In 2019, even before the pandemic, the World Health Organization called “the reluctance or refusal to vaccinate” one of the top 10 threats to global health. Little did the WHO know that attempts to resolve vaccine hesitancy would soon become even more ubiquitous, almost entirely through the use of persuasive tactics.
Since the advent of COVID-19 vaccines, we have tried everything to get friends, family, and the public to vaccinate: lotteries and gift cards; social media influencers; marketing campaigns; public health orders; exclusion from restaurants and cultural events; threats to job security, insurance coverage, and ICU beds; shaming; and numerous other scare tactics. The FDA’s authorization of the Pfizer-BioNTech vaccine has further emboldened governments and employers to mandate vaccination, but similar techniques to increase uptake overseas have seen wide-scale defiance and mass protests.
The vaccination rate in Colorado has started to plateau too, leading Governor Polis to announce a new grant program to support the distribution of vaccines in primary-care offices. Soon, vaccines will be available for nearly all age groups, but it’s unclear how many families will choose to vaccinate young people and how many will be angry they’ve been compelled or mandated to vaccinate. There still seems to be a collective waiting for the other shoe to drop in the form of new variants; we’re just hoping the next one is less deadly.
In short, persuasion hasn’t gotten us to herd immunity, and more aggressive strategies are clearly contributing to a deeper political and social divide. We are in need of a different approach.
Just before the pandemic, we happened to be studying how pediatric healthcare providers communicate with vaccine-hesitant families. All the clinicians we spoke with questioned the value of aggressively trying to persuade hesitant families to vaccinate their children.
Several explained that, early in their career, they worked tirelessly to increase immunization rates through “manipulation,” “pushy or sales-like” efforts, and “very convincing speeches.” With experience, though, they had become wary of persuasion, partly because it didn’t really work to increase vaccination rates and, more importantly, it felt “alienating for a lot of families.”
Instead of trying to convince vaccine-hesitant families to immunize their children according to the CDC-recommended schedule the first opportunity they had (the two-month well child check), most of the providers at the practice we studied seemed to do the opposite. That is, they created spaces that welcomed vaccine hesitancy; encouraged skepticism and thoughtful, unhindered decision making; and never judged a family’s decision to refuse vaccines, even when it completely contradicted the provider’s own recommendations.
Most astonishingly, many of those families who were vaccine hesitant prior to their two-month visit actually increased their vaccine uptake after the visit. Additionally, 98% of the 105 families we surveyed across the practice reported increased or very high trust in their provider, regardless of where the family fell on the vaccine acceptance spectrum: pro, hesitant, or anti. To top it all off, the providers seemed more satisfied and less stressed than at practices with strict pro-vaccine policies or approaches.
What’s going on at this clinic isn’t new. Invitational rhetoric, a theory proposed by Colorado professors Sonja Foss and Cindy Griffin in 1995, suggests people don’t need to be persuaded out of their particular way of knowing or existing in the world. Instead, invitational rhetoric offers a way to understand others, “an understanding that engenders appreciation, value, and a sense of equality,” without power struggles, domination, and control.
In today’s political and cultural climate, invoking empathy and gratitude for difference may feel quaint, especially in the face of yet another COVID-19 resurgence. Why try to understand others’ hesitation when the consequences can mean the difference between life and death? Why not try to persuade anti-vaxxers that not only is it safe to vaccinate, but they have a responsibility to do so?
What frustrates us about this line of thinking, however, is that we inevitably come to the limits of persuasion, express helplessness at our inability to persuade, then continue to cling to persuasion as the only recourse for getting back to some kind of normal. “I Don’t Know How To Explain To You That You Should Care About Other People,” as the Huffington Post piece puts it.
Framing the disagreement as a competition for control, unsurprisingly, leads to a stalemate. We can’t help but wonder: What if there’s an alternative to persuasion that doesn’t end in irreconcilable antagonism, or even violence?
For us, a radical commitment to appreciation and understanding across difference feels novel and even revelatory in the current moment, not in spite of the urgent need to transform our circumstances, but because of it. And although invitation is not about trying to change people’s minds, change is often the result of a meaningful invitational conversation. Indeed, invitation can transform not just others, but ourselves.
What might it feel like to be surprised by our own ability to see people’s fears, hesitation, and concerns as innately human and worthy of our compassion? What if instead of presuming malice, we led with curiosity, seeking to understand what experiences and priorities have led those we disagree with to view the world the way they do?
What if the best way to explain to you that you should care isn’t by shouting how you don’t, but by modeling that I do — about our differences, our shared priorities, alleviating suffering, about you — even and especially after our disagreement remains, or even deepens?
Could the audacity of not needing to transform — or rather, of not needing to be in control of each other’s transformation — be the best road we have toward transformation?
Jeremy Make, of Wheat Ridge, and Adam Lauver, of Pittsburgh, are independent researchers studying rhetoric, forgiveness, and radical communication ethics. Jeremy graduated with a master’s in Health Communication from CU Denver, and Adam completed PhD coursework in Communication at CU Boulder.