Several major hurdles in the fight against COVID-19 have been cleared: Effective vaccines have been developed and supply is gradually increasing. But as distribution efforts continue, vaccine hesitancy remains a major barrier to reaching the end of the pandemic – or at least returning to a somewhat more normal state of living.
Experts agree that improving communications and outreach around the vaccine will be integral to reaching marginalized communities, like Black and Latino populations. These groups are seeing lower rates of vaccination compared to white people, often due to lack of access and information. But such efforts will also be crucial to reach other vaccine-hesitant populations, including individuals who refuse vaccines for political, social or religious reasons.
The question of how to go about doing this in the most effective, targeted manner was the focus of a Thursday afternoon panel hosted by United States of Care, a nonprofit organization that works towards equitable and affordable healthcare. The main takeaway: that the communications push should revolve around micro-targeted messages to each vaccine-hesitant population based on their concerns and their worldviews, rather than a one-size-fits-all marketing blitz.
Recent data from the Kaiser Family Foundation’s COVID-19 Vaccine Monitor, which is based on interviews with 1,009 adults, give a sense of the wide-ranging worries about vaccines in the U.S. According to the foundation, the most common concern among Americans is the possible side effects. Others include the newness of the vaccine and fears about its efficacy and safety.
In January 2021, 41% of respondents said they wanted to receive the vaccine as soon as possible, while 31% said they wanted to wait and see how it was working. By comparison, only 13% said they would definitely not get the vaccine.
Kaiser EVP and COO Mollyann Brodie pointed to one group of Americans that should be the focus of outreach and communication efforts: the three in ten Americans who are in the wait-and-see group.
“The conversation in this group is going to have to be around getting people to come to the decision themselves that getting vaccinated is the best option,” Brodie said.
The Kaiser data also showed that many respondents reported simply not having enough basic information about the vaccines – such as how they work, how they’re developed and how to schedule appointments.
Gathering specific information about the concerns and hesitancy among different groups will be integral to changing perceptions, said Matthew Motta, assistant professor of political science at Oklahoma State University. In order to “move the needle” on COVID-19 vaccine uptake, he noted that three steps need to be taken.
First, it’s important to determine how many Americans hold views inconsistent with science. The second is finding out why they hold those views, and the third involves using that knowledge to “inform communication interventions that correct misperceptions and change behaviors,” he said.
For instance, to win over vaccine skeptics who are motivated by political or religious reasons, simply presenting “the facts” or debunking falsehoods won’t be enough.
“This approach assumes that people reject vaccine safety because they’re unaware of scientific consensus,” Motta explained. “Often, skeptics are aware of the scientific facts, but are motivated to reject them. They’re motivated by social, political and psychological concerns to reject the facts not in line with what they want to believe.”
According to Motta’s own preliminary research, COVID-19 vaccine refusal is highest among women, Black people and political conservatives. Addressing the concerns of those vastly different groups requires a tailored approach – to each population, certainly, but possibly even on an individual level.
Vaccine skeptics on the ideological right, for example, tend to be less trusting of information from medical experts and are more likely to trust family, friends or celebrities who share their political views, Motta’s research shows. One way of addressing that is to re-cast the Biden administration’s COVID-19 rollout as building off a foundation laid by the Trump administration.
Among Black Americans, major concerns include safety and severity of side effects; they also want to see other Black Americans receiving the shots. Among low-income communities as a whole, other major concerns – such as whether people can get to an appointment without losing hours of work or even their jobs – need to be addressed.
Much of the vaccine hesitancy among Black people is entrenched in their experience of systemic racism, both historically and in the present, said Dr. Rhonda Medows, president of population health management at nonprofit health system Providence.
“We need to make sure we are listening to their concerns and questions, and not being dismissive,” Meadows stressed. “The past history of what has happened to people of color cannot be erased or ignored.”
All in all, there is no one-size-fits-all approach to improve vaccine uptake.
“We live in a time when micro-targeting is possible via social media,” Motta said. “We don’t have to rely on flashy national ads during the Super Bowl. If we know the reasons behind [people’s] concerns, we can try to target them.”
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