Millions Are Saying No to the Vaccines. What Are They Thinking?

Feelings about the vaccine are intertwined with feelings about the pandemic.

An illustration of a vaccine needle and the word “No.”
Adam Maida / The Atlantic

Updated at 10:07 a.m. ET on May 4, 2021.

Several days ago, the mega-popular podcast host Joe Rogan advised his young listeners to skip the COVID-19 vaccine. “I think you should get vaccinated if you’re vulnerable,” Rogan said. “But if you’re 21 years old, and you say to me, ‘Should I get vaccinated?’ I’ll go, ‘No.’”

Rogan’s comments drew widespread condemnation. But his view is surprisingly common. One in four Americans says they don’t plan to take the COVID-19 vaccine, and about half of Republicans under 50 say they won’t get a vaccine. This partisan vaccine gap is already playing out in the real world. The average number of daily shots has declined 20 percent in the past two weeks, largely because states with larger Trump vote shares are falling off the pace.

What are they thinking, these vaccine-hesitant, vaccine-resistant, and COVID-apathetic? I wanted to know. So I posted an invitation on Twitter for anybody who wasn’t planning to get vaccinated to email me and explain why. In the past few days, I spoke or corresponded with more than a dozen such people. I told them that I was staunchly pro-vaccine, but this wouldn’t be a takedown piece. I wanted to produce an ethnography of a position I didn’t really understand.

The people I spoke with were all under 50. A few of them self-identified as Republican, and none of them claimed the modern Democratic Party as their political home. Most said they weren’t against all vaccines; they were just a “no” on this vaccine. They were COVID-19 no-vaxxers, not overall anti-vaxxers.

Many people I spoke with said they trusted their immune system to protect them. “Nobody ever looks at it from the perspective of a guy who’s like me,” Bradley Baca, a 39-year-old truck driver in Colorado, told me. “As an essential worker, my life was never going to change in the pandemic, and I knew I was going to get COVID no matter what. Now I think I’ve got the antibodies, so why would I take a risk on the vaccine?”

Some had already recovered from COVID-19 and considered the vaccine unnecessary. “In December 2020 I tested positive and experienced many symptoms,” said Derek Perrin, a 31-year-old service technician in Connecticut. “Since I have already survived one recorded bout with this virus, I see no reason to take a vaccine that has only been approved for emergency use. I trust my immune system more than this current experiment.”

Others were worried that the vaccines might have long-term side effects. “As a Black American descendant of slavery, I am bottom caste, in terms of finances,” Georgette Russell, a 40-year-old resident of New Jersey, told me. “The fact that there is no way to sue the government or the pharmaceutical company if I have any adverse reactions is highly problematic to me.”

Many people said they had read up on the risk of COVID-19 to people under 50 and felt that the pandemic didn’t pose a particularly grave threat. “The chances of me dying from a car accident are higher than my dying of COVID,” said Michael Searle, a 36-year-old who owns a consulting firm in Austin, Texas. “But it’s not like I don’t get in my car.”

And many others said that perceived liberal overreach had pushed them to the right. “Before March 2020, I was a solid progressive Democrat,” Jenin Younes, a 37-year-old attorney, said. “I am so disturbed by the Democrats’ failure to recognize the importance of civil liberties. I’ll vote for anyone who takes a strong stand for civil liberties and doesn’t permit the erosion of our fundamental rights that we are seeing now.” Baca, the Colorado truck driver, also told me he didn’t vote much before the pandemic, but the perception of liberal overreach had a strong politicizing effect. “When COVID hit, I saw rights being taken away. So in 2020, I voted for the first time in my life, and I voted all the way Republican down the ballot.”

After many conversations and email exchanges, I came to understand what I think of as the deep story of the American no-vaxxer. And I think the best way to see it clearly is to contrast it with my own story.

My view of the vaccines begins with my view of the pandemic. I really don’t want to get COVID-19. Not only do I want to avoid an illness with uncertain long-term implications, but I also don’t want to pass it along to somebody in a high-risk category, such as my grandmother or an immunocompromised stranger. For more than a year, I radically changed my life to avoid infection. So I was thrilled to hear that the vaccines were effective at blocking severe illness and transmission. I eagerly signed up to take both my shots, even after reading all about the side effects.

The under-50 no-vaxxers’ deep story has a very different starting place. It begins like this:

The coronavirus is a wildly overrated threat. Yes, it’s appropriate and good to protect old and vulnerable people. But I’m not old or vulnerable. If I get it, I’ll be fine. In fact, maybe I have gotten it, and I am fine. I don’t know why I should consider this disease more dangerous than driving a car, a risky thing I do every day without a moment’s worry. Liberals, Democrats, and public-health elites have been so wrong so often, we’d be better off doing the opposite of almost everything they say.

Just as my COVID-19 story shapes my vaccine eagerness, this group’s COVID-19 story shapes their vaccine skepticism. Again and again, I heard variations on this theme:

I don’t need some novel pharmaceutical product to give me permission to do the things I’m already doing. This isn’t even an FDA-approved vaccine; it’s authorized for an emergency. Well, I don’t consider COVID-19 a personal emergency. So why would I sign up to be an early guinea pig for a therapy that I don’t need, whose long-term effects we don’t understand? I’d rather bet on my immune system than on Big Pharma.

For both yes-vaxxers like me and the no-vaxxers I spoke with, feelings about the vaccine are intertwined with feelings about the pandemic.

Although I think I’m right about the vaccines, the truth is that my thinking on this issue is motivated. I canceled vacations, canceled my wedding, avoided indoor dining, and mostly stayed home for 15 months. All that sucked. I am rooting for the vaccines to work.

But the no-vaxxers I spoke with just don’t care. They’ve traveled, eaten in restaurants, gathered with friends inside, gotten COVID-19 or not gotten COVID-19, survived, and decided it was no big deal. What’s more, they’ve survived while flouting the advice of the CDC, the WHO, Anthony Fauci, Democratic lawmakers, and liberals, whom they don’t trust to give them straight answers on anything virus-related.

The no-vaxxers’ reasoning is motivated too. Specifically, they’re motivated to distrust public-health authorities who they’ve decided are a bunch of phony neurotics, and they’re motivated to see the vaccines as a risky pharmaceutical experiment, rather than as a clear breakthrough that might restore normal life (which, again, they barely stopped living). This is the no-vaxxer deep story in a nutshell: I trust my own cells more than I trust pharmaceutical goop; I trust my own mind more than I trust liberal elites.

So what will change their minds?

I cannot imagine that any amount of hectoring or shaming, or proclamations from the public-health or Democratic communities, will make much of a difference for this group. “I’ve lost all faith in the media and public-health officials,”said Myles Pindus, a 24-year-old in Brooklyn, who told me he is skeptical of the mRNA vaccines and is interested in the Johnson & Johnson shot. “It might sound crazy, but I’d rather go to Twitter and check out a few people I trust than take guidance from the CDC, or WHO, or Fauci,” Baca, the Colorado truck driver, told me. Other no-vaxxers offered similar appraisals of various Democrats and liberals, but they were typically less printable.

From my conversations, I see three ways to persuade no-vaxxers: make it more convenient to get a shot; make it less convenient to not get a shot; or encourage them to think more socially.

1. Try something like “DoorDash for vaccines.”

To get people to participate in an activity they don’t really care about, you make it as easy and tantalizing as possible. Some people have already suggested offering money, free food, or even lottery tickets in exchange for vaccination. But one source who asked to remain anonymous suggested that state health departments should offer something like DoorDash for vaccines.

With any new technology, the early adopters are the ones most willing to tolerate glitches and a bad experience. That’s fine when supply is limited, but as you try to get to mass market, you need to perfect the product and experience.

All of which to say: Cities should start to roll out a vaccine in-home service, which people can book on short notice. Providers come to you, and maybe bring you some sort of gift along with the vaccine. Cities should have enough capacity and staff to do that at this point, and a service such as this would be key to getting young people in particular to take it.

2. Make it suck more to not be vaccinated.

Governments and companies may find that soft bribery is the best way to get the no-vaxxers to the clinics. Michigan Governor Gretchen Whitmer, for example, has linked her state reopening policies to progress in shots, letting restaurants and bars increase their occupancy once 60 percent of the state has been vaccinated, and promising to lift mask orders when 70 percent of Michiganders have received both doses.

Millions of people want to go to sporting events, attend concerts, or travel internationally. If those who cannot prove that they’ve been vaccinated are denied service, I expect that some will sign up for shots purely as a means of reengaging in their favorite activities. “If all or most countries instituted vaccine passports, that might change [my mind],” Younes, the attorney, told me.

But the cultural backlash against domestic restrictions could be prodigious. If blue-state governors and sports stadiums deny economic activities to the unvaccinated while red-state stadiums allow anybody to sit at a bar or in the bleachers, it will deepen the culture-war tensions between scolding liberals and accommodating conservatives in a way that might not be good for Democrats politically, even if they have the upper hand in the public-health argument.

3. “What if natural immunity isn’t enough to protect your grandmother?”

The most common argument against the vaccines is: My immune system is good enough for me. One counterargument is: That’s right, but the vaccines are even better at protecting others.

Even for people who have already recovered from COVID-19, getting fully vaccinated strengthens the antibody and T-cell protection against the disease and likely provides superior protection from variants that can pierce our natural immunity.

Why do more levels of protection matter? Because the vaccines aren’t just about building a defensive wall around safe young bodies. We’re also collectively building a wall around the more vulnerable members of society. And little holes in the wall can lead to unnecessary deaths.

In April, the CDC reported that an unvaccinated health-care worker set off an outbreak in a mostly vaccinated Kentucky nursing home. Several vaccinated seniors got sick and one vaccinated resident died.* To be absolutely clear: The vaccines worked to protect most residents. But no vaccine is perfect, and the COVID-19 vaccines won’t stop all infections, especially for some people with weak immune systems.

I made this case to several no-vaxxers: Your grandparents, elderly neighbors, and immunocompromised friends will be safer if you’re vaccinated, even if you’ve already been infected. I played with the “COVID is no worse than driving” metaphor that many of them offered. I agree that driving is acceptably safe for most people, I said. But imagine, I added, if you could have a forward collision warning system installed in your car for free? An already-pretty-safe activity would become an even safer activity; and what’s more, you’d be protecting other people on the road at minimal cost to yourself.

I can’t tell you this argument got a lot of people to drop the phone, sprint to a vaccine clinic, and sign up for a Fauci tattoo on their arm. The truth is that I’m not sure that I changed anybody’s mind. But I can honestly say that this argument gave several no-vaxxers a bit of pause. They responded by talking about chains of transmission throughout the community, rather than focusing on their own immune system. Several of them asked to see evidence of my position so that they could examine it for themselves.

The United States suffers from a deficit of imagining the lives of other people. This is true of my side: Vaccinated liberals don’t take much time to calmly hear out the logic of those refusing the shots. But it’s also true of the no-vaxxers, who might reconsider their view if they grasped the far-ranging consequences of their private vaccination decisions. Instead of shaming and hectoring, our focus should be on broadening their circle of care: Your cells might be good enough to protect you, but the shots are better to protect Grandpa.

*This article previously misstated that two vaccinated seniors died in a Kentucky nursing home. In fact, only one vaccinated person died.