What’s wrong with people? If we’re honest, many of us have resorted to despairingly asking this question in the past. Currently we might be asking it of the vaccine hesitant. What is it that makes people refuse something that might not only save their own lives, but the lives of others?
If we want to understand why some reject not just vaccines but other evidence-based policies, though, a better question is what is right with them? What understandable beliefs would make reaching a seemingly irrational conclusion, rational?
In the case of vaccine hesitancy, the need for understanding is pressing. Although the Office for National Statistics has consistently found that fewer than one in 15 of us count as vaccine hesitant, in some sectors of society the proportion is much higher. Among black adults, the figure is between 21-30 per cent, while more than one in 10 Muslims and almost as many people living in the most deprived areas have expressed doubts.
Healthcare professionals tasked with vaccinating as large a share of the population as possible are not going to get very far in persuading the unpersuaded if they perceive their reluctance as unfathomable. And if you believe that people refuse a vaccine because they are scientifically illiterate, it is difficult to be genuinely sympathetic.
We wondered whether we could use a philosophical tool to help break down the barriers of incomprehension. So we set up a simple thought experiment, in which we asked 135 people who had themselves received at least one jab how much they understood those who were reluctant.
But before that, we asked a randomly selected sample of them two other questions. First, we asked them to think of a government or country they felt very distrustful of, and to say how much they would trust a Covid vaccine from this source that was still awaiting approval by UK authorities.
Not one person said they would trust such a vaccine a lot; 53 per cent were either “somewhat mistrustful” or had "major reservations,” and 30 per cent did not trust it at all. To put that in context, 93 per cent of all respondents trusted the vaccines being offered in the UK today a lot. We then asked this group: “If no other vaccine were offered to you, would you take the Covid vaccine that was being offered by the government you feel very distrustful of?” 32 per cent replied “probably not,” 8 per cent “definitely not” and 13 per cent “don’t know,” meaning that more than half fell into the ONS definition of vaccine hesitant in this imaginary scenario. This is a much higher proportion than is found in so-called high-hesitancy groups for the UK vaccines, such as black adults.
What the thought experiment shows is that it is not difficult to get people to imagine a situation in which they themselves would be very vaccine hesitant. Having done that, we wondered what the effect would be of simply asking people in this hesitancy-primed group to think for a minute about why some people in the UK might have historical reasons to distrust the UK government. Our hunch was that they would become more understanding of people who were actually vaccine hesitant right now.
The results bore this out. In our primed group, 55 per cent said they found it very or somewhat understandable that some people refuse to take one of the vaccines in the UK, compared to just 26 per cent of the others. Remarkably, fewer than one in 20 of those who had considered their own hypothetical hesitancy could not understand the very real reluctance of others, compared to nearly one in five who were asked the question “raw.”
Although this was a small study of 135 participants, many “proper” social psychology experiments are conducted on fewer people. We’d like to see a more thorough study conducted by university-based researchers and the first steps have been taken to make this happen. But the key messages already seem clear and important, not just for health information providers but more generally for understanding in a divided society.
First, for all the talk of filter bubbles, tribes and polarisation, mutual comprehension is often easier to achieve than we might expect. In our experiment, just a couple of minutes spent thinking about the right questions had a powerful effect on people’s ability to understand those they radically disagreed with. (It is important to distinguish between becoming more understanding of others and changing your mind to become more like them. When it came to personal willingness to take a vaccine or beliefs about the best policies around vaccine compulsion, having greater understanding did not shift opinions very much.)
Second, and perhaps most importantly, the study suggests that understanding why people oppose evidence-based policies requires taking wider reasons for distrust more seriously. Too often it is assumed that the problem lies with lack of scientific understanding or that people are just stupid. But scepticism is an intellectual virtue associated with thinking things through, and gullibility is the vice of the thoughtless. We lack the intellectual empathy to realise that all it takes are a couple of understandable fears for scepticism of evidence to become, if not justified, more rational.
Simple thought experiments have the potential to enhance intellectual empathy and help us better understand why otherwise sensible people do not always follow the evidence. Maybe it is not the scientific literacy of others that is the problem, but our own ineptitude in getting inside their thought processes. Thankfully, philosophers have always had ways of doing just that.
