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Public health messaging 101: How to convince the vaccine skeptics

Gabriel Perna | January 14, 2021

Georges Benjamin, MD

For health care provider organizations, COVID-19 isn’t just a constant battle to keep people healthy, out of the ICU and virus free. It’s also about the continuous public health messaging challenges that have popped up since the earliest days of the pandemic.

The first part of that challenge was informing the public about wearing masks, practicing social distancing, and battling misinformation related to the virus. The second part is getting people to take COVID-19 vaccines and help the country return to normal…while still battling misinformation.

It’s easier said than done.

As the first wave of COVID-19 vaccinations have begun across the country, it’s clear that not everyone is on board with inoculation. According to a survey from the American Public Health Association, the National Collaborative for Health Equity, and de Beaumont Foundation, only 26 percent of rural/farm communities, 27 percent of Republicans age 18-49, 28 percent of Black Americans 18-49, and 29 percent of women 18-49 were certain to get vaccinated. Another survey, from Kaiser Family Foundation, found that only 26 percent of Hispanics and 20 percent of Black Americans said they would get the vaccine as soon as possible.

“These are the groups that need attention. We as a society are only going to be as strong as the group that takes the vaccine the least and it’s incumbent on us to talk with all groups and tailor our messaging appropriately,” said Brian Castrucci, DrPH, President and CEO of the de Beaumont Foundation. “We can’t stay silent. There are far too many people who are trying to share misinformation and mislead the public.”

In total, one-quarter of the population, according to the Kaiser study, is vaccine hesitant. This spreads across a swath of diverse population subgroups, who have different reasons for not wanting to take the vaccine.

How can health care organizations tailor public health messages that will reach specific population groups in an efficient manner that will actually increase uptake? Castrucci and Georges Benjamin, MD, Executive Director of the American Public Health Association, shared a few insights to help health care CEOs create an effective COVID-19 vaccine public health messaging strategy.

Tailored but universal themes

Those in rural America have different reasons for their hesitancy than those in urban areas. For that reason, it’s imperative to get at the heart of why certain groups don’t want to take the vaccine and tailor messages to them, whether it’s safety, cost, or something else.

However, tailoring messages to a patient population across large health care organizations (not to mention your employees) isn’t going to be an efficient use of time. As such, Castrucci and Benjamin say there are common themes that span different demographics. For instance, according to the survey from de Beaumont, people are most willing to take the vaccine for their family as opposed to country, economy, community or friends.  

“People have a desire to help family members. Using that kind of language is more acceptable to people than serving their community,” Benjamin says. “People want to serve their communities, but it’s easier for them to internalize it better when you’re talking about their families.”  

Moreover, people want a return to normal and to re-open the economy. Benjamin also encourages messaging that emphasizes the vaccine is “safe and effective.” Because the vaccine was developed in less than a year, many people are concerned about safety, says Benjamin. In fact, according to a National Geographic-Morning Consult poll conducted in December, seven in 10 Americans say they are wary of the potential side effects of any COVID-19 vaccine.

Benjamin advises health care organizations to emphasize the word “research” in their messaging when talking about how safe it is rather than talk about how it was a “discovery” or using “invent.” “Research is a word that people hear better. When we talk about medical research vs. the pharmaceutical companies, a lot of people have negative thoughts on pharma companies, but they don’t have strong feelings on medical researchers themselves,” he says.

Words matter: Talk about benefits rather than consequences

In fact, choosing words carefully when cultivating a public-facing message on the vaccine is of the utmost importance, experts say. Safety is a better word to use than security, says Benjamin. Vaccination is better than inoculation. The word “every” is critical when talking about the vaccine development process. (For example, “Every study, every phase, and every trial were reviewed by the FDA and a safety board.”)

homepage image: Steven Cornfield/unsplash

People don’t respond well to negative messaging. No one likes finger wagging. No one likes to hear about the bad side of things. Americans like the benefits of things, not the consequences.

Brian Castrucci, DrPH, de Beaumont Foundation

These words matter and de Beaumont has actually devised a “language cheat sheet” that helps improve vaccine acceptance through better messaging. More than anything though, experts say focus on the benefits of a vaccine rather than the consequences. In fact, research from Health Communication in May found that this was true for other types of vaccinations, such as the one for HPV.

“People don’t respond well to negative messaging. No one likes finger wagging. No one likes to hear about the bad side of things. Americans like the benefits of things, not the consequences. It’s sales 101. You want to think about what’s in it for people you’re trying to sell to whether it’s family, a return to normal, getting to next Thanksgiving, there is some positive aspect of this vaccine that will resonate with people,” Castrucci says.

It is worth noting that some “negative effects” public health campaigns have been effective in the past. An anti-smoking campaign that ran from 2012-2014, created by the CDC, focused on the consequences of smoking and helped 400,000 smokers quit. Other anti-smoking campaigns in mass media have been effective using these or similar strategies.

Create a multi-platform strategy

In the 1950s, Elvis took the polio vaccine on the Ed Sullivan show and encouraged Americans across the country to do the same. In the 1980s and 1990s, public service announcements on the dangers of drugs and smoking filled the airwaves with memorable spots.

Those days are done. While celebrities and politicians are doing their part, and a number of health care organizations have run COVID PSA spots, there is no singular medium in 2021 that has gotten everyone’s attention to increase vaccine uptake. For this reason, experts say it’s imperative to create a multi-platform strategy that can reach different age groups and demographics.

“Once upon a time, there were three channels of news and the news was between 5 pm and 7 pm every night. That was it. And then you had the newspaper in the morning. Now with social media and a 24/7 news cycle, it’s not just TV, the internet and radio, but YouTube, TikTok, and all these other platforms. We’re going to have to do this in a multi-faceted way,” Castrucci says. “That’s the challenge for this vaccine response compared to previous campaigns.”

Fight back against misinformation

The presence of social media and other 24/7 platforms calls out another challenge that CEOs must address: misinformation. The rise of the anti-vaccination movement caused the World Health Organization to rank vaccine hesitancy among the world’s 10 biggest health problems in 2019—before COVID-19 was in the picture. Wide-scale misinformation on the COVID-19 vaccine threatens to be a big thorn in the side of health care leaders in 2021 and beyond.

While social media sites are trying to remove misinformation on the COVID-19 vaccine, critics say they are losing this overall battle. Benjamin says in some cases it’s not even the misinformed anti-vaccination community that’s actively trying to discourage inoculation, but people with far more sinister intentions.

Benjamin points to a false infographic posted to the COVID-19 disinformation site for the New Jersey Department of Homeland Security that falsely uses the CDC logo and urges people to go to churches, synagogues and mosques.

“The people who crafted that were trying to get people to go out and infect other people purposefully, but it looks like an official document. There were flyers passed around early in the COVID-19 pandemic that told Americans to avoid getting a vaccination. This was before we even had one,” says Benjamin, who says this was especially a problem in communities of color. “We have to push back against this in a much more aggressive way.”

Address concerns directly

In divisive times, there is no need to make vaccine hesitant people feel bad for not wanting to take one. Anyone who has a legitimate concern should have their questions directly answered in public forums and messaging.

“Opening up a dialogue with people on why they’re concerned and normalizing their concern can help us promote better confidence,” Castrucci says. Benjamin agrees, “Leaders should recognize that not everyone is the same. Some people are hesitant. Listen to what their concerns are and directly address those concerns. Listening is going to be very, very important.”

About the Author

Gabriel Perna, Senior Manager, Digital Content

Gabriel Perna is the Senior Manager of Digital Content at Health Evolution. He brings 10+ years of experience in covering the intersection of health care and business. Previously, he was at Chief Executive, Physicians Practice and Healthcare Informatics. You can reach him via email or on Twitter at @GabrielSPerna