Today’s emotionally fraught landscape is part of the context around any communication about vaccines and vaccination.
Health and public health pros who talk and/or write about vaccines and vaccination have research-based knowledge — as well as strong feelings –about vaccines and their use.
Add to this the human, economic, and emotional toll the pandemic has taken. And the volatile social climate. And the urgent need for people to act in ways that help slow and prevent the spread of COVID. It’s an enormously complex and emotionally-charged communication scenario. For clinicians, public health professionals, digital health pros, and more.
This is where reflective practice may be especially helpful. It invites us to step back, and get some emotional distance, from what we’re doing.
I’ll suggest reflecting on vaccine communication is particularly important. Why? You’re aware that COVID-19 disproportionately impacts marginalized populations. You’re also aware of the well-documented links between health disparities and systemic and individual bias within the health sector.
One way biases can pass nearly unnoticed is through a deficit perspective. Deficit perspectives are subtle, and fairly common.
You might think of a deficit perspective as the tendency to maintain a focus on negative instances, examples, or qualities. Like seeing patients as passive recipients. Or centering on what a patient doesn’t understand, or doesn’t do; what a patient’s situation lacks; what is seems his or her community can’t provide. Or focusing on negative results, effects, examples, depictions, or instances.
It’s no secret that negative depictions of people’s attitudes get much of the press and social media around vaccines and vaccination (thanks to Tara Haelle [@TaraHaelle] for this article).
Vaccine communication can be as prone to deficit perspectives as any communication. Perhaps even moreso.
So I’m inviting you to think about what’s beneath the hood of your communication about vaccines – COVID-19’s vaccines, and any others.
I’d like to ground this invitation in a recent Twitter post that’s since gone viral.
Earlier this week, Dr. Lachelle Dawn Weeks, a hematology/oncology Fellow in Boston, described a conversation about vaccines and vaccination between her and a Lyft driver who was taking her to work. It began:
An observation re: language, media information distribution & #COVIDー19 vaccinations. I took a Lyft to work this morning because I was running late. My Lyft driver was an older Black man who after asking if I was a doctor he asked me about the #COVIDー19 vaccine:
“I heard on the news that they *targeting* Black people to get the vaccine first. Why *target* us?” He emphasized targeting/target.
We got into a convo about higher covid19 mortality for Black and Latinx populations and the myriad reasons for this. When we started talking about the vaccine, I learned his concern was about being forced to be a “guinea pig”
An observation re: language, media information distribution & #COVIDー19 vaccinations.
I took a Lyft to work this morning because I was running late.
My Lyft driver was an older Black man who after asking if I was a doctor he asked me about the #COVIDー19 vaccine:
— Lachelle Dawn (@Lachelle_Dawn) December 1, 2020
Dr. Weeks added in a later tweet:
“So persuasion can’t be the goal. If someone doesn’t trust you & you walk in trying to persuade them to do something rather than to build & mend relationship, all you do is widen your trust gap. This is how humans work. And in case it needs to be said: Black people are humans.”
I’m grateful to Dr. Weeks for sharing this story. There are many layers to it, and certainly more richness than I can explore in this short article. But I’ll invite you to take up some of the topics Dr. Week’s conversation raises as you reflect on these questions.
What kind of a person are you trying to be or sound like? If you’re writing, what kind of voice are you giving your organization? How is your language reflecting this?
Communication is about more than imparting information. You’re also hoping to show yourself as a particular kind of person (or organization).
You can’t help but speak from your own position. When it comes to vaccination, your position might be ‘do it!’
You’re also speaking from the blend of the personal and professional cultures you’re a part of. From your organization’s history, and the history of healthcare and public health. When it comes to vaccines, these collective histories are complicated.
Nonetheless, we all can fall into the trap of thinking that our ways of seeing things are normal, or neutral, or common sense. So, when speaking or writing about vaccines/vaccination, remember where you stand, how you’re seeing, and how you got there. Bonus points if you acknowledge (out loud, or in writing) your own position and what you tend to take for granted.
If you’d like a bit of practice, listen closely to the next person you hear speaking. Who does this speaker think he/she is? How does their language reveal this?
What kind of a person do you think your patient is? If you’re writing, what kind of people do you think you’re writing to? What do you tend to think of people in this social group? How is your language reflecting this?
Conversations about vaccines can present challenges because of the tendency to focus on people who are not expressing interest in being vaccinated, expressing skepticism, or expressing their intention to remain unvaccinated.
With the vast majority of health professionals being team ‘heck yeah get vaccinated,’ it’s a built-in battle!
Consider how many well-meaning posts, presentations, or talks about vaccines are framed as antagonistic. The not-subtle message: ‘it’s us versus them.’ Conflict isn’t great for any relationship and can bog down communication.
An us-versus-them attitude can also have the effect of short-circuiting any attempts you’d make to find out people’s reasons for thinking what they think.
Take a close look at your language. Keep an eye on how your word choice, framing, even conversational dynamics help to interrupt–or to reproduce–biases or stereotypes. Including stereotypes about social groups such as ‘people who are reluctant to be vaccinated.’
Here’s a hack that can help you be sensitized to framing and word choice in language. The next time you hear someone speaking, read a statement from an organization, or view an ad, ask yourself: Who do they think you are? How can you tell through the ways they use language and images?
What do you tend to assume ‘normal’ people do in terms of keeping healthy? What do you consider ‘normal’ knowledge, beliefs and assumptions about vaccines and vaccination?
When we’re not hearing from a person what we think is basic or fundamental, that perceived lack or gap can become our focus. That is, we sometimes focus on a person’s perceived weaknesses, based on what we think is or should be normal. This risks getting close to a deficit perspective.
This can hurt the relationship…and your chances to be helpful to this person.
Communication about vaccines can surface differences in people’s knowledge, beliefs, and attitudes real quick. Once you get to thinking that you’re not on the same sheet of music as the person you’re talking to, all sorts of barriers can emerge. This is because it can be easy to regard the ways other people understand vaccines or act upon health information as problematic. Especially when it’s not what you think is or should be normal, or basic, or fundamental.
Your assumptions about what’s normal inform the style and content of your communication, often unconsciously. Be ready to look closely at what your assumptions are, and at what it means to hold those assumptions rather than others.
If your audience’s attitude toward vaccines and vaccination differs from yours, how (or under what conditions) might their attitude make sense?
This one’s perhaps the most difficult to do. It’s also the most important if you really want to educate and not just lecture. Let’s dig in.
Health professionals like yourself have some of the best-informed stances on vaccines and vaccinations. They are built on decades of research, supported by your study, and enriched by your years of experience.
The rest of us non-specialists are also walking around with ideas about vaccines and vaccinations. Those ideas may or may not have scientific merit. But just like yours, they are based on our experiences, our knowledge, and our communities.
Differences in ideas can feel like barriers to communication.
As the holder of the expert information, it’s part of your job to make the connection between where your audience is at and where you’re at. In order to do this, you need to take seriously what that person or group thinks about the topic at hand. Even just for a moment, try to find a part of their understanding that makes sense to you.
In Dr. Week’s story, for example, I see an implication that she understood the Lyft driver’s concern over being “targeted” and seen as a “guinea pig:”
“I heard on the news that they *targeting* Black people to get the vaccine first. Why *target* us?” He emphasized targeting/target.
Though we don’t know if Dr. Weeks explicitly spoke with the Lyft driver about the long history of Black people being targeted and used as guinea pigs by health professionals, there is heavy hinting it was at least in the background of their conversation.
When it comes to misconceptions about vaccines and vaccinations, I invite you to try to understand your audience’s understanding. The faster you can see the sense behind what your audience is thinking, the faster you can get on with communication that matters.
Communication that’s going to meet them where they’re at. Communication that shows respect. Even and especially when you’re on your last scrap of patience.
Keep in mind that whatever your audience says is related to assumptions or beliefs that they hold. Furthermore, these assumptions and beliefs make sense to them.
I’m focused in this short essay on interpersonal conversations and mass communication. But there are systemic factors at play too, and serious work to be done there. If you’d like help with this in your organization, contact me.
If you’re involved with a vaccine or contact tracing app, there’s serious health literacy considerations I can guide you through.
Also, you may have heard: I have a self-paced course coming up on reflective practice in health. If these questions have got you thinking, and you’re interested in the course, please let me know. You can find me on twitter and on LinkedIn.