Thread by @WheatNOil

So, @DrKyle has a thread here about vaccine hesitancy, and how this may be concern in Saskatchewan. And while I don’t disagree that vaccine hesitancy is a concern, I think it’s important to reframe how we think about it.

https://twitter.com/drkyle/status/1383955681376489475

We tend to view vaccine hesitancy as some sort of binary. You’re either for the vaccine or against it. But it’s not as simple as that.

For instance, here we see that the rate of vaccination for 60-69 year olds is starting to drop off. But I think it isn’t quite fair to view it as vaccine ‘denial’.

(Though, I very much appreciate the work he put into gathering this data & think there’s ‘potential’ concern)

https://twitter.com/drkyle/status/1383955685159817221

For any new change, there will be people in the population who are early adopters, middle adopters, and late adopters.

Early adopters are going to knock down the door trying to get whatever it is first. They’ll proudly display it. They’ll tell all their friends.

The folks in the middle, they don’t want to be the ‘first’ people to take on this new thing, but once a few people have done it, they’ll follow suit. Like they don’t want to be 1st person to get the vaccine but once it starts rolling & seems okay, they’ll wade in.

The late adopters are hesitant about the new thing. Maybe they’re suspicious by nature. Maybe if the new thing is a behaviour change, they’re more set in their ways.

They’ll come around, but only when almost everyone else has gone first.

Then there’s the Nevers. These folk will doggedly hold out even if they’re the only ones left on the planet.

It’s this group that probably won’t ever get the vaccine. But I think at times we conflate the Nevers with the Late Adopters.

So when Kyle, rightfully, points out that an age group is eligible but is dropping off in vaccinations, I think we should view this as ‘expected’.

We’ve exhausted the early adopters & maybe the middles. But we should ‘expect’ the late adopters to continue to trickle in.

What Sask has done pretty well so far (it appears) is move the vaccination age downward just as the early adopters finish booking. As we slow down to the middle-to-late trickle, we open up to the next age range and let those early adopters in.

But as that happens, we continue to see people from ‘all’ age ranges above it to continue to trickle in. All those middle-to-late adopters coming around one-by-one.

We just need to give them time & support to overcome their hesitancy.

We see this in the vaccine hesitancy poll data. As the pandemic wears on, and as more people get vaccinated, the number reporting hesitancy about the vaccines continue to decrease.

Last poll I saw only had ~8% in the Nevers. Everyone else was at least a potential late adopter.

As more and more people get vaccinated, this normalizes that process.

Some vaccine hesitancy is combatted purely by numbers. It’s one thing to be hesitant about something very few people have. It’s another when 3/4 of everyone you know has had it.

Another type of vaccine hesitancy is people being concerned about vaccine ‘type’. Say they’re worried about the AZ.

Ok, we can provide education there. But also, eventually, these individuals will get vaccinated. They want vaccination. They just are waiting for a specific one.

So while we provide education, a reasonable move is what Ontario has done with Health Canada approval. Move the age range down to access other early adopters. The late adopters will come around as more vaccine is available later.

They still contribute to herd immunity.

Yet another type of vaccine hesitancy are people who want to check with their healthcare team first. “I heard about clots, my mom died of a blood clot, am I at increased risk? I want to see my doctor first.” So it takes a couple weeks to see their family doc. THEN they book.

Another type of vaccine hesitancy are people who want to get vaccinated but feel they can keep themselves safe (they work from home, otherwise healthy) and so want others at more risk to get theirs first. They’ll also get theirs. But they’ll be late.

Another is people who feel the vaccine was rushed. “It’s too early!” Ok, how many will feel the same way 6 months post-launch? 9 months?

If they say “I’ll get it when it’s been out for a year”, they’re in the planning stage of change, not precontemplative. That’s shiftable.

This list could go on and on, but you get the idea. There are a multitude of reasons people might not be breaking down the door. But that doesn’t mean they WON’T get it. In the meantime we need to keep getting doses in arms until they come around.

But none of this is to say that we should rest easy. He’s right, we can’t sit back.

Hitting 70%, I suspect, is very achievable.

85%? That’ll be a push.

https://twitter.com/drkyle/status/1383973656590618629

If we want to convince that remaining group to come on board, we do in fact have to listen to them. Meet them where they’re at. Address their needs and concerns.

I gave a 10-ish minute talk about using a Motivational Interviewing approach here. vimeo.com/527398251

One more thing, Andrew’s story here is pretty common. I think we’ve done better at this in Sask, but a lot of my friends tell me it’s a full time job trying to book a vaccine in some other provinces. We HAVE to make this extremely easy for people.

https://twitter.com/AndrewBerkshire/status/1383978317749972999

This is also a good point. Barriers to access the vaccine take many forms beyond difficulty booking. Remote locations is one. Mobility is another.

These things matter as we squeeze for those remaining few percent.

https://twitter.com/ACaitlyn14/status/1383988623272382469