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5 reasons some Idahoans didn’t get the COVID vaccine — and what might persuade them

After the Pfizer COVID-19 vaccine was opened to Idahoans age 12 to 17, a group of Idaho teens went together to get their vaccines. (Courtesy of St. Luke's Health System)
After the Pfizer COVID-19 vaccine was opened to Idahoans age 12 to 17, a group of Idaho teens went together to get their vaccines. (Courtesy of St. Luke's Health System)

Lotteries, cash and jet skis won’t get Idahoans to roll up their sleeves.

A new report on vaccine hesitancy in Idaho sheds light on what’s behind the state’s low COVID-19 vaccination rate.

More than 710,000 people in Idaho have now chosen to get the COVID-19 vaccine. That’s about 47% of the people eligible at this point.

But public health experts believe it will take a lot more people getting immunized to make the coronavirus less of a threat — and keep it from mutating into something worse.

The state in January signed a $3 million contract with Boise-based firm GS Strategy Group to survey people about their attitudes toward the coronavirus vaccine and find ways to build confidence in the vaccines.

A survey conducted earlier this year of a wide-ranging group of Idahoans found that some had already been vaccinated or planned to be. Among those who hadn’t been vaccinated, “their concerns are mostly about safety, especially politically right of center Idahoans on the fence about whether or not to get the vaccine.”

The agency earlier this month did another phone survey, focusing just on Idahoans who remain unvaccinated. They surveyed 300 people between June 5 and June 10. They asked a series of questions, finding several key reasons those Idahoans are holding out, and what might persuade them to roll up their sleeves.

1. There’s a big chunk of Idaho that probably can’t be persuaded.
About 39.2% of Idaho’s population — including children — is partly or fully vaccinated at this point.

The survey asked 300 unvaccinated Idahoans about their plans for the COVID-19 vaccine.

Based on the survey’s results, around 30% of Idahoans are “definitely” not getting the vaccine. While some of the respondents who aren’t vaccinated said they expect to get their children vaccinated, most were reluctant. That could mean Idaho will struggle to reach 70% to 80% vaccination rates statewide, even if children under age 12 become eligible.

What about the rest of Idaho that hasn’t yet been vaccinated? About 41% of survey respondents weren’t totally opposed to getting vaccinated, were likely to get vaccinated, or planned to and just hadn’t yet.

That’s where state public health officials — and public health agencies nationwide — are focusing their attention.

2. What tips the scales for some Idahoans? Time off work.
That group — those who are hesitant or have delayed vaccines — said one of the best incentives would be time off work.

The survey found that was one of the most influential incentives — more effective than being offered cash, being entered into a lottery or getting “outdoor gear like guns or jet skis.”

Gov. Brad Little last week announced that Idaho state employees who are vaccinated for COVID-19 will get four hours of paid time off, as long as they receive a shot by the end of August. He also urged business leaders and private employers to follow suit.

The survey’s data suggests that, among Idahoans who say they’re likely to get the vaccine, getting time off work is one of the major reasons they haven’t yet.

That could mean that employers who offer time off work are removing a barrier to vaccination.

3. The big S factors: safety, side effects.
The survey found that unvaccinated Idahoans aren’t worried about getting infected with the coronavirus; they’re worried about the vaccine.

That was true even with the arrival of more contagious, and potentially more serious, COVID-19 variants, the survey found.

Only about 14% of the Idahoans who were most likely to get the COVID-19 vaccine in the future said they were worried about catching the virus if they weren’t immunized.

Conversely, about 68% said they believed it was common for people to have “significant side effects” from the vaccine, beyond soreness, fever and fatigue. It isn’t. Serious adverse reactions are extremely rare.

As more than 319 million Americans have received a COVID-19 vaccine, the most common side effects reported are soreness at the injection site; and signs of immune response to the vaccine, such as chills, fever, fatigue, headache, muscle aches or joint pain. Side effects usually go away within a day or two. Some people have no side effects.

About 73% said they disagreed that enough time has passed “to know that major side effects from getting the COVID vaccine are extremely rare, and the vaccines are safe and effective.” Among that group, most said they just wanted more time — a year, two years, less than a year, five years — or wanted them to have full FDA approval.

Those worries may have been worsened by reports in April of cases of serious blood clots developing after the Johnson & Johnson vaccine. There were 15 cases reported among the nearly 7 million people who received that vaccine.

The CDC’s vaccine advisory committee also on Wednesday reviewed reports of temporary heart inflammation among primarily male adolescents and young adults following the Pfizer or Moderna vaccine.

The side effect is rare, amounting to about 12.6 cases per million doses administered in the United States, according to the University of Minnesota’s Center for Infectious Disease Research and Policy.

But blood clotting and heart inflammation are also side effects of COVID-19.

A group of the nation’s public health leaders, hospitals, physicians and nurses released a statement after the CDC’s committee reviewed the heart inflammation cases and concluded that the benefits of the Pfizer and Moderna vaccines outweighed the risks of harm.

“The facts are clear: this is an extremely rare side effect, and only an exceedingly small number of people will experience it after vaccination. Importantly, for the young people who do, most cases are mild, and individuals recover often on their own or with minimal treatment,” the statement said. “In addition, we know that myocarditis and pericarditis are much more common if you get COVID-19, and the risks to the heart from COVID-19 infection can be more severe.”

4. It’s true. Most Idahoans not wearing masks are unvaccinated.
The survey confirmed a theory that has circulated since the Centers for Disease Control and Prevention said in mid-May that people no longer need to wear masks if they’ve been vaccinated. The survey was conducted a few weeks later.

The theory: that most people not wearing masks are, ironically, not vaccinated.

According to the survey, about 58% of unvaccinated Idahoans had stopped wearing masks by early June, including in places like grocery stores.

Among the Idahoans most resistant to ever getting a vaccine, 78% had stopped wearing masks anywhere, the survey found.

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5. Talking to people about the vaccine makes a difference.
Near the end of the survey, the callers read Idahoans a series of factual statements about COVID-19 and the vaccines, such as, “These vaccines are very safe. All COVID vaccines distributed in Idaho have been rigorously tested on tens of thousands of Americans before they were (FDA authorized). This is well established science that can be trusted.”

The survey asked one last question: “Based on everything you’ve heard, when it comes to getting the COVID vaccine, which comes closest to your opinion?”

When the researchers compared those responses with the opinions at the start of the survey, they found something surprising. People who’d said they were unsure, and even a few who’d said they would never get vaccinated, had moved over into the “definitely will” group.

Just talking about the virus and the vaccine, and hearing information, seemed to alter their opinions.

The Idaho Department of Health and Welfare reported Tuesday that just over 50% of Idaho adults had chosen to be vaccinated. Public health officials listed all the things they and health care providers are doing to raise that number.

One approach: talking to people. Listening to their concerns and giving them answers.

“One shot is a success to me, because that’s one more person that wasn’t vaccinated the day before,” said Elke Shaw-Tulloch, administrator of Idaho’s Division of Public Health, during a media briefing Tuesday. “We’re not giving up, I think is the biggest message here. We will continue to work with our partners to make sure that we make those vaccines available. So again, to me, success is that … we’re just making those small gains over time.”

The Idaho Capital Sun is a nonprofit news organization delivering accountability reporting on state government, politics and policy in the Gem state. As longtime Idahoans ourselves, we understand the challenges and opportunities facing Idaho. We provide in-depth reporting on legislative and state policy, health care, tax policy, the environment, Idaho’s explosive population growth and more. Our mission is relentless investigative journalism that sheds light on how decisions in Boise and beyond are made and how they affect everyday Idahoans. We aim to tell untold stories and provide data, context and analysis on the issues that matter most throughout the state. The Capital Sun is part of States Newsroom, a national 501(c)(3) nonprofit supported by grants and a coalition of donors and readers. We retain full editorial independence.