As the United States screams past 500,000 fatalities, the choice between a deadly disease and a shot in the arm might seem like the easiest decision in the world.
Or not. One-third of American adults said this month that they don’t want the vaccine or are undecided about whether they’ll get one. That figure has declined in some polls. But it remains disconcertingly high among Republicans, young people, and certain minority populations. In pockets of vaccine hesitancy, the coronavirus could continue to spread, kill, mutate, and escape. That puts all of us at risk.
When we disentangle the constituent parts of vaccine hesitancy—conspiracy theorizing, wait-and-see deliberation, frustration, and distrust—it becomes clear that vaccine reluctance will never be solved by one big thing.
Better national messaging on how vaccines could change our lives might encourage young people to get the shot, but would do little to change inequities at the community level. Clearer eligibility rules and more equitable distribution could accelerate vaccination in low-income neighborhoods, but might not solve vaccine indifference among young white Republicans. Motivational interviewing might bring along the skeptical, but more information is unlikely to convert the full-blown conspiracists.
The multiple-choice question of combatting vaccine resistance has an obvious answer: We need all of the above.