By Vivian Nguyen
Northwest Asian Weekly
Sean Li Cheah comes from a family of medical professionals, and for her entire life, she’s been surrounded by the practice of science and medicine.
Still, she chose to not get the COVID-19 vaccine.
“I believe in science,” said Cheah. “But because our body can produce antibodies, I believe that my natural antibodies are more reliable than whatever could be available in a human-made vaccine.”
Cheah is one of many people locally and across the nation who are questioning or speaking out against the vaccine. Although their reasons vary and are deeply personal, this demographic is becoming increasingly more vocal about their hesitation or opposition.
“It’s easy to oversimplify and collapse this idea of why other people don’t get the vaccine and write them off,” said Joshua Liao, an internal medicine physician at UW Medicine, behavioral scientist, and associate professor at the UW School of Medicine.
The issue of vaccination is often more complex, he said, and influenced by specific factors like an individual’s community and preferences. Information dissemination—like where you read your news, someone sharing an opinion on a local or national mandate, or a news article sent to you—can also play a major role in determining someone’s vaccination stance.
“There are a lot of reasons why people don’t get the vaccine,” said Liao. “Not all reasons to remain unvaccinated refer to hesitancy. It’s how we disseminate information [about vaccines] that’s important. And hesitancy is not necessarily due to misinformation, but more about how we interpret data based on the community, resources, or environment around us.”
Vaccine hesitancy, he said, is more about the perceived barriers that an individual mind creates.
“[A position of hesitancy] is a greyer area, which is different from those who have the vaccine, or even people who are definitely not getting it because they believe they’re immune and healthy,” he said.
“We’ve heard people say, ‘I’m waiting until it’s fully approved by the Food and Drug Administration (FDA) before getting it.’ I don’t consider that hesitant. This is the posture of someone who plans to get the vaccine when they feel it’s right for them.”
Vaccine conversations among family and friends
Based on Liao’s experience, if people know or see someone in their social circle that has gotten the vaccine, it creates salience that isn’t there if people aren’t talking about it.
“If these conversations aren’t happening in their social circles, but heard only in the news or from official sources, it’s a big detriment,” said Liao. “We need to encourage people to talk in their communities and natural settings about their personal experiences.”
“If people get the vaccine, they should externalize it in conversation,” said Liao.
For Cheah, who’s 41 years old and based in Olympia, her circle consists of people who have and haven’t gotten vaccinated. Some were required to get it as a prerequisite for work, while other family and friends chose not to and preferred, like Cheah, to rely on their natural antibodies to fight the virus should they contract it. Cheah also had family and friends who tested positive for COVID but recovered without issue.
Regardless of their vaccination status, Cheah hasn’t felt pressure from her network to get it. Vaccinated people in her life also haven’t swayed her to reconsider getting the vaccine.
She does, however, feel indirect pressure from the state and her broader community. Although Cheah doesn’t work—she’s a stay-at-home mom and teaches piano as a hobby—and acknowledged she doesn’t face the same vaccination mandates that some employers require, indoor mask mandates still encroach on her personal liberties. Social gathering mandates also limit her ability to connect with friends, causing her to feel trapped in what she can and cannot do freely.
“I’m worried about being ‘caught,’” she said about not wearing a mask in certain situations. “It’s the wrong worry. I want to go out without a mask and hang out with my friends.”
Evaluating pros and cons
Liao conceded that holding intimate conversations isn’t a silver bullet to resolve vaccine hesitancy or awareness.
“I believe it’s always been a multi-pronged approach,” he said. Talking about vaccination with your circle is a crucial component, but we need an array of solutions to encourage vaccinations.
For many people, the news and media play a pivotal role in swaying people in a specific direction.
Cheah believes the media should focus more on calming the public down.
“Why isn’t there more media coverage of people who recovered from the virus naturally?” said Cheah.
Instead of fear mongering, she said, the media should highlight people who successfully fought the coronavirus with their natural antibodies in addition to promoting how people can stay healthy and build a strong immune system—an essential strategy that she believes will help people fight the virus naturally.
Even now that the FDA has approved the Pfizer vaccine, Cheah expressed concern over the potential side effects.
“No, I’m still not ready to take the vaccine because of side effects such as heart inflammation, pericarditis, myocarditis, and death. The side effects of the vaccine are greater to me than contracting COVID-19.” She also expressed skepticism over the role of Scott Gottlieb—former FDA commissioner and now on the Pfizer board of directors.
When it comes to risk, Liao said people should strive to make appropriate comparisons.
“Every time we make a decision, we’re always creating a reference point,” he said.
“Vaccination doesn’t completely protect someone from COVID—even vaccinated people can get it,” he said. “But when you stack COVID risks and negatives versus vaccine risks and negatives, [and the protection that vaccines confer,] it’s clear what’s the better choice.”
“The problem is that people don’t make that comparison [using that reference point] all the time though—people compare the risks to how they are now. They’re not comparing negatives to negatives. Instead, some people are comparing the positives of not getting the vaccine to the negatives of not getting it.”
“The wrong comparison can contribute to hesitancy,” he said.
Vivian Nguyen can be reached at firstname.lastname@example.org.
This health series is made possible by funding from the Washington Department of Health, which has no editorial input or oversight of this content.