Minds, Made Up or Malleable? Vaccine Refusal at the Eclipse of Public Health Communication

Although millions have died from SARS-CoV-2 illness, COVID-19 vaccines are credited with stemming the tide. Vaccinations and boosters significantly lessen the incidence of severe illness and death (even if they do not usually prevent milder cases of COVID-19 infection). Despite the success of global vaccination efforts, frequent reports of vaccine hesitance and refusal suggest that public health communications need improvement. The chapter begins by acknowledging adverse events associated with COVID-19 vaccination, including rare cases of anaphylaxis, GBS, and myocarditis. I offer an inoculation-theoretic rationale for this admission of vaccine risks: just as immune defenses mount when organisms get exposed to pathogens, so too may rhetors preemptively refute an opposing viewpoint when exposed in small doses. Next, I propose that psychologistic accounts of vaccine decision-making (including from psychological reactance theory, prospect theory, the elaboration likelihood model, gain/loss framing, and others) view minds as either (a) already made up or (b) subject to change upon encountering incoming stimuli. These “stimulus sensitive” premises can become coexisting variables, sometimes within a single study. Finally, I consider controlling language and ways to avoid “face threat,” including modal adverbs and restating imperatives as assertions. Deciding what makes a command direct or indirect indicates definitional ambiguity in the literature. The ideas presented here may suggest alternatives to deficit models that frame audiences as epistemically challenged “cognitive misers.”