The Covid-19 Vaccine: How to Cope with Uncertainties

COPING WITH VACCINE ANXIETY

The Covid-19 vaccines have been available for several months now in the United States, and roll-out efforts continue nationwide. After more than a year of lockdown conditions, it finally feels like there’s not only a light at the end of the tunnel, but that it’s shining a little brighter, too. However, not everyone is walking toward that light, because not everyone is ready to embrace vaccination.

WHY DOESN’T EVERYONE JUST GET THE VACCINE?

Despite the plethora of empirical data supporting the effectiveness and safety of the Covid-19 vaccine — with the Pfizer-BioNTech and Moderna vaccines showing 91-percent and 94-percent efficacy, respectively, at preventing disease — people remain skeptical. 

According to an April 2021 poll by the Kaiser Family Foundation (KFF), nearly 35% of adults reported continued reluctance to get vaccinated, with 13-percent indicating they will “definitely not” get the vaccine. While these numbers are dropping over time, this remains a significant portion of the adult US population. These percentages may be reflected in younger generations as the vaccines become available to younger age groups, as the KFF poll found that parents’ attitudes toward vaccination for their children reflects their vaccination intentions for themselves. 

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Whether this reluctance is due to worries about long-term effects of the vaccine, mistrust in the government, confusion around updated and changing guidance from health agencies, or feeling overwhelmed by contradictory information, the overarching fear of the unknown is a relatable, existential experience that can result in paralysis for those who struggle with it.

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In order to regain a sense of control and relieve discomfort, our ingrained fight-or-flight response relies on past experiences and assumptions to fill in the knowledge gaps and determine the next steps that are in our best interests.

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In the complicated context of a tumultuous political climate, this human tendency has resulted in some people leaning toward misinformation, conspiracy theories, and confirmation bias, even as the majority of adults choose vaccination. Regardless of the underlying reasons, this behavior hinders the ultimate goal of herd immunity — in this case, when a large enough percentage of the population has achieved immunity, through both vaccination and/or recovery from Covid-19, to protect against further spread.

HOW DOES LOCUS OF CONTROL AFFECT VACCINATION HESITANCY?

During a time of tremendous stress across the globe, it’s understandable that so many people are feeling a loss of control over their lives and their place in the world. The current pandemic has led many to question their locus of control (LOC) — the extent to which a person believes that he or she has control over his or her life and the outcome of its events.

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Those with a stronger internal locus of control — whereby they interpret situations and consequences as being a direct result of their actions — feel more confident and more resilient than individuals who have an external locus of control, in which they interpret situations as being out of their hands and dictated by chance and other circumstances. 

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Most people exhibit a combination of internal and external loci of control, depending on their individual circumstances, experiences, cultural background, health status, and socioeconomic status. These “bi-local” individuals are oftentimes more adept at handling stress and anxiety due to their ability to make proactive decisions that they assume will influence the outcome, while simultaneously accepting outside assistance.

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More specifically, the Health Locus of Control Model reflects the degree of perceived control someone has regarding their health. A person’s health locus of control may also relate to pandemic-specific attitudes and behaviors, such as mask-wearing, social distancing, and hand-washing. Studies show that individuals with a strong internal locus of control have better physical and mental health, and they may be more likely to follow pandemic guidelines to lessen the risks of spreading the virus. Conversely, there is an assumption that people who express a lack of confidence in the vaccine, or who don’t take personal responsibility for their decision to get vaccinated, are unlikely to make and keep vaccination appointments.

HOW DO I DECIDE WHETHER OR NOT TO GET VACCINATED?

It’s important to be comfortable with the information and the options that are presented to you. To avoid misinformation, you can consult credible sources like the CDC and your state and local health authorities for updated information and guidelines about vaccinations. While doing your own reading to learn more, be sure to read entire articles rather than skimming headlines or glancing at photos. Consider whether statements are founded on credible and trustworthy evidence, or if they are instead expressions of unfounded opinion.

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You can increase your confidence by learning to identify, address, and debunk the myths and misinformation circulating about both the coronavirus itself and the vaccine options. For instance, there is no evidence that the Covid-19 vaccine affects fertility, nor that receiving the vaccine will infect anyone with the virus. Those who have been vaccinated should still follow appropriate precautions, as outlined by the CDC in their updated guidelines. Also, those who have previously been sick with Covid-19 may still benefit from getting the vaccine, as re-infection is possible and severe health risks remain.

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These and other myths — such as that the vaccine alters a person’s DNA, or that vaccine development was rushed so its safety is suspect — can be easily addressed by consulting vetted sources of information like the CDC and by talking to your doctor. The science from these reliable sources about the safety and effectiveness can be trusted.

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It is also important to consider the impact of any vaccination decision, and this includes examining the benefits and potential drawbacks of getting the vaccine, as well as assessing any advantages and risks associated with not getting vaccinated. Consider any underlying health conditions, your work, and your lifestyle, and how both of these figure into the equation. This exercise should include the benefits and risks not only to yourself but to others as well. 

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An effective approach to weighing the pros and cons of getting the vaccine is by using a skill taught in Dialectical Behavior Therapy (DBT). This DBT tool enables you to make a thorough evaluation of the advantages and disadvantages of any decision, and it can help you assess the costs and benefits of maintaining or changing your behaviors and beliefs through multiple lenses; it will also offer you additional insight that you might not have recognized otherwise.

ACKNOWLEDGING THE DIFFICULTY in MAKING THE DECISION TO GET VACCINATED

It is crucial to acknowledge the intense circumstances surrounding this decision. The global coronavirus pandemic has filled many of us with anxiety and can make us feel like we, and the world, are “out of control.” We have been forced to change the way we see ourselves and how we view the world around us. Many of our relationships and deeply held beliefs continue to be challenged during a time when we are reshaping our expectations of ourselves, our communities, and even our governments, all while we grapple with the risks of infection and mortality and discover the depths of our resilience when dealing with extended uncertainty.

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As guidance from the government and health authorities continues to change and evolve, it can feel confusing and frustrating not to have all the answers. It’s acceptable, and even necessary at times, to take a step back from the online world and the overwhelming barrage of information, to take the time and space to formulate your own questions, and then to address these questions with your doctor, who understands your specific situation and concerns. Ultimately, the decision to vaccinate or not is yours, because your feelings and concerns are valid and deserve to be taken into account, while weighing the facts, doing your research, and talking to your doctor.