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How to address allergies of the mind

We tend to assume that people are hesitant because they’re under-informed. Give them good information, and they’ll come around, right?

Demand for Covid vaccines is drying up. Vaccination efforts have reached a large percentage of the willing, the delta variant is spreading rapidly, and our nation now faces the challenge of persuading “vaccine-hesitant” Americans. Public health officials are searching for strategies that work, and finding ways to nudge the uncertain into getting the vaccine. But a bigger obstacle to herd immunity looms, and current thinking obscures the solution.

We tend to assume that people are hesitant because they’re under-informed. Give them good information, and they’ll come around, right? For some, this approach works. In January, one half of Americans were vaccine-hesitant; by March, it was closer to 30 per cent. That’s progress, and new information probably accounts for some of it.

But tens of millions remain vaccine-resistant, their reluctance anchored in political identity: 33 per cent of Republicans insist they won’t get the vaccine; another 20 per cent remain unsure. This resistance could prevent the country from achieving herd immunity. Many Republicans seem allergic to the very idea of being vaccinated. I mean this literally. Allergies occur when an immune system overreacts: In a misguided attempt to fight off a perceived threat, the system produces a superabundance of antibodies. This is exactly what happens in the minds of vaccine-resisters: Their minds overproduce cognitive “antibodies”—doubts and fears—in an attempt to neutralise the “Get vaccinated” message. Heavier doses of allergy-inducing information won’t have the desired effect.

For 60 years, scientists have been studying mental immune systems. They’ve learned that exposure to an ineffective message can leave a mind resistant to better-calibrated messaging. Translation: A botched “get vaccinated” messaging campaign could leave millions more resistant to getting their shots.

“Cognitive immunologists” are also finding that you can inoculate minds against misinformation. They’ve successfully employed a process called “prebunking” to reduce susceptibility to science denial and fake news. Properly primed, a mental immune system will deploy doubts, questions, and evidence to prevent the uptake of bad information. If we apply the principles of cognitive immunology to systematically strengthen mental immune systems, outbreaks of viral nonsense should become far less common. We might even heal our ideology-torn world.

Like their bodily counterparts, mental immune systems can get confused. They can fail to identify real threats, overreact to fake ones, and rush to the defense of identity-defining beliefs. In partisan times, audiences view “push” messaging as a form of manipulation. This tends to inflame mental immune systems and provoke ideological backlash. The science, though, suggests that there’s a fundamental difference between broadcast efforts to mold public opinion and “narrowcast” conversations that support a person’s desire to learn and grow. Where the former can trigger a hypervigilant response from the mind’s gatekeepers, the latter can slip past and affect real learning.

In early March, veteran GOP pollster Frank Luntz convened 19 vaccine-hesitant Americans in an effort to understand their reluctance. Most participants felt that there were “too many unanswered questions”. They thought it hadn’t been rigorously tested. (It has). They worried that the side effects might be worse than Covid itself. (They aren’t.) They were wary of “the government telling me what to do.” (The government is asking, not telling.) Then Luntz had former CDC director Tom Frieden address participants’ concerns. By the end of the session, all 19 reported being more willing to get the vaccine.

Looking for effective talking points, Luntz zeroed in on Frieden’s facts. The real active ingredient, though, was probably his team’s listen-first approach. They gave vaccine-resistant participants a chance to air their concerns, and by listening, demonstrated a lack of manipulative intent. This calmed the participants’ mental immune systems so they could hear what Frieden had to say. That’s the recipe for addressing vaccine hesitancy.

When the Native American Osage Nation got disappointing results from mass vaccination events at its casinos, its leaders switched to a “house-by-house campaign against misinformation and wariness, waged with long conversations and patience”. “You kind of grind it out,” said Ronald Shaw, the Osage Nation’s medical director. His team listened, and addressed concerns one by one. As a result, the New York Times reports, “the vaccine rollout in Native communities has been a surprising source of strength”.

To achieve herd immunity to Covid, we need to address a second kind of susceptibility—susceptibility to misinformation. We need to understand the principles of mental immunity, and learn how to calm politically inflamed minds. The solution will surely involve an ancient form of cognitive immunotherapy called listening.

— Psychology Today

Andy Norman directs the Humanism Initiative at Carnegie Mellon University. A public philosopher and award-winning author, he is developing the conceptual foundations of cognitive immunology — the emerging science of mental immunity.