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Vaccine conversations can be messy. Here’s how to talk about the shots.

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As millions of Americans eagerly roll up their sleeves for coronavirus vaccines, a significant number of others remain hesitant about the shots or reject them altogether. Consequently, many people are finding it difficult to navigate conversations with loved ones who have divergent views about the vaccines, as well as social situations involving those with different vaccination statuses.

While a poll conducted by the Kaiser Family Foundation in March showed that the share of Americans who have gotten vaccinated or want to right away is growing, 17 percent of Americans were still taking a wait-and-see approach, 7 percent were planning to get vaccinated only if required and 13 percent said they would definitely not get a vaccine.

“I don’t know if I’ve encountered one person that has not had challenges around these conversations, because there’s at least one or two people within your circle that have differing opinions on how to take care of themselves health-wise considering the vaccine,” said Akua Boateng, a licensed psychotherapist in Philadelphia.

Vaccination in general, Boateng and other experts say, is often a high-stakes topic tied to personal beliefs about health, safety and survival. In the case of the coronavirus vaccines, political views may come into play as well.

“It’s not like discussing the weather,” said Gregory Zimet, a behavioral scientist who studies vaccination and a professor of pediatrics in clinical psychology at Indiana University’s School of Medicine. “Unfortunately, coronavirus vaccines in particular became and continue to be highly politicized, so conversations about vaccines end up being, in some sense, conversations about politics, which are often fraught and highly charged and lead to alienation and polarization.”

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But experts say it is possible to avoid straining or damaging your close relationships and still have productive conversations about vaccines with family and friends who don’t share your views. Here’s what they recommend.

Manage your expectations and set boundaries

It would be a mistake to enter a conversation convinced that you are going to be able to persuade another person to change their mind, said Paul H. White, a psychology professor at the University of Utah who studies attitudes and persuasion.

“If you’re going into it going, ‘I am going to win this argument,’’ you may, you may not,” White said. “And, if anything, you may fray the relationship connections you have with your family, with your friends, with your close person.”

Zimet agrees, calling the approach a “setup for failure.”

“It’s human nature to get defensive when your belief system is being challenged and attacked,” he said. “People tend to identify with their belief systems and an attack on your belief systems feels very much like an attack on you.”

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While it’s worth making an effort to talk to close friends and family members who appear to be unwavering in their views, Zimet said you should set your expectations low and adjust them based on how strong you perceive the other person’s stance to be.

It may also be helpful to have “a conversation about having a conversation,” Boateng suggested. “Identify your boundaries around what you feel comfortable talking about and what you don’t,” she said, adding that you can agree to create a judgment-free space or figure out what to do if tempers start to flare. This discussion, she said, “sometimes helps people to sort out the conflicts that might arise in having the [vaccine] conversation.”

Acknowledge concerns and learn the reasons for them

How you bring up the subject matters, Zimet said. Instead of asking pointed questions such as, “Why haven’t you gotten your vaccine,” you can try sharing your own experience with the vaccine and give others the opportunity to ask you questions.

What to know before heading into your vaccine appointment

If you’re talking to someone who isn’t ready to get vaccinated, it’s important to acknowledge their feelings and let them know that they aren’t alone, said Sunil Kripalani, a professor of medicine at Vanderbilt University Medical Center who studies health communication. “That allows you to begin with a position of empathy and understanding.”

Tamera Coyne-Beasley, a vaccine researcher who has also been engaged in national vaccine policy development, said she often starts conversations with loved ones by pointing out how confusing and difficult the decision can be.

“I realize that they’ve received a lot of conflicting information, particularly if they’re looking on the Internet or talking to people who aren’t familiar with vaccines,” said Coyne-Beasley, vice chair and professor of pediatrics and internal medicine at the University of Alabama at Birmingham. “I want to acknowledge their concerns and understand what their issues may be.”

The National Foundation for Infectious Diseases released a report in March detailing various strategies to help with communication about covid-19 prevention measures and vaccines, said Coyne-Beasley, who is a member of the organization’s board of directors.

“You want to make sure that they understand that your recommendation is coming from your care for them and that you have no secondary gain other than to prolong their life and keep them and their family healthy because you love them and want them to be around,” she said.

You also shouldn’t jump to conclusions about why someone is reluctant to receive a vaccine.

“It’s important to take the time to understand the individual’s rationale and decision-making process rather than jumping right to ‘You should do this, and here’s why,’ ” Kripalani said.

Your questions about coronavirus vaccines, answered

Don't lecture, shame or threaten

When talking to a relative or friend, avoid becoming “preachy and moralistic,” said Vish Viswanath, a professor of health communication at the Harvard T.H. Chan School of Public Health. “At some point, if they feel that they are being disrespected, they’re not being listened to, that their concerns are not being validated, then they will pull away from you.”

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Zimet suggested a strategy known as “motivational interviewing,” which includes asking if it’s okay for you to share what you know and your perspective.

You can also ask people what would help them feel more confident or increase their interest in getting vaccinated, Kripalani said. “It’s a disarming way to ask and it gives you something that is more positive to talk about, which can help move the conversation forward.” Be prepared to direct loved ones to sources they would trust, such as other family members, faith leaders, community groups, or prominent health officials and organizations.

One of the quickest ways to shut down a conversation is shaming the other person, White said. “If you’re wanting people to be vaccinated and you start telling them, ‘Well, this is selfish. You’re being horrible for not doing this,’ their almost natural response . . . is to defend themselves,” he said.

You should similarly try to keep yourself in check when encountering a relative or friend who is sharing misinformation, especially if it’s happening in a public forum such as social media. Rather than publicly contradicting or humiliating anyone, Zimet said, try to address misinformation issues in private conversations.

Experts also discouraged using threats of exclusion to persuade people to get their shots. Telling someone they won’t be invited to gatherings unless they’re vaccinated is harmful to relationships and “not appropriate for helping somebody through a medical decision,” Kripalani said.

Boateng recommended trying to find common ground, for instance, recognizing that everyone wants to stay healthy and safe. Then, she said, work together with family and friends to think of alternative ways to stay connected, such as spending time outdoors, wearing masks and staying distanced, or coordinating Zoom hangouts.

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Know when to back off the conversation

Though conversations about vaccines aren’t likely to be resolved quickly, you should know when to stop. There are often clear signs, experts said. Sometimes a person will say they don’t want to talk anymore. “That would be the nice, easy neon-flashing sign,” White said.

Other signals to pay attention to include mood and body language, and where the discussion is going. If tempers are starting to rise and the conversation becomes combative or defensive, it’s time to back off. “The more you try to convince them, the more you’re reinforcing their beliefs,” Viswanath said.­ “At some point, you want to just let them be and wait for the right moment.”

That doesn’t mean giving up, Coyne-Beasley said. “You should always leave the door open.”

If, however, you can’t persuade your loved ones to change their minds and are feeling distressed, Boateng suggested taking time to process and seek support from other sources. “You’re just caring for yourself in a way that you would if you incurred emotional loss and emotional injury, all while affirming the bravery that it took to navigate caring for your health and your family’s health,” she said.

Finally, avoid spiraling into what-ifs about how you handled the conversation, White advised, and remember you can only control your half of a relationship. While your loved one might not agree with you, he said, that “does not mean you did not do your best or you did not try your best.”