In a fascinating exercise, economist Angela Duckworth and author Steven Dubner (co-author of Freakonomics) debated if they would take a vaccine that prevented them from having any confirmation bias. One conclusion: the result of widespread use of such a vaccine would be economic paralysis. For everyday life to proceed efficiently, we rely on the confirmation bias. However, innovation, justice, and good policy depend on having at least a few individuals who are able, at least some of the time, to more carefully weigh different options before drawing a final conclusion. The most flexible will be willing to change their initial views in the face of evidence to the contrary.

Many individuals who are still refusing COVID vaccination initially felt that they did not want to be vaccinated, but those views solidified under the effect of confirmation bias: they latched onto any concerns, no matter how far-fetched, and actively wrote off evidence of the benefits of vaccination as tainted by a profit motive or a government drive to control citizens. These individuals need a way to allow them to change their view without feeling like they are “selling out” in some way. They need a way to save face.

One option may be to promote the coming Novavax COVID vaccine, likely to be approved for Emergency Use in adults in the next two months. Here is the narrative:

• This two-dose series uses tried and true purified protein technology, used for decades in Hepatitis B and Tdap vaccines.
• No fetal cell lines were used in any stage of its research or production.
• The vaccine uses completely different adjuvants, so there is not a risk of cross-anaphylaxis.
• The early reports of effectiveness show it comparable to the Pfizer and Moderna vaccines, but with less fatigue and local side effects.

This will not resonate with everyone opposed to COVID vaccination, but it does address several common stated concerns around current vaccine options. It may allow them to change their mind and accept COVID vaccination, in a way that is congruent with their earlier negative views.

A key is for early impressions of the Novavax vaccine to be positive, in your conversations with patients and your social media, leveraging the confirmation bias to increase support of vaccination.