Behind every vaccine question is a person

After six years of listening to questions, doubts, and pushback, this is where our thinking has landed so far.

The mom who chooses not to vaccinate her child believes she is making the best possible decision for her child. She is not careless, and she is not stupid. She is doing what every parent does: trying to protect her kid with the information she has. Our goal is never to tell her she is wrong. It is to understand how she got there, and to reach her with the best available evidence in a way she can hear. The premise underneath all of this is that the person in front of you is reasonable and acting out of care.

Which is why, when it comes to comms, canned messages do not work.

I have been doing this in the public eye via social media for about six years now, and in that time, I have encountered a lot of characters, a lot of questions, and a lot of pushback. What I love about our platform is that we work painstakingly hard to create a place where all folks can come and be heard. This includes skeptics, the uncertain, and the simply curious, who have questions about vaccines, antibiotics, fluoride, or whatever it happens to be that day. While we love our loyal readers who understand the value of what we do, we’re not interested in only speaking to people who get it. That feels like preaching to the choir, and that’s not where the work is.

So instead, we spend most of our time behind the scenes of social media, constantly listening, conducting surveys, doing interviews, and running sentiment and thematic qualitative analyses of our messages, comments, and DMs, all in service of understanding the patterns beneath what people are actually saying.

A huge focus for us (obviously) is vaccines.

One thing to say upfront: most people are not vaccine-hesitant. The large majority still vaccinate themselves and their kids. This is not a piece about a country that has turned against vaccines, because it has not. It is about the smaller set of conversations that are harder, and how to have them better.

For some of our vaccine-focused work, my team and I have begun to map out personas of vaccine hesitancy, drawing on the CDC-funded PANDEMIC project, the WHO SAGE 3C/5C antecedents work, and the Surgo Ventures persona scale, layered against what we are actually seeing and hearing from real people in 2026.

We are not the first to map this terrain. Researchers like Matthew Hornsey and Kelly Fielding have identified the “attitude roots” underlying vaccine hesitancy, and Stephan Lewandowsky’s group has gone further by identifying distinct profiles of hesitancy. Where that research maps the psychology, often in controlled European samples, our aim is to translate it for the US in its current moment, built from what we hear from real people every day, and simple enough to use in the first thirty seconds of a real conversation, whether you are a pharmacist or someone’s sister.

This framework is aimed at anyone having these conversations: clinicians, pharmacists, and science communicators, but also parents, family members, and anyone who has found themselves at a dinner table (or a bar!) trying to explain why they chose to vaccinate. And if you find yourself recognizing your own thinking in one of these personas, that is useful too. Understanding where your own hesitancy or uncertainty comes from is the first step toward working through it. For each persona, we have tried to distill not just who they are, but also what tends to work in conversation. Here is where we have landed so far.

The seven personas

1. The Naturalist. You probably know a Naturalist. They may say things like, “My body doesn’t need vaccines, I prefer natural protection.” They see “clean” living and “food is medicine” as real prevention, and view vaccines as meddling with a system that is already working. The Naturalist also frequently has concerns about ingredients, additives, and what is “really” in the shot, and often turns first to herbal remedies, supplements, or integrative medicine traditions before reaching for anything pharmaceutical. Listen for words like “natural” and “clean,” and frequent questions about ingredients. What works: engage the worldview rather than dismiss it. Reframe vaccines as something that supports the immune system rather than overrides it, and answer ingredient questions honestly and directly.

2. The Worried Well. This group is not outright opposed to vaccines, but may be anxious about side effects, feeling sick after vaccines, or getting “too many at once.” This is often a parent, and someone who wants to do the right thing, but is paralyzed by the fear of doing the wrong thing. Listen for questions about side effects, fevers, and dose spacing. What works: validate the worry, then reframe post-vaccine symptoms as signs the immune system is working, not signs of illness. Naming what to expect in concrete terms takes the fear out of the unknown.

3. The Skeptic. The Skeptic does not necessarily doubt the science. The doubt is aimed at the institutions delivering it (the CDC, pharma, and federal guidance) and at the motives behind the recommendation. They tend to assume a profit motive is driving it. To be clear, pharma is for-profit, and pretending otherwise does not build trust. The Skeptic’s wariness of institutions is not always misplaced, and that is part of why the conversation requires care rather than dismissal. Listen for mentions of CDC, pharma, “follow the money,” and “profit.” What works: transfer trust from the institution to the relationship in front of them, whether that is their pharmacist, their clinician, or someone in their community who knows them.

4. The Conspiratorial. This group is certain that vaccines are poison, a scam, or that someone is hiding something. This is the persona most associated with escalation risk in clinical settings, and the one where rational conversations or scientific evidence are often dismissed. Listen for “poison,” “scam,” “they’re hiding it,” and language that signals the conversation is not happening in good faith. What works: stay respectful, focus on building trust, and leave the door open for a future conversation rather than burning the bridge with a debate that will not change the outcome. You never know what seeds you may plant, even if it doesn’t seem like you got through. (A note on this term. We went back and forth on it, because the last thing we want is for someone who recognizes themselves here to feel dismissed, which defeats the whole point of this piece. We kept “Conspiratorial” not for the content of the belief, since plenty of personas hold mistaken ones, but for its shape: it assumes deliberate, hidden harm. We use the word with care and without contempt.)

5. The Confused. These people are victims of all the noise, and they are looking for a clear answer. There is no emotion behind their confusion; they are genuinely unsure given shifting guidance and schedule changes. In 2026, this might be the fastest-growing segment, and frankly, who can blame them? Listen for “wait, do I still need this?” questions about the current schedule, and questions about what changed. What works: Be the trusted source. Give a clear, direct answer about where things stand right now, without overloading them with the history of every guideline change that got us here.

6. The Unimpressed. As far as the Unimpressed is concerned, the experiment has already been run. They, or someone close to them, got vaccinated and "still got sick"; they "already had the disease" and figure they don't need the shot; or they simply heard the vaccine "doesn't really work" (the flu shot is the usual example). Either way, the verdict is the same: what's the point? The Unimpressed needs a reframe of what "working" actually means, since reducing severity is not the same as preventing every infection. Listen for "still got sick," "already had it," "doesn't work," and "what's the point." What works: reset the goalposts. Vaccines are not a force field; they are a way to make the version of illness you do get less severe, shorter, and less likely to result in hospitalization or death.

7. The Deferrer. The Deferrer is not opposed to vaccines. They just have not gotten around to it yet, held up by friction like time, cost, coverage, or wanting to check with their doctor first. The Deferrer is often the lowest-hanging fruit, and we miss them constantly because we assume they are a no when they are actually a not-yet. Listen for “not today,” “my doctor,” “cost,” and “next time.” What works: remove the friction, whatever friction you can remove. For a clinician or pharmacist, that means walk-ins, no appointment, and a coverage check on the spot: “We can do it right now while you are here.” For everyone else, it is making the path obvious: tell them it is walk-in and covered, send the booking link, or offer to go together. The move is the same either way; take the next step off their plate.

This is our 1.0 version of the persona list, and we have been thinking about it for a very long time.

A few things to keep in mind

These personas are not clean buckets, and most real people are a blend. A common pattern right now is a Confused patient with a Skeptic streak who says something like, “I don’t know what to listen to anymore, and honestly, I’m not sure I trust the people changing the rules.” Someone can be a Worried Well parent who is also a bit of a Naturalist, or a Deferrer who tips into Unimpressed after their third bout of COVID. The personas are a starting point for the conversation, not a label to slap on someone.

It is also important to be realistic about what success looks like. We are not trying to “win” conversations or shift anyone’s entire worldview in a single conversation. Success is often partial, and that’s ok. Someone can swear by herbal supplements and still roll up their sleeve. I’d argue that a Naturalist who decides to vaccinate while still buying her elderberry gummies is a win.

A lot of people in this space talk about the “movable middle,” meaning the segment of folks who can actually be reached with the right conversation. I would not try to map these personas cleanly onto that idea, but my honest read is that some are more reachable than others. The Confused, the Deferrer, the Worried Well, and even a lot of Naturalists are very much in the movable middle. The Conspiratorial persona, generally, is not, and a clinician or pharmacist trying to win that conversation in a five-minute window is going to burn time that would be better spent with the patient behind them in line. That is not a judgment of the patient; it is just an honest accounting of where a clinician’s limited bandwidth is best spent.

This works for more than vaccines

This framework can be applied to almost any health topic where there is tension between the evidence and the public conversation, whether that is fluoride, seed oils, sunscreen, GLP-1s, or microplastics. We all see the world through our own lenses, we consume information differently, and we place emphasis on different priorities.

So why would I, or a clinician or pharmacist with an extremely limited window of time with patients, spend that time talking to a Goop/Gwyneth/crunchy type about the extreme rigor of pharma regulation if her hesitancy lies in the belief that infection immunity is superior? While we are on the subject, can we retire “natural immunity”? My team has been pushing for “infection immunity” or “survivor immunity” because you have to first survive infection to get the good stuff.

One evidence base. Many topics. And for each topic, seven different conversations.

Why we think this approach works

A reasonable question at this point is whether any of this works. We have not yet formally tested the seven-persona framework against patient outcomes, and that work is in progress. But we have a fair amount of evidence that the underlying listen-first, meet-people-where-they-are approach is doing something.

Our 2026 audience survey of more than 1,500 respondents found that 65% use our content to make health-related decisions, and more than half share it with family and friends. We also see actual behavior change: On Instagram, 17% of followers say our content significantly changed their perspective, and 34% stopped following a harmful health trend after seeing our content. On Facebook, 15% of followers took a vaccine-related action after engaging with our content. None of this is a controlled trial, but real behavior change is rare in this space, and these numbers are a positive indication.

More specifically, within the persona framework, we have built virtual escape rooms that use these personas to train clinicians to navigate real conversations with hesitant patients. After completing the training, clinicians report gaining substantial clinical confidence on tough topics, including a 67-point jump in confidence when discussing vaccine ingredients (the kind of question a Naturalist tends to bring) and a 44-point jump in confidence when addressing medical mistrust (the kind of question a Skeptic tends to bring). Whether that confidence translates into more effective conversations with actual patients is the next thing we need to study, and we are working on it.

A caveat about scale

In a one-on-one conversation (a pharmacist and a patient, a clinician and a parent, you and your hesitant brother-in-law at Thanksgiving), tailoring to a specific persona is realistic and probably essential. In a mass campaign in communities or on social media, we cannot tailor to one person, because audiences are mixed and exposed to everything at once.

What this means for mass communication is slightly different. Instead of tailoring a single message, we put out a varied portfolio of messages that address different personas and concerns over time. One post addresses ingredient questions, another addresses shifting federal guidance, and another addresses the “I already had it” reframe. Over weeks and months, the audience gets exposed to the message that speaks to where they actually are, even if we never knew which persona they belonged to.

What is next?

This is a work in progress. We are still testing and refining these personas against new pulse survey data, feedback from clinicians and pharmacists on the front lines, and our ongoing listening across social media. The labels will probably shift, the triage cues will sharpen, and there may be more (or fewer) than seven. I wanted to give you a sneak peek at where our thinking is right now, and at the approach we keep coming back to, because the alternative (which is to keep blasting canned “vaccines save lives” messages at audiences who have already tuned them out) is not working for anyone. If something here resonates, or if you read a persona and thought “you’re missing one,” we would love to hear it, because that is exactly the kind of input that gets us to a 2.0.

Stay Curious,

Unbiased Science