Nor should we forget the many social factors that might influence people’s uptake – the “constraints/convenience” factor in the 5Cs. Quite simply, the perception that a vaccine is difficult to access will only discourage people who are already sitting on the fence. This might have slowed the uptake in Germany, which has a very complicated system to identify who is eligible to receive the vaccine at any one time. People would respond much more quickly, if they received automatic notifications.

We need to consider the question of convenience, particularly for those in poorer communities who may struggle with the time and expense of the journey to a vaccination centre. Travelling to and from that may be a huge issue for most people who are on minimum wage or unemployment benefits. That’s why it’s often best for the vaccines to be administered in local community centres. There has been anecdotal evidence of it being more successful in places of worship, mosque, gurdwaras, and churches.

Finally, we need to be aware of the context of people’s decisions – such as the structural racism that might have led certain ethnic groups to have lower overall trust in medical authorities. It is easy to dismiss someone else’s decisions if you don’t understand the challenges they face in their day-to-day lives.

Opening a dialogue

So what can be done?

There is no easy solution, but health authorities can continue to provide easy-to-digest, accurate information to address the major concerns. The major barriers continue to be patient’s concerns about the side effects and the fears that the vaccines haven’t been adequately tested.

For the former, graphics showing the relative risks of the vaccines, compared to the actual disease, can provide some context. For the latter, we need more education about the history of the vaccines’ development. The use of mRNA in vaccines has been studied for decades, for instance – with long trials testing its safety. This meant the technique could be quickly adapted for the pandemic. None of the technology that has been used would be in any way harmful because we have used these technologies in other areas in healthcare and research.

Governments should stop thinking they can reach the mass of niches out there with one mass-market vaccine message

A targeted approach will be necessary. Governments should stop thinking they can reach the mass of niches out there with one mass-market vaccine message, and work more creatively with many effective communications partners. That might involve closer collaborations with the influencer role models within each community, who can provide consistent and accurate information about the vaccines’ risks and benefits.

Health services need to make it clear that they are engaging in an open dialogue – rather than simply dismissing them out of hand. We have to listen to people’s concerns, acknowledge them, and give them information so they can make an informed decision.

It’s essential to engage in a two-way conversation – and that’s something that we could all learn as we discuss these issues with our friends and family. Being respectful and recognising people’s concerns could actually be more important than just spitting out the facts or statistics. A lot of the time, it’s more about the personal connection than it is about the actual information that you provide.