Vaccine hesitancy could prolong the pandemic. A local team created a toolkit to overcome it.

"There's still progress that we could make to cut down vaccine hesitancy."

An employee at a pop-up clinic in Haverhill waves to vehicles. David L. Ryan / The Boston Globe

After state and federal officials spent the first several months of the COVID-19 vaccine rollout grappling with the constrained supply of doses, a new challenge now threatens to “derail” the United States’ well-won progress inoculating its population against the society-altering disease: Demand.

While more than half of American adults have already gotten at least one shot, health experts say that reaching those who are less eager, hesitant, or simply unwilling to getting the vaccine will require even more painstaking work.

“This reluctance to get vaccinated among certain U.S. populations could threaten to derail the progress and really prolong this pandemic,” Evan Benjamin, a health policy and management professor at the Harvard T.H. Chan School of Public Health, told reporters during a conference call Friday, noting that roughly 20 percent of Americans are hesitant about the vaccine and another 15 percent say they definitely won’t get it.


Some disease experts now think reaching full herd immunity is unlikely in the United States.

However, Benjamin doesn’t believe it’s a lost battle.

Benjamin, who works as the chief medical officer of Boston-based health innovation center Ariadne Labs, led a team that created a toolkit for increasing public confidence in the vaccines.

“There’s still progress that we could make to cut down vaccine hesitancy,” he said.

According to Benjamin, reluctance to get the vaccine generally falls into three different buckets: concerns about getting sick from the vaccine, doubts about whether it actually offers protection, and distrust in the pharmaceutical companies and government officials that developed and approved the vaccines.

The guide looks to directly address those patient concerns, noting that the vaccines provide nearly 100 percent protection against complications from COVID-19 and that the chance of serious side effects are less than one in a million — far smaller than the risk of hospitalization or death due to COVID-19 for unvaccinated individuals. It also notes that medical experts have worked on the mRNA science behind the COVID-19 vaccines for years and that they received approval so quickly due to unprecedented government investment and elimination of “red tape.”

The toolkit also includes best practices for medical providers looking to start those conversations with hesitant patients, from techniques like nonjudgmental listening to tips for easing into a discussion and understanding patients’ concerns. Polls have shown that doctors and nurses are the most trusted messengers when it comes to decisions about getting the vaccine.


The intention of the conversation guide is to “tease out” when people are waiting to get the vaccine and then specifically address those reasons, Benjamin said, describing the process as “nudging through education.” There’s even suggested language to help physicians answer over a dozen common vaccine questions.

Suggested language for vaccine answers from the COVID-19 toolkit.

“Many people were forming opinions before they’ve had conversations with their own physician,” Benjamin said. “And so the purpose of creating the toolkit was to make sure that actual conversations based on facts, based on listening to concerns, answering with accurate information, making sure those conversations were happening, rather than people making decisions based on anecdotes or their Facebook feeds.”

To younger individuals who think they don’t need to be vaccinated because their immune systems will naturally fight off infection, Benjmain said that “this is much more than about you,” explaining they could unknowingly catch the disease and pass it on to someone more vulnerable. He also noted that the more the virus is allowed to freely spread, the more opportunity it has to mutate.

“If it mutates into something that’s even more transmissible or more deadly, that’s a real concern to us — or not susceptible to a vaccine,” Benjamin said.


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