As the COVID-19 vaccines continue to roll out, vaccine hesitancy poses a difficult obstacle to overcome, with many of us wondering how best to talk to people who voice concerns about safety and the vaccines’ rapid development.
U.S. PIRG’s Matt Wellington co-hosted a public forum with Doctors for America on Jan. 19, featuring expert panelists Drs. Saad Omer, Rob Davidson, Christine Grady and infectious disease journalist Helen Branswell to discuss strategies for communicating effectively about the vaccines.
The excerpts below have been condensed and edited for clarity.
The message is more effective if it comes from a trusted source
Rob Davidson, MD, is the executive director of the Committee to Protect Medicare and has practiced as an emergency room doctor for the past 20 years in a small rural town in western Michigan. Here’s what he had to say about discussing vaccine hesitancy in his community:
I’m working in an area that’s about 70-30 who supported President Donald Trump in both 2016 and 2020. We know from national polling that folks who support Republicans certainly have a bit more vaccine hesitancy than folks who identify as Democrats, and so that is a challenge in our community.
As a hospital, we like to use local voices — primarily family practice physicians, emergency physicians — who have been in the community for as long as I have and others have, talking to people so they have a friendly face, someone in their community, talking to them about the impact of COVID-19.
Using local stories, telling people about patients you took care of in their community who have been struggling with this disease sometimes goes a lot farther than statistics and numbers, and that’s how we’re trying primarily trying to communicate and I think that’s how folks should be communicating in their communities.
The right environment can help build vaccine confidence
Dr. Saad Omer, MBBS, MPH, PhD, FIDSA, is a vaccinologist, infectious disease specialist and director of the Yale Institute for Global Health. He described the behavioral approach to cultivating vaccine acceptance:
The first thing is an enabling environment for vaccination. So before you communicate, when you go to a vaccination place, are you treated with kindness, understanding, respect, ease? There are a lot of older people, people who are not used to interacting with the health system, who need to be vaccinated.
The other thing is: Is the information clear? Is it accessible? So before we get to persuasion, just the basic information — and we are in an information deficit scenario even with health care providers.
The second bucket is social influences: We look at other people’s behavior and it influences our behavior. If you are dealing with measles, one approach is to highlight the social norm. We don’t have a social norm with the COVID-19 vaccine because we haven’t reached that level of coverage where we can say with a straight face that it’s a social norm. “All the cool kids have gotten it, why aren’t you getting it?”
But there’s another related phenomenon, which is highlighting a new and emerging norm in favor of vaccination. So we can say that, in terms of absolute numbers, millions of doses have now been given, and the fact that a lot of people who know best — like physicians, like scientists — are getting vaccinated in droves and with eagerness. Highlighting that in our communications has some evidence behind it.
The vaccines were developed in record time and they are safe
Dr. Christine Grady, RN, PhD, serves as chief of the department of bioethics of the National Institutes of Health Clinical Center and is a former member of the President’s Commission for the Study of Bioethical Issues. She elaborated on the rapid pace of COVID-19 vaccine development and emergency use approval:
Despite the discouraging numbers of COVID-19 cases and hospitalizations and deaths, vaccines are an example of a really great success. They’ve built on decades of exquisite scientific progress and research, but also on the coordinated efforts and contributions of many, many people.
The research that’s been going on for decades has led to opportunities to develop novel platforms for vaccine development, like the messenger RNA vaccines that we currently have available to us under emergency use authorization (EUA).
Rapid sequencing of the SARS-CoV-2 virus in January 2020 led to the design and development of these messenger RNA vaccines, which went into phase one clinical trials at a really unprecedented pace.
The research that ensued after that was a really coordinated effort between private industry, the U.S. government, Operation Warp Speed, ACTIV, a bunch of organizations and the contributions of many many people — researchers and research staff, research institutions, vaccine companies, the U.S. government and other governments — and reviewers at multiple levels, including the SMBs, the FDA and tens of thousands of clinical trial volunteers, so that we now have two vaccines that are being widely distributed and others in the pipeline that are likely to come to the fore pretty soon.
So the process was fast, but it was building on other important work that had gone before, and all of the critical steps were taken. The familiar phases of clinical trials occurred, the review was transparent, and the FDA issued the EUAs for these two vaccine candidates after concluding, on the advice of a public meeting, that the benefits of these two vaccines — very high efficacy rate with very low risk — were worth it.
And so they issued the emergency use authorization in order to save lives during this really extensive emergency.
Don’t dismiss your audience’s concerns or fears
Dr. Davidson spoke to the power of personal relationships,trust, and overwhelming the negative narratives with the positive:
I’ve had a number of nurses, techs in the emergency department and the hospital in general, paramedics, ask me “so what do you think? I’m not sure, I’ve heard this, I’ve heard that.”
I think we lean on the trust that these folks have in us in general, particularly if you’ve been working in the community for a fair amount of time. I think we get others of our colleagues who are also accepting of and excited about the vaccine and getting people vaccinated to do the same.
And I don’t think we try to negate the frame of what people have been hearing. I don’t think we attack the conspiracies. We don’t attack those negative messages. We just have to profoundly overwhelm the senses with the positive messages — in addition to showing them the spot on your arm where you got the shot.
You can certainly direct people to references, direct them to sites that can tell them more, but my guess is they know how to find that. They know how to find both sides of this discussion and they have ample opportunity to find it, but you as the trusted voice, I think really you just have to lean on that.
Photo: Army Spc. Angel Laureano holds up a vial of Pfizer-BioNTech’s COVID-19 vaccine at Walter Reed National Military Medical Center in Bethesda, Maryland. Credit: Department of Defense photo by Lisa Ferdinando via Wikimedia Commons, CC BY 2.0.