The Big COVID Vaccine Holdouts: Republican Men

WEDNESDAY, April 21, 2021 (HealthDay News) -- Outspoken pandemic denier Ted Nugent announced this week that he's tested positive for COVID-19, after 10 days of symptoms so severe that at times he "literally could hardly crawl out of bed."

But despite his illness, the Republican rocker from Michigan remains skeptical about COVID vaccines.

"I haven't taken the vaccine, because nobody knows what's in it," Nugent said in a Facebook Live post announcing his diagnosis. "Actually, some people do know what's in it, and if you can't even honestly answer our questions of exactly what's in it, then why are you testing it on human beings and forcing it upon people in such a short time?"

About half of Republican men agree with Nugent. In polls, as many as 49% say they won't get the shot.

Americans need at least some of these guys to change their minds and take the jab, if the nation is going to ever reach herd immunity and regain some sense of normalcy, public health experts said.

"They're terribly important. If we want to get up to 80% of adults vaccinated, we need them," said Dr. William Schaffner, a professor of infectious diseases at Vanderbilt Medical Center in Nashville, Tenn. "And, of course, they have influence in their families and their communities, so it goes beyond their individual numbers."

Convincing these men, therefore, is one of the many pressing pandemic problems facing the nation. So how to do it?

Vaccine hesitancy isn't something that's confined to Republicans or men, said Dr. Paul Offit, director of the Vaccine Education Center at Children's Hospital of Philadelphia.

"Crunchy granola" all-natural folks on the far left can also oppose vaccines because, they say, "I'm not going to put anything in my body that is not a product of nature," Offit noted.

By contrast, right-leaning vaccine skeptics generally share a "libertarian notion of 'government off my back,'" he said.

"'I'll do what's best for my family and myself because I will become educated myself and I don't need the government to tell me what do to. I want freedom' -- I think that's at the heart of this," Offit said. "Those are the words you hear."

Experience a teacher

Still, experts are hopeful that as the vaccines establish a real-world track record of safety and effectiveness, and as more people fall ill with COVID, that skeptics on either end of the political spectrum will be persuaded by the facts on the ground.

"As people tragically have more of an experience with the disease, either themselves or a loved one or someone down the street, it becomes more real to them," said Dr. Georges Benjamin, executive director of the American Public Health Association. "It's no longer a theoretical discussion or political discussion."

The key to persuading Republican men could be simply appealing to their free-thinking nature and their sense of patriotic duty, without embarrassing them over their past skepticism regarding COVID, Schaffner said.

"You have to give them a way to save face," he said.

Appealing to opponents' skeptical nature by offering just the facts could be one way to let them change their minds without exposing them to ridicule, Benjamin said.

"They don't want to be manipulated by anybody. They want the facts," he said. "And I think if we continue to give them the facts in a neutral way that's medical in nature and then let them think about it, I think they're more likely to come along."

That way, it's a positive change of heart rather than a capitulation, Schaffner said.

"You can move off your hard anti position because you can say, 'Oh, that was then, but this is now.' You save face that way," Schaffner said. "You don't have to say you were wrong. You've been thoughtful. You've been analytical. You've been careful. And now you're convinced that they're safe and they're effective."

Business leaders, clergy, and state and local politicians also could help the effort by coming out strongly in favor of vaccination, because these people still have some degree of credibility among Republican men, Schaffner added.

He imagines his Republican governor in Tennessee, Bill Lee, announcing that "I want our state to be the best-vaccinated state in the country. I need every adult to be vaccinated, make no bones about it, and here are the reasons."

Lee would then speak to this individual, independent decision-making, Schaffner imagines, and say, "'The single most responsible thing you can do is to be vaccinated to protect yourself, your family and your community. That's how I define responsibility,'" Schaffner said.

Die-hards tough to reach

But such efforts need to be local, experts said. At this point, federal politics have become so poisonous that the words of any national politician -- Republican or Democrat -- will be greeted with hostility and defiance, they said.

Even respected local leaders need to be prepared to take some flack, Schaffner said, and that's why more haven't spoken out in favor of vaccination.

"They don't want to alienate their supporters, whether it's their churchgoers, their customers or their voters," he said. "But leadership is persuading people to do the right thing. That's part of the job."

Even with all this, Offit is concerned that some Republican men might now have moved from vaccine skepticism into full-fledged cynicism. Those folks might be beyond the reach of either logic or reason and impossible to convince.

"They're conspiracy theorists. They don't believe anything they're being told. They think people are lying to them," Offit said. "If someone reaches a conclusion not based on reason or logic, reason or logic is not going to talk them out of it."

Measures like vaccine passports might be needed to compel such diehards into getting vaccinated, the experts agreed.

These measures probably won't be implemented in a punitive way to force people to take the jab, but will develop as a result of societal pressure when vaccinations become widespread.

"Once we get a sizable amount of the public vaccinated, people aren't going to want to get sick because you came next to them, whether it's on an airplane or in a movie theater or somewhere else," Benjamin said. "If most of the nation is vaccinated but they're not, they will lose personal freedoms, because the society won't tolerate it."

Offit agrees that the pressure to get vaccinated will continue to mount over the coming months and years.

"This is a mucosal virus. We're not going to eliminate this virus for a long time," he said. "You're going to have two choices over the next few years -- either get vaccinated or get infected."

Even if the best efforts are mounted to convince skeptics, Benjamin warns that Americans should be prepared for continued COVID outbreaks in isolated pockets of the nation where people have outright refused vaccination -- similar to outbreaks of measles and whooping cough that regularly strike vaccine-resistant communities.

"We can reach herd immunity so that we're telling people not to wear masks, generally, and things are near normal, but we ought to anticipate there are going to be outbreaks in communities of unvaccinated people," Benjamin said.

More information

The U.S. Centers for Disease Control and Prevention has more about COVID-19 vaccines.

SOURCES: William Schaffner, MD, professor, Preventive Medicine, and Division of Infectious Diseases, Vanderbilt Medical Center, Nashville, Tenn.; Paul Offit, MD, director, Vaccine Education Center, Children's Hospital of Philadelphia; Georges Benjamin, MD, executive director, American Public Health Association, Washington, D.C.