9 common COVID-19 vaccine hesitations and how to respond to them


by Alex Arroliga, MD, MSc, FCCP, FACP

Sep 22, 2021

Hesitations and misunderstandings about the COVID-19 vaccines abound. You probably know someone who is skeptical about the vaccine or has chosen not to get vaccinated. It’s difficult to know what to say in those moments when the topic comes up, especially when someone you love starts spreading misinformation.

Here are some conversation tips to help you know how to respond to some of the most common COVID-19 vaccine hesitations. This is what I have personally found to be helpful and effective when talking about the vaccine. Use these responses as guidelines in your own conversations.

1. “These vaccines were rushed, and I don’t trust them.”

I understand you’re concerned about your safety, and I get it. I’m not going to try to convince you of anything. I’m just going to tell you what’s known about this technology.

People think this vaccine technology is new, but it’s not new. It’s been around for at least three decades. Scientists have studied both mRNA vaccines and viral vector vaccines for use against other viruses like Ebola, the flu, Chikungunya, RSV, rabies and Zika.

That’s why the pharmaceutical industry was ready—they had already been researching and just had to modify the technology for this particular vaccine. Only one thing was cut during this process, and that’s the red tape, to help get the vaccines distributed faster.

2. “COVID-19 is no worse than the flu. I’m not worried about it.”

I pray that you’re right, but why take a chance? That’s what a lot of people have thought, and some of them ended up in the hospital or even died.

Can I share some data with you? A study from the CDC reports that an unvaccinated person is 10 times more likely to require hospitalization and 11 times more likely to die than someone who is vaccinated.

Plus, even if your infection is mild, you can still transmit it to someone who may be older or high risk, and it may end up killing them. Is it worth that risk?

3. “If people are still getting sick after getting vaccinated and still have to wear a mask, what’s the point?”

Here’s the point. The vaccine was developed to decrease hospitalizations and deaths—which it does. That’s a very clear outcome. These vaccines protect 90% of the time against those things, even after 6-9 months. Remember all the people who were dying in the beginning? That’s why the vaccine was developed in this way.

That means the protection against infection with the virus is lower (around 70%) which has been known since the beginning of vaccine distribution. We have to remember that the vaccine wasn’t developed to completely prevent infection, only to decrease severe illness and death from it.

Why masking and physical distancing? This is like saying that you’re going to win a war only by bombing. It’s not a very effective strategy. But if you have the bombing plus an army and tanks on your side, then you have a higher likelihood of winning that war. We need the vaccines, the masks and the physical distancing to win this war.

To put in another way, cars don’t just have one safety measure. A car has brakes. A car has a seat belt and an air bag. And nowadays, a car has features that light up and beep when another car gets close. All these things help protect you and give you peace of mind that you and your family will be safe if an accident (aka COVID-19 exposure) happens.

4. “I’m concerned about possible side effects of a COVID-19 vaccine.”

Your question about side effects is extremely important, but this vaccine is as safe as any other. All vaccines have the possibility of short-term side effects. For the COVID-19 vaccines, that looks like fatigue, fever, chills, nausea and headache that can last up to a few days. Some people don’t even have any side effects.

If you’re worried about possible long-term side effects, the chances of that happening are really low. Vaccine monitoring has historically shown that side effects generally happen within six weeks of receiving a vaccine, and that severe side effects are extremely rare. The FDA required each of the authorized COVID-19 vaccines to be studied for at least eight weeks after the final dose.

5. “I’m pregnant and worried about my baby.”

I understand that as a mother, your baby’s safety is what matters most to you. But getting the vaccine is even more important if you’re pregnant. If you get the infection, you’re more likely to require hospitalization and need a ventilator.

Plus, it puts your baby at risk too. COVID-19 has been linked to an increased risk of preterm birth, premature rupture of membranes, growth problems and stillbirth.

Getting COVID-19 during pregnancy can be life-threatening for you and your baby, but getting the vaccine is a proven way to protect you both with very few risks. Studies show the antibodies from the vaccine can pass to your baby through umbilical cord blood and breast milk.

Here’s a resource if you’re interested in learning more.

6. “mRNA vaccines are dangerous and alter your DNA.”

I know this rumor has been circulating, but it’s not based on science. It’s simply not true. Did you know that RNA is different from DNA? The RNA in an mRNA vaccine doesn’t even get to the center of the cell, meaning it has no ability to impact your DNA at all. Here’s how they really work.

In addition to being studied for other vaccines, mRNA technology has been used in cancer treatment to target cancer cells. It’s not dangerous, and it’s highly effective.

7. “Everyone who gets really sick with COVID-19 has a pre-existing condition.”

Not really. Right now, the people who are getting sick are the unvaccinated, many of whom are younger than you might think. Take a look at this demographic data from the CDC on COVID-19 associated hospitalizations to date.

8. “What about ivermectin? I’d rather take that than get the vaccine.”

Let me tell you why people are promoting that. In the lab, ivermectin (which is an anti-parasitic drug) may have an effect on the virus. However, you would need to take 20-30 times the doses that are commonly used—and safe to use—in order to achieve the amount of medication that may stop the virus. With that level of medication, you may end up with significant side effects like vomiting, diarrhea, low blood pressure, dizziness, seizures, coma and even death. 

Vaccines, however, are well-studied and have been used to prevent serious illness for decades. The doses are carefully administered and highly effective without the risk of damaging your long-term health in the way that COVID-19 infection or heavy ivermectin use might.

Keep in mind that ivermectin is not approved by the FDA for use against COVID-19, but the COVID-19 vaccines are.

9. “The recovery rate of COVID-19 is high.”

This may be true for many people, but have you heard about the long-term effects of COVID-19, or “long COVID”? I’ve read stories about people experiencing long-lasting effects like difficulty sleeping, fatigue, headache, continued loss of smell and taste, increased forgetfulness and even depression. Even if your initial symptoms are mild, these effects can show up later and last much longer.

There is still so much unknown about how the virus could impact us down the road. Why take a risk?

Ready to have the conversation? First, make sure your head is in the right place with these tips from a psychologist.

About the Author

Alejandro Arroliga, MD, MSc, FCCP, FACP, is the chief medical officer for Baylor Scott & White Health.

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