Use empathy and active listening when having vaccination conversations

Purnima Madhivanan, associate professor in health promotion sciences and director of the Global Health Training Program at the Mel and Enid Zuckerman College of Public Health

Maiya Block, doctoral student in the Mel and Enid Zuckerman College of Public Health
Being unvaccinated doesn't mean someone is "anti-vax," or categorically opposed to getting a vaccine. Assuming they have access to vaccination, it often means they have concerns that aren't being adequately addressed. This phenomenon is called vaccine hesitancy.
"Vaccine hesitancy is on a continuum, from not getting a recommended vaccine immediately, to delaying it for months, sometimes years, to maybe never," said Purnima Madhivanan, associate professor in health promotion sciences and director of the Global Health Training Program at the Mel and Enid Zuckerman College of Public Health. "Anti-vax refers to a person who may be against all vaccines or are suspicious about one specific vaccine, like the COVID vaccine."
Just before the pandemic, Madhivanan, along with other University of Arizona faculty and partners at the Pima County Health Department, founded the Alliance for Vaccine Literacy, which is composed of Health Sciences and other undergraduate students, graduate students and faculty. Originally focusing on vaccine hesitancy surrounding the flu shot, the group soon expanded its focus to the COVID-19 vaccines, with the overarching goal to improve communication about the safety and efficacy of vaccination with the general public.
"The Alliance for Vaccine Literacy is an important project founded by Health Sciences faculty and fueled by the enthusiasm and talents of our incredible students. For them, education isn't just about training for tomorrow – it's about making a healthier world today," said Michael D. Dake, senior vice president for health sciences. "The contributions of these students are helping to mitigate the effects of the pandemic one conversation at a time."
As part of her involvement with the Alliance for Vaccine Literacy, public health doctoral student Maiya Block joined forces with other students to spearhead a series of virtual workshops to help people navigate conversations with vaccine-hesitant individuals, giving participants the opportunity to learn communication techniques and practice using them in role-playing scenarios.
"Personally, I've been struggling, and a lot of people on our research team have family members or friends who are not getting vaccinated," Block said. "They were not sure how to talk about it in an effective manner. People get their feelings invested, and it's difficult to see eye to eye."
According to the Arizona Department of Health Services, just under 65% of Arizonans are vaccinated against COVID-19. But the most vulnerable remain at risk, breakthrough infections and new viral variants are looming threats, and social, emotional and economic suffering endures.
Tips for effective communication
The workshops produced by Block and her fellow students guide participants in how to have challenging conversations with vaccine-hesitant friends and loved ones in a way that emphasizes collaboration and respect. The first step, they say, is to listen actively. Don't wait for someone to stop speaking so you can jump in with your argument. Listen with empathy, trying to understand the root of their concerns.
"It's important to tailor our conversations to the specific issue the person is concerned about," Madhivanan said. "A one-size-fits-all approach is not going to work."
"Understand the other person's point of view and where they're coming from. Reflect back what they're saying and request clarification to verify what you're understanding," Block added. "Then, with their permission, you can share good information from sources they trust. Identify what those sources are and find information from those sources that might support your cause."
Madhivanan and Block suggest focusing on shared values, such as being healthy or spending time with loved ones.
"It's important to focus on commonalities," Block said. "The first conversation has to be centered on setting the tone where you and the other person are on the same side, not arguing against each other. Once you start talking too much about your differences, it turns into a debate rather than a conversation."
Block says it's important not to spread misinformation yourself.
"It's OK to say, ‘I don't know.' If you're not sure about something, come back to them at a better time," Block said.
One topic that has come up repeatedly in the workshops is that the issue is so emotionally charged that conversations can quickly be derailed.
"It's easy to say, ‘Yeah, I'm going to listen,' but to actually do it in the moment, especially when you're feeling all these emotions, is difficult," Block said. "Finding the right moment to have the conversation is key. If you're not in the right place emotionally, that probably isn't a great time."
Madhivanan adds that empathy, kindness and civility are paramount in effective communication.
"If they think you're talking down to them, they're going to shut you off, and you missed out on a unique opportunity," Madhivanan said.
A version of this story first appeared on the Health Sciences website. Read a related story about the Alliance for Vaccine Literacy.