions for the rest of a possibly very long life, but still a pretty good life that's a lot better than being dead.

I think making people articulate this stuff out loud is key. Probably you should be more patient than me in asking and listening, but I don't know that you should entirely refrain from holding them somewhat responsible for their attitudes and contradictions.
posted by Lyn Never at 12:10 PM on April 27, 2021 [6 favorites]

I'm not trying to be flip, I swear, but I did want to add, regarding the "the long-term effects" argument in this instance (in case it helps you or someone else):

My uncle was quarantined after testing positive for TB as a kid (spending three years on a farm in New Jersey). He's now in his 70s, has COVID risk factors beyond age, and had no problem with getting vaccinated. One of his less-eager peers expressed reservations similar to your parents' concerns, and, as my uncle related to me, "I told the guy, you're worried about long-term effects? LONG-TERM, at our age? Listen, if this shit accidentally makes me immortal, there will be hell to pay, but in the meantime, I don't want to die alone on a ventilator, and neither do you."
posted by Iris Gambol at 12:20 PM on April 27, 2021 [23 favorites]

Mr. Meat has been the "covid intubation guy"; we have a LOT of doctors in our circle of people.

Every single one of them has leaped to get this vaccine. "I would take it in the eyeball" is a refrain I've heard.

These are smart people. Hella smart people. I trust them because I KNOW them.

tldr; The smartest people I know are all getting it. I want to be on that bandwagon.
posted by Ms Vegetable at 12:22 PM on April 27, 2021 [6 favorites]

Oh, also:

My mom had polio as a child. She has dealt with lifelong strength issues, and lung issues, and general issues because of this - the polio vaccine rollout came out too late for her.

She has also gotten the covid vaccine as early as possible because she has spent the last 70 years experiencing the results of not having one.

(I know these are just anecdata and my not sway your parents.)
posted by Ms Vegetable at 12:25 PM on April 27, 2021 [11 favorites]

Further to my original point above, you need to find a reason to make it worth it to your parents. Science alone is not a sufficient reason. I see a lot of people stating that we don’t know the long term risks of the vaccine but we know the long term effects of COVID and that is exactly the problem. When I was deciding to get the vaccine, I actually found this argument really insulting to my intelligence. The fact that we know what happens to people with long haul COVID is exactly the issue - we can see what they are facing right now and can decide if we want to risk it. But the vaccine risks or lack thereof are 100% unknown.

If bringing out science as an argument was sufficient to help everyone change their mind and get the vaccine, we wouldn’t even need to be convincing anyone because they would already understand it’s importance. The science clearly is not enough to sway certain people. So the focus needs to be what motivates the individual. If you have kids, maybe you can say that your parents cannot visit their grandchildren until they are vaccinated. Or perhaps let them know that international travel will be easier if they can prove vaccination. Maybe they love concerts and sporting events, which will be easier to access in the future with proof of vaccination. The end goal is getting them vaccinated, even if it isn’t for the “right” reasons.
posted by lovelygirl at 12:30 PM on April 27, 2021 [2 favorites]

My parent also has a wait-and-see mentality. I'm hoping the doctor will be more persuasive than me.
posted by olopua at 12:55 PM on April 27, 2021

Best answer: I personally felt iffy about these vaccines at first because they just seemed to come along so fast, it seemed crazy to me. I started to turn around the more I saw more people getting them, and how they seemed to be both very effective and also about as safe as any vaccine is. It helped also to read about all the years of research that went into them, even if this specific virus is still new. I saw all the happy older people and health care workers on TV getting vaccinated and then the older people in my family started getting vaccinated, and well, if they're getting vaccinated and they all seem fine, then it's probably fine for me to get it too. I have since been vaccinated myself.

I know other people who only started to open up to the idea of getting the vaccine when faced with potential consequences of not getting the vaccine, which included vaccinated family members not being willing to visit unvaccinated family members.
posted by wondermouse at 12:55 PM on April 27, 2021 [4 favorites]

What country are you in? Which vaccines are available to them?

The place that started vaccinating earliest in large numbers is Israel, where (mRNA) vaccination started in December. I'm going to link to an earlier comment of mine that links to graphs of infection rates, death rates, and vaccination rates there. Maybe seeing it in pictures would help nudge them a little. There's a really, really dramatic decline in cases that correlates with vaccination rates. There are still some holdouts there against the vaccine (mostly in Arab communities that have a lot of well-earned distrust of the government) and children haven't been vaccinated yet; at the same time, infection rates have plateaued to about 130 cases a day. You might urge your parents to consider whether, considering the data in front of them, they think the infection rates would drop down to near zero once the last parts of the population got the vaccine.

At the same time, there haven't been any long term effects that anyone's noticed. On the contrary, there have been many reports of people with long covid feeling better after the vaccine.

Meanwhile, life there is increasingly back to normal, grandparents are hanging out with grandkids and kids, schools and businesses are open again, and for the first time there, reopening hasn't gone hand in hand with another wave of infections. All the other slumps in that graph correlate with lockdowns, and all the places where infections start to climb again correspond to reopenings. If more people there had made the decision that your parents are making, the whole country would still be in the grips of the pandemic, with no end in sight.

I feel like we take so many things into our bodies on a normal basis: pollution, microplastics, hormones (in drinking water, meat if they eat it, etc.), and more. We don't know about the long-term effects of these (well, except various forms of air pollution and water pollution), but unless your parents have made the choice to move to an unsullied rural area and eat only traditionally-grown foods, they ingest them constantly anyway. Not to mention medications that have known long-term side effects, many of which are terrible, but which occur at a low enough frequency that the risk is easy to ignore. What is it about this specific vaccine that is worrying them more than all the rest? Can they compare their thought process about it to their thoughts about taking, say, cold medicines, pain relievers, or antihistamines?

Finally: is there any end in sight to this pandemic, other than the vaccine?
posted by trig at 12:55 PM on April 27, 2021 [5 favorites]

You can refer them to my mother, who made the very practical point, "I'm 77. I'm not worried about the long-term of anything."
posted by DarlingBri at 1:06 PM on April 27, 2021 [15 favorites]

One more thing: if ethics, or religion, are very important to your parents, maybe it would be more effective to start there. Ethically speaking, even if there's a (minuscule) risk that there might be some side effects many months after taking the vaccine, do we not have a responsibility to take that (tiny) risk in order to help save millions of lives and end this ridiculous nightmare? And how would taking that risk, or refusing to, be looked on in their religion?

In the past I never used to get the flu vaccine, because I usually react badly to vaccines in the short term, I know there's a (small) potential for more serious side effects, flu vaccines can have a much lower success rate, and I never saw the flu as something really vital for me personally to avoid. The risk didn't seem worth the reward. Whereas from now on I'll be taking it yearly, because now I know how many people die of influenza and this pandemic has made me all too aware of my responsibility towards them. Now I see the risk as worth it.
posted by trig at 1:09 PM on April 27, 2021 [7 favorites]

Who do they trust?

That's not a flip response. Who are the people your parents trust? What are the institutions, or media outlets, they generally believe? What are the processes they use in other areas to understand things? How do they make other medical decisions? If you can find information that comes from those places, it is more likely to be convincing. Also, where have they already gone for vaccine information? You may be able to address the reliability and/or relevance of those sources, as well. (Eg, if their friend the nurse had a vaccinated patient contract covid, you can talk with them about how individual breakthrough infections work and how widespread vaccination actually makes them less likely. Or if their friends tell them they had really bad side effects, you can argue that even the chance of bad side effects is worth it if the alternative is getting or spreading covid.)

People gain knowledge and trust in different ways. For example, I personally was convinced by: reading the scientific literature about the mRNA vaccines; following the clinical trials; reading vaccine articles by academics and reporters whose work I already trusted; having a baseline understanding and trust in vaccines as a technology, specifically, even though I have broad skepticism toward our medical system and pharma in general; watching in real time as case numbers have plummeted in targeted groups (which suggests an efficacy that would be worth even great side effects); a moral imperative where I felt compelled to assume some risk to myself for a great potential benefit to others. Some things that have convinced other people but were not convincing to me were: appeals to "trust science"; my friend's vaccine selfies (although they made me very happy!); the CDC's recommendations; a desire to resume activities or be vaccine credentialed.

Also, I'm a big fan of open-minded but still probing, detail-oriented questions about the exact nature of someone's skepticism, and in particular about the mechanism of the thing they fear. A general fear of "long-term effects" could cover a lot of different, specific worries: concerns about vaccines generally; distrust of Big Pharma and profit-based medicine; the mechanisms of the mRNA vaccine; the quickness of the vaccine's development and fear of cut corners; a fear of change that is more emotional than rational, etc, etc. Any of these can be addressed, but not until you know exactly what they're thinking.

Or, possibly, are they concerned about one specific side effect, one that you might be able to address by taking it seriously? I know, for instance, that there has been a lot of baseless speculation that the covid vaccines could effect fertility; presumably your parents aren't worried about that one, but maybe there's another. If so, you can address it head on, either by finding the claim's origins and discrediting it or by researching the mechanisms by which it might happen to see if it is at all feasible or likely.
posted by CtrlAltDelete at 1:51 PM on April 27, 2021 [2 favorites]

What I can offer is similar emotional argument to Ms Vegetable, above. My mom had polio, measles, mumps, and chicken pox. My husband had mumps, measles, and chicken pox - the measles landed him in hospital for 11 days. I only had chicken pox.

Well, I had pneumonia too - 9 times. I spent my 20s out of breath if I wanted to run for a bus. Eventually my lungs healed enough to feel ok again. Now there's a (limited - certain kinds only) pneumonia vaccine, and I get that, because my lungs don't have wriggle room.

The difference between us all is a vaccination schedule.

I also have known people who had family members abroad die of rabies - I did not, despite being (possibly) exposed because I had the round of shots (and they were pretty awful.)

There are a few unknowns, and mRNA vaccines are somewhat new, sure. But I cannot actually come up with a disease where there is a vaccine where the risks of the vaccine are worse than the disease - not hepatitis, not yellow fever...etc.

For me, I would rather take even a relatively new vaccine than an antibiotic any day because for me it's more natural -- engaging my own immune system rather than killing a whack of stuff in my body -- which is why I get the flu vaccine every year.

I don't think you can argue them into it but I present my thoughts in case they are helpful.
posted by warriorqueen at 2:01 PM on April 27, 2021 [2 favorites]

Another possible factor: your parents can protect themselves from getting covid by wearing masks and not going out (the control feels mostly in their hands), but they can't protect themselves from getting vaccine long-term side effects (they have no control at all there).

This is similar to how people feel safer driving a car (where they're in control) than flying in an airplane (where they're not).

How do your parents feel about driving vs. flying? Can you make an analogy here?

Separately, a friend of mine who works in an assisted care facility says that the most helpful direction has been something like, "Oh, you're still thinking about the vaccine? That makes sense, you'll figure it out on your own time. I got mine a few weeks ago and I'm feeling great! My friend so-and-so says the same thing!" Once people stop feeling pressured, they usually make the sensible choice.
posted by danceswithlight at 3:04 PM on April 27, 2021 [8 favorites]

Best answer: I think everyone’s covered the science. But I would encourage an alternate - or add-on - approach. So they want to wait on the vaccine - how are they going to keep themselves and other safe from covid in the meantime? And what information will help them stop waiting and make a decision?

Maybe they say they are going to only see friends outside and masked, and that they won’t travel. If they aren’t willing to do anything to protect against covid, then that’s a different issue - one that might impact how you engage with them.

Maybe they say they’re waiting on full FDA approval. If that came next week, would that be okay? What kind of side effects would not be okay? Or maybe they want to wait a year - if so, what are they doing in the meantime to protect from COVID? I wouldn’t pose any of this as rhetorical questions - they are adults and can make their own decisions, but you can also prove them to set a plan. Even if not vaccinating; they can still minimize risk.

I am an epidemiologist but this is just my own view; I don’t have a ton of experience in health promotion. I do think it’s important to meet people where they’re at. Im also not approaching it from a family perspective, which obviously differs from the public health or medical perspective.
posted by quadrilaterals at 7:38 PM on April 27, 2021 [2 favorites]

We had similar vaccine hesitants in our family and weirdly enough what worked best was peer pressure: so and so cousin already had it, friend of same age got first shot last week etc. Not scientific but there you have it.
posted by St. Peepsburg at 7:42 PM on April 27, 2021 [4 favorites]

That doesn’t surprise me, St. Peepsburg. One of the most effective ways to get people to vote is to convince them that everyone they know will be voting. People generally don’t want to be left out of something that everyone else is doing.
posted by ArbitraryAndCapricious at 7:50 PM on April 27, 2021 [3 favorites]

This is a cynical view but someone posted on reddit a while back that the vaccine must be worth it because all the rich people/politicians have been first in line for a dose. If it was iffy, they'd let the lower classes try it out and see what happens.

For my far right relative, it was Trump and Melania were vaccinated before leaving office so it must be okay. They're still not gun ho, they're willing to get the shot now even if they're still saying Covid is overblown.
posted by stray thoughts at 8:37 PM on April 27, 2021 [6 favorites]

The Children's Hospital of Philadelphia publishes are regular newsletter about vaccines and vaccinations (not just Covid, but all types of vaccinations). Their February 2021 issue has detailed information about the situation regarding any possible long-term effects of the Covid-19 vaccine. This is one of the best summaries of the available scientific evidence and past experience with vaccine side-effects that I have seen:

- Brief summary of the main points
- Full article: Long-term Side Effects of COVID-19 Vaccine? What We Know

Among other things, it discusses all the previous vaccine side-effect cases that give us a strong indication that:

#1. When these events occurred, the onset was within eight weeks of receipt of the vaccine.

#2. In all of these cases, except narcolepsy following H1N1 vaccine, the side effect of the vaccine was something that could be caused by the infection, meaning that getting infected with the virus also carried a risk of experiencing these outcomes. In the narcolepsy experience, the cause was determined to be related to the adjuvant used in that preparation of vaccine.

They conclude there is strong evidence that the Covid-19 vaccines will not cause long-term harm. However they point out that "history humbles vaccine scientists". That is why they continue to keep a sharp eye on the data and don't make sweeping statements like "There is no possibility at all of long-term vaccine effects."
posted by flug at 11:57 AM on April 28, 2021 [1 favorite]

I know there was discussion of "risk of Covid vs risk of the vaccine" above, and it makes sense to approach this idea with care and caution when discussing it with people. You're weighing a risk that is pretty well known now vs one that is unknown. People (very understandably!) find that scary and hard to do, and often would rather accept the known risk than roll the dice on an complete unknown.

For me, understanding the relative size of the two risks really does help, though. The possible future risk of the vaccine isn't completely unknown--it's something we at least have an idea of and can put something of an error bar on (see previous post).

This article from the Lancet studied over 200,000 Covid cases and has some solid numbers for the long-term effects of Covid. It compares a matched set of patients with another respiratory infection (flu, etc) to 'mild' Covid cases and hospital/intensive care unit Covid patients, over the six months following the disease diagnosis.

The data here is eye-opening--at least to me:

* Intracranial hemorrhage: 0.56% (all Covid patients); 2.66% (intensive care)
* Ischaemic stroke: 2.1% (all); 6.92% (intensive care)
* Dementia (new diagnoses post-illness): 17.39% (all), 19.15% (intensive care)

Compared with flu patients, the Covid patients had far higher rates of these conditions:

* Intracranial hemorrhage: 2.44X as many cases in Covid patients vs flu
* Ischaemic stroke: 1.62X as many cases in Covid patients vs flu
* Dementia: 2.3X as many cases in Covid patients vs flu

So . . . those are significant percentages. If the vaccines had side effects anywhere near this large, they would never have made it to Stage 3 trials, let alone public release.

With the vaccines, we are now finding side effects that happen in 1/50,000 to 1/1,000,000 cases--that is, the conditions that don't give a clear signal in a Phase 3 trial with 50-100K participants (at most) but do show up with millions of doses administered.

In the future we might find side effects happening in the 1/1,000,000 to 1/100,000,000 range, as the vaccinations are given to hundreds of millions to billions of people.

Just to put those percentages in perspective:

- 6.92% (ischaemic stroke, intensive care Covid patients)
- 2.10% (ischaemic stroke, all Covid patients)
- 0.002% (a condition affecting 1 in 50,000 vaccine recipients; 1/1050 of 2.1%)
- 0.001% (a condition affecting 1 in 100,000 vaccine recipients; 1/2100 of 2.1%)
- 0.0001% (a condition affecting 1 in 1,000,000 vaccine recipients; 1/21,000 of 2.1%)
- 0.00001% (a condition affecting 1 in 10,000,000 vaccine recipients; 1/210,000 of 2.1%)

Side effects like the clotting disorder in Astrazeneca & J&J vaccines are somewhere in the one in 50,000-100,000-1,000,000 range. That makes the ischaemic stroke incidence in Covid patients somewhere in the range for 1050X-21,000X more common than the clotting disorder incidence in vaccine recipients.

Undiscovered vaccine side effects are very likely in the one in a million, one in ten million, or lower ranges.

So these undiscovered side effects--the ones undiscovered simply because they are very, very uncommon and we have not yet given enough doses to suss them out--are not just lower incidence than the known long-term health effects of Covid, but far, far, FAR lower incidence.

Again, his is assuming the Covid vaccines follow the pattern we've seen with other vaccines. You can't rule out the possibility that some long-term side effect will pop up in three years, that affects say 10% of vaccine recipients. But that is something that has never happened before in the past 100 years of vaccine development.

It could happen, but the odds are very, very low. Given that all previous vaccine side effects have surfaced by 2 months post-vaccination, the most likely scenario is, say, something pops up in month 3. Even less likely that something pops up in month 4, 5, or 6. Far, far, far less likely that something suddenly pops up in, say, year 5.

Well, vaccine trials started a year ago and mass vaccinations started in December--about 5 months ago now. A side-effect affecting (say) 5% of vaccine recipients and showing up within 12 months after vaccination would have been detected by now. One affect 1% of recipients and occurring within 5 months of vaccination would definitely be detected by now.

What we are left with is side effects that long after vaccination or affect only a very small percentage of vaccine recipients.

I can't say what the odds of that happening are, but they are small. Very small.

For example--far, far, far lower than the ~2.7% chance of ischemic stroke or intercranial hemorrhage you face if you have a Covid infection.
posted by flug at 1:12 PM on April 28, 2021 [3 favorites]

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