The Three Ingredients to Overcome Vaccine Hesitancy: Science, Religion, and Love for Grandma

By James Firman, Ed.D. and Prabhjot Singh, M.D., Ph.D.

Within the next two months, it is likely that everyone who wants a COVID-19 vaccine will be able to get one. But a persistent public health challenge will remain: vaccine hesitancy. According to a recent national poll by NPR/PBS NewsHour/Marist, 30% of American adults do not plan to get vaccinated. Most resistant are Republican men (49%), people who voted for Donald Trump in 2020 (47%), White men without college degrees (40%), and White evangelical Christians (40%).

It’s become clear over the past year that government officials admonishing people and pleading with them to wear masks, practice social distancing, and get vaccinated will fail to move large segments of U.S. adults. They don’t see a compelling reason to get vaccinated and they don’t think the benefits outweigh the risks.

The Facts

In the U.S., more than 535,000 people have died so far. Of those, 420,000 were over the age of 65, and 315,000 were over the age of 75. Most of the people who are dying from COVID-19 are America’s grandparents, great aunts, and great uncles.

The best scientific evidence tells us that, compared to younger adults, people over 65 are 90 times more likely to die if they get COVID-19, people over 75 are 220 times more likely to die, and people over 85 are 630 times more likely to die. We call this the lethal threat risk.

The good news is that the COVID-19 vaccines are more effective than most people realize. As several of our nation’s most respected public health experts recently wrote in USA Today:

All seven COVID-19 vaccines that have completed large efficacy trials — Pfizer, Moderna, Johnson & Johnson, Novavax, AstraZeneca, SputnikV, and Sinovac — appear to be 100% effective for serious complications. Not one vaccinated person has gotten sick enough to require hospitalization. Not a single vaccinated person has died of COVID-19.

New Findings

Over the past six months, BellAge has worked with the states of New York, Florida, Michigan, and Washington, and the city of Los Angeles, to survey more than 70,000 adults about their attitudes, knowledge, and behaviors related to COVID-19.

According to our most recent survey of 3,121 adults, a large majority (79%) dangerously underestimated the lethal threat risk that COVID-19 poses to older adults. More than half of all adults estimated the relative risk to be less than one-tenth of what it actually is.

More importantly, we found that once they learned the magnitude of the lethal threat risks, 63% said they would not have visited with elderly relatives over the holidays, or they would have exercised much greater precautions.

Especially alarming is that among the highest risk age group (the 22 million Americans aged 75 and older) a majority (58%) and especially older men (67%) underestimated their own risk of hospitalization or death if they get COVID-19.

Our research leads us to conclude that the key to overcoming vaccine hesitancy is for people to understand two things: 1) the magnitude of the lethal threat risk that COVID-19 poses to their older relatives, and 2) that getting vaccinated virtually eliminates their risk of hospitalization and death from the virus.

Combining Science and Religion to Change Behaviors

While there are deep ideological, political, and regional divides in knowledge and attitudes about COVID-19, almost everyone loves their parents and grandparents. If we want people to act more safely, make sure their older relatives get vaccinated, and have a compelling reason to get vaccinated themselves, we need to make the case on both scientific and religious/moral grounds.

Science makes one clear and compelling case: COVID-19 poses a lethal threat to older adults and the vaccines are almost 100% effective in preventing hospitalizations and deaths. By talking about grandma, grandpa, and great aunt Sally, these statistics become more meaningful and relevant.

The Ten Commandments provide two equally compelling religious and moral arguments: Thou shalt not kill, and honor thy father and thy mother.

James Firman is the co-founder and Chief Innovation Officer of BellAge. He served as President and CEO of the National Council on Aging for 25 years. Prabhjot Singh, M.D., Ph.D. is a physician focused on health system design who serves as associate clinical professor of medicine and global health at Mount Sinai’s Icahn School of Medicine and Chief Medical & Scientific Advisor to BellAge.