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Communicating the COVID-19 Vaccine: Common Ground + Cognitive Biases

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The language experts from maslansky + partners take on the smartest, savviest, and sometimes stupidest messages in the market today. CEO Michael Maslansky and President Lee Carter bring their experience with words, communication, and behavioral science to the table — along with a colleague or two — and offer up a “lay of the language.” Their insight helps make sense of business, life, and culture, and proves over and over again that It’s Not What You Say, It’s What They Hear™.

Is it possible to persuade folks to take the COVID-19 vaccine?  In this week’s edition of HearSay, Michael and Lee talk to colleague and pharma expert Sarah Hendry about the unique challenges in getting people vaccinated. They touch on cognitive biases at play, past healthcare experience that may impact today’s hesitancy, missed opportunities at some key moments, and whether its even possible to find common ground with anti-vaxxers.

Listen below or on your preferred streaming platform:

LINKS MENTIONED IN THE SHOW

Lee Carter’s book, Persuasion

Michael Maslansky’s book, The Language of Trust

EPISODE 2 TRANSCRIPT:

Lee Carter:  
They said what? Welcome to Hearsay, a podcast for language strategists at Maslansky and Partners, where we provide our take on the smartest, savviest, and stupidest messages in the market today and what you can learn from their experience. Our philosophy is, it’s not what you say, it’s what they hear. And that’s why we call this Hearsay. I’m Lee Carter, and I wrote a book called Persuasion, Convincing Others When Facts Don’t Seem To Matter. 

Michael Maslansky:  
And I’m Michael Maslansky, CEO of the firm that invented language strategy and the author of The Language of Trust: Selling Ideas in the World of Skeptics, and we are here today to talk about COVID communications. Specifically, we’re going to talk about communications around the vaccine. Now that the vaccines are rolling out around the world, with greater or lesser success, and we’ve seen communications evolve throughout the pandemic, we want to understand what it is that we can communicate today to accelerate the acceptance of the vaccine to overcome the negatives or the disinformation about the vaccine, and what we can learn more broadly. For this episode, we have brought in our colleague, Sarah Hendry, who is a vice president with us at Maslansky and Partners, who is one of our gurus in the area of pharmaceutical and biotech communications, and she is, as we say, our not-so-secret weapon when it comes to finding the right language to talk to patients, providers, payers and really anybody that intersects with pharmaceuticals. And so, Sarah, welcome to HearSay. 

Sarah Hendry:  
Thank you. I’m sad to say I have not written a book like either of you, but there’s time. 

Michael Maslansky:  
So, Sarah, we’re going to jump in, and we’re going to start by talking about the hesitancy that there is around the vaccine right now. And we’ve seen, actually, the conversation about the vaccine evolve from six or eight months ago when we didn’t know if we would even have a vaccine to Operation Warp Speed where we actually got to a vaccine really quickly. Now we’ve got this vaccine, but not everybody wants to take it. So Sarah, tell us a little bit. Set the stage for us a little bit  
 
Sarah Hendry:  
Yeah, so it’s kind of crazy to the fact that we have gone from no vaccine to some that have been approved, and likely more on the horizon in a short span, where we’ve never seen that happen before. I think there are a couple of reason for the hesitancy, but we’ll get into that in a minute. Since the election, I think more folks have been willing and ready to accept vaccination, and that’s for a variety of reasons, political and otherwise. But within certain communities, particularly the Black community and other communities of color, that hesitancy has continued, maintained pretty steadily. It’s a really interesting conversation in terms of, this has moved faster than we have ever seen before. It’s a different process; we’re building on new technology that folks haven’t heard of with MRNA and other different, high science topics and pieces of language. And then, we have even different understanding, different communities, different areas that we’re getting our facts and information when it comes to different communities, and particularly communities of color, who have suffered at the hands of healthcare in different ways over time, so the hesitancy is not unfounded. There’s a lot of opportunity to overcome that hesitancy and that skepticism, using the right language and certainly using the right communicators too. 
 
Michael Maslansky:  
Great, so if you look at the polling that is out there now or as it’s evolved over time, we’ve got upwards of a third of the overall population that says that they are hesitant to take the vaccine. In some populations that number is even greater. Even among healthcare professionals, we’ve got people who say that they are either hesitant or opposed to the vaccine. And leaving aside the anti-vaxers, why aren’t people doing it? 

Sarah Hendry: 
There are a lot of reasons, kind of both present, cognitively, as well as things that we don’t think about, so some cognitive biases or heuristics underpinning some of this decision-making that we may or may not even be thinking about. And a lot of this is different depending on the community and depending on your support system. But like you said Michael, there are folks in the healthcare community who are hesitant as well. So it’s not about being uninformed, it’s about the type of information we’re receiving and where it’s coming from. A couple of specific things that are particularly of interest to me. One of them is just the fear of the unknown. There’s this ambiguity bias, we tend to prefer things that we are familiar with or aware of, over unknowns. I think in particular, there has been this perspective or perception that has continued to be somewhat pervasive over time that COVID is just like the flu, it’s not worse. And so there’s some hesitancy to take the vaccine because there are unknown side effects or risks of the vaccine. Where on the flip side, if you’ve only been exposed to relatively mild cases, you might think that those side effects are not worth the trade-off, if you’re not considering the really severe dire effects that could happen from COVID.  There’s also the base rate fallacy, thinking about the perspective and the place where we get our information. So that just means we don’t have outside of the industry, people don’t know what we know or what the makers of the vaccine know. So we might see in 90% something effectiveness rate within the industry and say, wow, that’s so much higher than we ever could have expected. But on the flip side, people outside of that, look at a 90 something percent efficacy rate and think, oh gosh, what about that other 10%? This isn’t a perfect vaccination, this isn’t a perfect option. They don’t know that flu shots are like 40 to 50% effective and that’s just off the top of my head, probably not the accurate stat, but regardless flu shots are way less effective than this COVID vaccine. And people just don’t have that place to make that comparison because they don’t have the data, understandably, it’s not something they’re thinking about all that often. I think there are a lot of other reasons behind it, but, in particular, the kind of fear of the unknown I think is the biggest one. Fear of unknown side effects and fear of potential interference And the Operation Warp Speed language didn’t necessarily help for folks. Because this has moved so much faster than we ever thought I think there are just a lot of unanswered questions. 

Michael Maslansky:  
Lee, what are you seeing, what do you think are some of the biggest biases out there? 
 
Lee Carter:  
People are really concerned about political interference as part of this vaccine process and also the speed in which it was delivered. And I think Sarah just sort of touched on that and it’s really important that we underscore what that means. People don’t believe there’s enough history with this vaccine to fully understand the impact it will have on them. And so I’ve seen some studies that talk about younger women who are very, very concerned about taking this vaccine because they’re worried about their future fertility. Because it’s all of these things that when something is unknown, unproven, people are going to fill it with their own narrative. And when you don’t have the data on your side and we don’t always make decisions with data, but I think people are filling it in with the concerns that they have in general. And so I think that’s one piece of it. The other piece that I think is really important is your politics have a big impact on how you viewed this. 

Michael Maslansky: 

It’s really interesting, people are effectively rejecting the data about how dangerous COVID could be in favor of their own kind of perception and rejecting the data about how safe the vaccine can be in order to make a decision to do effectively do nothing. What do you do in that situation? 

Sarah Hendry:  
Oh boy. Good question. I mean, I think it makes sense to me personally, as someone who is terrible with numbers, digesting the data is so hard that it makes perfect sense that the narratives would be more powerful. We all communicate through and can better understand stories than we can understand facts. I’m not surprised that there are these different narratives that are super pervasive. I think from a messaging perspective, narratives can help us too, we can put narratives out there in a way that can be really motivating and meaningful without just resting on the data. So being able to contextualize in terms of what people do understand without refuting the truth that they hold. So without coming out and saying COVID really is that bad and the vaccine really is not that bad. That’s not going to work and we’ve seen that not working. So we need to be able to recognize and acknowledge the difficulty that is being faced. And in this case, I think the communicator makes just as much difference as what is being communicated. That is often the case. But I think in this instance even more so. Having folks highlighted who are part of a community group that we’re looking to communicate to. So for example, really leveraging the voices and expertise of Black healthcare professionals who are really in tune with the challenges of their communities. And being able to tell that story, even talk about their own hesitancy. I’ve seen some really great articles about black and other healthcare professionals of color, talking about their own hesitancy to take the vaccine and what helped change their minds.  So being able to bring it down to the personal level and talk about an individual or group of individuals who have decided to get the vaccine, being really transparent about their experience and not sugarcoating the fact that sometimes you do have a few days of flu like side effects and you’re not going to feel great. So being able to use those really short anecdotal experiences to highlight the challenges and help people be more comfortable, I think will make a huge difference here. 
 
Lee Carter:  
Yeah, Sarah, I think you’re right on as far as the importance of storytelling and relevancy in this whole thing. It’s not going to be until people see people like them getting the vaccine that they’re going to be comfortable.  So one of the things that we talk to our clients a lot about when they’re trying to overcome obstacles is the importance, both of symbols and of stories. I think it was a really important symbolic gesture that the former presidents got the vaccine in public so they could see people getting it. I was really, really sad, actually, on the other hand, there was a huge missed opportunity in my opinion at the Super Bowl. The Super Bowl, I was surprised because I thought we’re just going to have cardboard cutouts and the stands were kind of full. And what I didn’t realize is the people that they allowed in there, they weren’t just journalists, they were first responders who had already been vaccinated. And I think that was a huge missed opportunity because we could have heard that over and over and over again, that if you take the vaccine you can start living your life and you can start having these experiences. And look, that’s people just like you who have already taken it and are on doing great things. And it was a big miss because the Super Bowl, I think they said at once, you had to have almost read about it. And the way that people watch Super Bowl is you come in and out. They should have been reinforcing that message over and over and over again. And in fact, we’re far off from the Super Bowl, but we could still be talking about the fact because if that was a symbol with a story told the right way, be something that we would all remember.  

Michael Maslansky:  
Yeah. I think that’s a really important point. I think they missed it on a whole host of levels.  I think the government and others should be asking themselves, when do they have these moments where people are really paying attention and they can kind of make it easy and obvious.  

Lee Carter:  
So what we just talked about I think is a fairly straightforward, folks that might be uncomfortable, a little bit apprehensive, and that’s one category of people who are not taking the vaccine. And then there’s a whole other host of folks who are not taking the vaccine. And those are the folks who have bought into misinformation or disinformation. Some of it is on purpose and some of it isn’t, but the fact of the matter is COVID has become really, really political. And so how do we combat that or how do we find common ground? It’s really hard. I think this is something that we probably all have had a conversation in our personal life with someone and you say, you believe what? Are you kidding me? And you don’t approach the conversation in the best way. And then, we’ve got clients who are navigating this in the pharmaceutical space, how do you actually address when there’s a huge rumor, there’s narratives that this actually is meant to sterilize people. There’s narratives that are out there that are saying, this is big pharma’s revenge on all of us. There’s narratives about the ingredients of what’s in these vaccines being really unsafe or being made from fetal parts. There’s a lot of misinformation that’s out there and it’s easy to dismiss it as a rumor. It’s easy to say something like, “How could he possibly believe that?” But Michael, I know you’ve done a ton of work on trying to understand how do you categorize somebody’s criticism or concern and address it? 
 
Michael Maslansky:  
Well, I think how to deal with rumors is something that in the world of dealing with crisis communication, in general, comes up a reasonable amount of time. You can get a negative rumor about a company or a situation, often the company’s predisposition is to reject it as a rumor, to say, “It’s just not true.” What we’ve learned in our research, what we see a lot in the behavioral science literature is that, you cannot overcome a rumor or de-bias a myth by simply telling people it’s not true, that there’s no amount of factual information that you can use in many cases, to overcome a rumor that people think is really true, that they want to believe, because it ties into some bigger narrative about their belief in government, or their belief in industry, or their belief in parenting, you name it.  And so, often what ends up happening is when you repeat the rumor in an effort to reject it, you actually reinforced it. You end up making more people believe in the rumor itself. And so instead, it becomes really important not to spend time on the rumor, but to focus on replacing the narrative, that rumor narrative, with something else more positive. There will always be a lot of disinformation out there. And the answer is unlikely to be trying to combat that disinformation or misinformation one-to-one. It will be trying to replace that information with the other side of the story, with the positive, with new data that isn’t meant to kind of go directly at the misinformation or disinformation, but is meant to give people a broader, more positive narrative about the topic. And so in this case, it is, the stories of 80 Black doctors talking to their community, it is stories and examples of people getting through the vaccine, of being healthy, of talking about it. It is stories about presenting the positive data in a way that is easy for people to understand, and gives them a reason to want to reconsider their opinion about vaccines. 
There’s one other thing that I’ll say is that, in this, much like any political campaign, you have to know how to segment your audience to focus your limited resource needs in the right places. And so you’ve got a group of people who are already inclined to get the vaccine, you want to make sure that they know exactly where and how to get the vaccine so that they get it. Then you’ve got a group of people who are hesitant, but not necessarily rejectors. And you’ve got to focus your next set of information on trying to get them to vaccination sites to get vaccinated. With the most virulent anti-vaxxers, in some respects, you just want to ignore them. In others, you want to make sure that you’re in those conversations with them, so that there’s a counterpoint, but you’re not really doing it in order to convince them to change their mind. Ultimately, they may not be necessary in order for us to get to herd immunity. And it’s going to require more money, time, and energy than we have in order to convince that last 10% that their views are just bizarre. 
 
Lee Carter:  
I want to talk about those views that are a little bit bizarre, for a minute, because I think all of us in our own lives, whether it’s any of us who have parents or relatives who won’t get the vaccine because of something that they’ve heard from someone, or just in our day-to-day lives, we’re all having these conversations. And it’s hard not to say, “Are you serious? You what? There’s no way. Don’t look at the… Don’t no, no, no, no,” and just send them a link to your data or tell them what you’ve seen instead. How do you deal with those kinds of conversations? Sarah, do you have any tips for anyone who’s trying to navigate these tough conversations? 

Sarah Hendry:  
Yeah, I think the biggest one is just to recognize that someone coming to you with this story that they heard or that their friend told them, this is their truth. If they’re telling you this, then that means they believe it and that is truth to them. We all have our own truths. I think truth is not a binary. There’s a lot of different shades of gray. So I think just reminding ourselves that this is their truth and they believe this to be true. And it’s so important not to laugh or to shame that person for having that perspective or view, because that’s just going to shut down the conversation immediately. I think we can all probably appreciate that in our personal lives, in any context, in a partnership, romantic relationship, a friendship, whatever it is, if someone comes to you and tells you something that is serious to them and is true to them and you laugh in their face, it’s over. So if you want to continue the conversation, you have to appreciate that no matter how silly it sounds or outlandish it sounds, it is true enough for that person to believe it and to feel it’s true. So you need to acknowledge it and come at it from that perspective and have a conversation with them. Help them understand where you’re coming from, as much as you try to understand where they’re coming from. 
 
Michael Maslansky:  
Yeah, I think that’s one of the hardest parts of doing this, when you have somebody who has a view that’s diametrically opposed to your view, and you just want to persuade them. Doing it effectively often takes a lot more time and patience than most people want to give it. I want to turn to a slightly different topic and that is that, I come back to this idea that this vaccine really is a miracle. Forget how we got there. It’s an extraordinary statement about our pharmaceutical and biotech industry and it would seem to be an incredible opportunity for the industry, who, certainly over the last couple of years have again found itself in somewhat hot water over either drug pricing or innovation that doesn’t quite meet the promise. It seems like this has the potential to change the narrative. Lee, Is it doing that? And whether or not it’s done it so far, what should companies be thinking about right now in order to change the narrative about the industry? 

Lee Carter:  
This is probably one of the biggest opportunities for the pharmaceutical industry to renew its reputation that has existed in a generation. We work in a lot of industries and we’ve seen industries ebb and flow in the reputation. And about five years ago we started to see this rise in anti pharmaceutical company sentiment.  We started to try and understand. Pharmaceutical companies do amazing things. They invent life saving therapies. They’re inventing cures to the diseases that are taking our family members that we love and people that we care about and they’re doing this each and every day. And what we saw as we started to work on this is that people had no idea that it was pharmaceutical companies that were inventing these cures. If somebody had a family member who had cancer, they didn’t pray to God for a pharmaceutical company to invent a cure. They signed up for a fundraiser. They donated to a nonprofit because they thought it was nonprofits and academic institutions that were finding cures and that it was pharmaceutical company that was making money off of the academic’s and the nonprofit’s work. Fast forward to today, we all know that it’s the pharmaceutical companies who are sponsoring all of this R&D activity. And so there’s a huge opportunity for pharmaceutical companies, because we said the first step in rebuilding reputation for pharmaceuticals was actually that, people understanding the innovation that they did, that they were the ones behind the lifesaving therapies and even just life improving, things that we take for granted that the pharmaceutical companies do every day. Now we have a huge awareness. We can all see into the pipeline, see what they’re doing, understand that it’s so much more than we thought. And it’s an opportunity for every single pharmaceutical company that exists, whether you made the vaccine, a therapeutic or you’re making nothing related to it, we now know what’s out there. So I think every pharmaceutical company needs to step into this and step into that narrative, and really open the doors on what it is that they’re working on, why they exist. What are the life saving therapies that you’re working on? What are life improving therapies and agents that you’re working on? I think opening the window into those pipelines, we don’t often do it as pharmaceutical communicators. Often, that’s reserved for investor calls or for filings in the FDA, but we don’t promote it. I think there should be a much bigger window in all of the things that we’re working on because I think it’s going to make us all feel more optimistic and better about the industry as a whole. And I think that if we don’t do it, I think the industry is going to get defined by the least of what happens now, which is going to be any issues that come up after people start getting the vaccine. What happens later down the road if we have to start charging for the vaccine, or if it doesn’t last because there’s another strain that’s coming out? Whatever those cases are, I think that unless everybody starts to take hold of their own narrative, then the story is going to be told for them. 
 
Michael Maslansky:  
Sarah, what about you? You’re involved with a lot of these different companies and in different contexts. What advice would you give them right now? 

Sarah Hendry:  
It’s a good question. I mean, it depends on what you’re communicating about, certainly. But I think overall, I completely agree with Lee. I think it’s an opportunity just to embrace radical transparency to that extent that they can, obviously there are legal ramifications for talking about certain things. But I think, to the greatest extent, these companies can be transparent about their R&D process, and really take advantage of the fact that research and development is more in the spotlight now than it’s ever been. That will definitely have lasting implications for trust in the industry, as well as potential downstream effects like better clinical trial enrollment, if people really understand the process and are more interested in getting involved. I think the advice is really just to take advantage, not in a way that hurts anyone, certainly not with that connotation of the language taking advantage, but just making sure that they’re leveraging the space that they have now to be talking about some of these things and to be highlighting the great science. It’s a really cool moment in medical history. 

Michael Maslansky:  
But I want to play devil’s advocate a little bit for a minute and just say, sometimes companies can get themselves into trouble when they try and take advantage of a moment and start talking about themselves, or trying to persuade the public that they’re much better than their reputation would warrant. So how do they take advantage of the good without looking like they’re taking advantage? 
 
Lee Carter:  
Well, I think it’s a really fair question. I mean, there’s a fine line that you walk between being opportunistic and actually being authentic. Right? And what we’ve seen is that there’s an appetite for people to consume stories that actually make them feel good about humanity and each other. I think if you’re doing it in not an authentic way, and it’s not real storytelling about something that’s really amazing, it’s going to come across as disingenuous and it’s just like you’re trying to get a pass. But I think that when you hear the story of how things are invented, it makes you feel better about the company and about the process as a whole. So, I’ll give you one example. We, we have a client who actually used to be a R&D scientist at a pharmaceutical company before he moved on into a different role. And he actually, himself, discovered an antibiotic when he was in the Pine Barrens in New Jersey. And he tells a story about the agent and how he discovered it in nature, and then talks about the testing process they went through and then the impact it’s ultimately had on helping other people. There’s something about the first time I heard that story, about this man who actually found and discovered a antibiotic in nature,  it totally transforms the way you view of the drug invention process and of the company that sponsored the research.  So I think you have to be really intentional about how you tell those stories and make sure that it’s told in the right way, that you’re told by the right storyteller and the right spokesman, with the right reasons in mind. 

 
Sarah Hendry:  
Yeah, and I think highlighting real people, Lee, to your point. So talking about the scientists, talking about the people who are benefiting from these agents, focusing on partnerships and talking about how so many different groups are coming together in this way. I think that’s an opportunity for us to talk about the good that pharma is truly doing without it sounding too much like we’re focusing on ourselves. 
 
Lee Carter:  
I will say this too. I think it’s important to note that whenever there’s an opportunity for a reputation to be rebuilt, there’s always baggage that lurks right beneath the surface. And it’s really, really important to know what that baggage is. One of the biggest pieces of baggage the pharmaceutical industry has associated with it, is greed and profits before people. So I think as they tell their story today, so that you can understand what it is that’s happening and why things cost so much money, and all of the things they’re working on, think they really need to be very, very mindful of the fact that that’s just underneath the surface. So any action, anything that they do in this moment that reinforces that idea, that they’re a greedy company or that they’re putting profits before people, is going to blow up any opportunity that they have for good storytelling and reputation building. And we’ve seen this happen in other industries as well. So it’s a real cautionary tale, and something I think that they need to be very, very mindful of in this moment. 

Lee Carter:  
Okay. Sarah, we ask these of every one of our guests, so no pressure, because we’ve heard some good ones, but what’s your favorite or least favorite word? 
 
Sarah Hendry:  
I set this up as an exercise in our language labs all the time, and I never have a good answer. I think my most favorite word today, at least, it’s cozy. It’s pretty cold outside right now, but also just makes me think of my partner and my tiny six-pound dog who wants to just be on my lap all the time. So I think that’s my favorite word. 
 
Lee Carter:  
That’s a great word, actually. I’m with you on that one. All right. One of the things that I often love to find out about people is, I think everybody has a superpower, something that they’re really, really good at, that makes them different and special. What’s yours? 
 
Sarah Hendry:  
Oh, gosh. That is a very hard question. My superpower. Well, I found out yesterday that I’m actually pretty good at making pretzels. I had never made soft pretzel dough without a stand mixer, with a dough hook, but I kneaded them myself yesterday. So I think my superpower is bread kneading. 
 
Lee Carter:  
Wow. 
 
Sarah Hendry:  
Turned out pretty well. 
 
Michael Maslansky:  
I don’t even know what a dough hook is. 

Lee Carter:  
Why does that not surprise me? 
 
Sarah Hendry:  
It’s extremely useful. You don’t have to use any upper body strength to make bread if you have one. But I got a great workout yesterday too because I don’t have a lot of upper body strength. 
 
Lee Carter:  
I can’t wait for the pandemic to be over where I’m coming over for some fresh bread. 
 
Sarah Hendry:  
Gladly. 
 
Lee Carter:  
And pretzels. All right. The last question. What is one thing you wish everyone would take away from this conversation? 
 
Sarah Hendry:  
I think one of the biggest pieces that has stood out to me in the process of learning more about this and thinking about some of the challenges that we’re facing with vaccination is, just really the importance of embracing empathy and really trying to understand where other people are coming from, and understanding their truth as truth. 

 Michael Maslansky:  
Yeah. Sarah, I think that’s such a great point. And all of this really comes down to, we got to understand why people will look at what can be a lifesaver and question it, and have the patience and willingness to engage them, to try and get them to overcome that hesitancy. So thank you so much for being here with us on this episode of Hearsay, and thanks to everyone listening in for joining us as well. For more language insights and to be in the loop on all the other fun stuff we’re doing, we hope that you will follow us on LinkedIn at Maslansky-Partners and join our mailing list at maslansky.com/connect. If you’ve got questions or feedback, or you hated something that I said, or ideas for us, please reach out to us. We’ve got an email just for this because there’re so many people who do reach out. It’s [email protected]. That’s all for now. Thanks and join us next time on Hearsay because it’s not what you say, it’s what they hear. I’m Michael Maslansky.  
 
Lee Carter:  
And I am Lee Carter. 

Thank you for your interest.

Thank you for your interest.