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The 5C’s of Vaccine Hesitancy

A covid 19 vaccine




I feel it’s important to say right off the top that I am fully vaccinated.

Not only am I vaccinated, but I cried a little bit when I got my vaccine because I was so grateful for the many people whose hard work over many years1 made it possible to produce life-saving vaccines so quickly. But why do I feel the need to state that so vehemently off the top? Because as we all know, the vaccine has become a divisive and controversial issue. 

Unfortunately, this kind of controversial issue can divide societies into camps, which move us away from the ultimate goal of living in the safest, healthiest and happiest society that we can live in. Isolating members of society is counterproductive to that goal.

Instead, I hope to take a more clinical approach to the decision-making behind why some haven’t gotten vaccinated using the case study of a classmate.

Cornelia Betsch et al.2  studied the five “antecedents of vaccination.” The study asked participants questions that fell into five categories that were later summarily referred to as the 5C’s. The 5C’s are as follows: 


The 5C’s

  1. Confidence: The person’s trust in the vaccine’s efficacy and safety, the health services offered them, and the policymakers deciding on their rollout.
  2. Complacency: Whether or not the person considers the disease itself to be a serious risk to their health.
  3. Calculation: The individual’s engagement in extensive information searching to weigh up the costs and benefits.
  4. Constraints (or convenience): How easy it is for the person in question to access the vaccine.
  5. Collective responsibility: The willingness to, or perceived importance of protecting others from infection, through one’s own vaccination.


I had these determining factors in mind while chatting with my classmate Bonnie Chakawa, who only recently got her vaccine. 

For one, Chakawa had dabbled in what she referred to as “conspiracy theories” in the past. As a self-described curious person, some of what she saw and read made her question whether adequate research had been done and whether we knew enough about the long-term effects of the disease. As a disclaimer, please see the bottom of this article for reliable links to resources about the vaccines. Chakawa cited her social media community as the main source of information that made her hesitate.  She says she takes what she hears “with a grain of salt,” but Chakawa’s lack of confidence in the vaccine was one reason she did not initially get the vaccine. 

As well, although she had received many shots throughout her life, it seemed a not-insignificant factor that her mother, a nurse, was advising her not to get the vaccine. Our parental relationships are some of the most important in our lives, and we cannot help but seek their approval in big and subtle ways. Throughout her life, her mother had shed doubt on what was contained within vaccines. When the vaccine became mandated, her mother reluctantly got the vaccine in order to keep her job which Chakawa mentioned as another reason for later feeling more comfortable getting the vaccine.

I wondered with her if her decision about not getting the vaccine came from a lack of belief that the virus could really affect her complacency. Chakawa said she did believe in the severity of the virus, after all, a 27-year-old family friend in South Africa had died from the disease early on, but she also said that where we lived most people who died were older. 

Had she done her own research on the vaccine calculation, I asked? While social media gave her pause and made her want to do her own research before getting the vaccine, she said she never found the time. 

While our program is demanding, Chakawa conceded there was no constraint on her getting the vaccine—there being a vaccine site on campus. 

Last, we chatted about how collective responsibility played a role in her decision-making. With parents over sixty, despite her mother’s vaccine hesitancy, she does hope having the vaccine will ensure she does not expose them to the virus.

What became clear to me throughout our interview was that Chakawa’s not getting the vaccine was less a choice than a lack of choice. Many times she stated, “I just didn’t care.” 

It’s easy to sit on a moral high horse struggling with individuals not getting vaccinated when one’s personal belief is in the collective responsibility to protect one another from harm. But this won’t get us any closer to understanding and therefore changing the minds of those who have not yet had their vaccine. Instead, we should be careful not to villainize and remember that they are making the best decision they can for themselves, based on the information available to them. 


The solution, therefore, is not to try and convince those who are reluctant, but instead to focus on protecting society as a whole. 


4 Million3 people worldwide have died due to COVID-19. Researchers4 know that when the virus is allowed to continue to spread it results in ever worse variants meaning more deaths. In other words, there are consequences for the society for people not getting vaccinated. Choices that have collective implications, should have solutions that protect the collective.   

In the end, Chakawa wanted to go to a concert and it required being double vaccinated, so she got her vaccine. 



DISCLAIMER: For those who wish to do their own research, the government of Canada website lists all the ingredients in the vaccines approved in Canada. Many additional resources can be found on the WHO website and the Center for Disease Control’s website.



Betsch, Cornelia, Philipp Schmid, Dorothee Heinemeier, Lars Korn, Cindy Holtmann, and Robert Böhm. “Beyond Confidence: Development of a Measure Assessing the 5c Psychological Antecedents of Vaccination.” PLOS ONE 13, no. 12 (2018). 

“The Effects of Virus Variants on Covid-19 Vaccines.” World Health Organization. World Health Organization. Accessed October 24, 2021.

Solis-Moreira, Jocelyn. “Covid-19 Vaccine: How Was It Developed so Fast?” Medical News Today. MediLexicon International, December 15, 2020. 

“Who Coronavirus (COVID-19) Dashboard.” World Health Organization. World Health Organization. Accessed October 24, 2021.