Blog - Vaccine Hesitant? It’s About What You Know and Who You Trust

The US is promising 100 million people vaccinated in 100 days; the UK is aiming for 36 million by August while France is looking at 70 million by the end of August.  Lofty goals at a time when even distributing the vaccines is a logistical challenge.  But perhaps the biggest challenge is getting people to have the vaccine at all.  Consider the measles outbreak of 2019 in the US.  In 2000, the Centers for Disease Control (CDC) deemed measles eradicated as an endemic disease in the US, but in 2019, an outbreak created a public health threat that medical experts say could have been avoided if parents had not declined to give their children a safe and reliable vaccine.  Named one of the 10 greatest health threats of 2019 by the World Health Organization, “vaccine hesitancy” was cited as a causal factor in the measles outbreaks.

Vaccine hesitancy is a significant concern in mitigating COVID-19.  A study across seven European nations and the US showed that 26% of European adults indicated hesitance or resistance to a COVID-19 vaccine and that number increased to 33% in the US. And while recent UK experience suggests the recent communications on the threat of Corona virus can change perceptions with the UK public demonstrating very high confidence in the COVID-19 vaccines, 90%+ of those vaccinated so far are white.  Across countries, the communities disproportionately impacted by COVID-19 are the same communities that, due to long standing social and health disparities, have a deep distrust of Government and the systems administering and communicating about the vaccine.

The high level of distrust among those that report vaccine hesitancy for those who represent authority may only deepen resistance to messages encouraging vaccination. Vaccine hesitant individuals may be more receptive to messages regarding COVID-19 vaccine safety and efficacy if they are delivered by individuals within non-traditional positions of authority and expertise. Key to this effort is a multi-disciplinary approach engaging social and behavioral change communication experts, social marketers, medical anthropologists, psychologists, and health care practitioners.

Reaching the vaccine hesitant to support COVID-19 vaccination

Many are quick to cast those individuals who are hesitant as misinformed, naïve, or worse, conspiracy theorists.  Yet, concerns in a pandemic are natural and a more thoughtful consideration of drivers of issues can go a long way toward bringing people closer to acceptance. Critical here is to understand the difference between those who are ‘hesitant’ and those who are ‘refusers’ as this should inform both approaches and communication priorities. Some approaches to closing the hesitancy gap:

• Understand individual concerns: Both rational and emotional factors inform perceptions of the risks and benefits of vaccination.  Moving the conversation from pure medical facts to a more human and emotional context – (“tell me why you are worried and let me share why I am worried that you are not vaccinated”) – can go a long way toward earning trust. It is no coincidence that most misinformation on social media channels is highly emotive and therefore engaging.
• Take time to explain all… with empathy:  It’s vital health professionals rebuild trust, engaging in ongoing conversations to transparently answer questions and address fears.  Taking the time to share how the vaccines work, how safety is monitored, what new variants mean and, in the UK with at least 15m people having received at least one dose of a coronavirus vaccine (as of 14/02/21), what the real-world experience is telling us about side effects. But, community leaders, friends and family, employers and spiritual leaders can help by sharing their personal acceptance of the vaccine and why they want the hesitant individual to be protected.
• The expert is back, so put them front and centre, and even better ensure they represent the communities they are trying to reach. With many vaccine-hesitant individuals confused as to who they should trust - physician, best friend, Facebook page or the pharmaceutical company? The pandemic has seen the public once again look to experts for their guidance in an age of ‘alternative facts’ and talk of people ‘having enough of experts’. In the UK we’ve seen leading healthcare professionals from minority communities, such as Professor Van-Tam, Deputy Chief Medical Officer for England, specifically answering questions and concerns from ethnic communities – while also urging the public to listen to reliable sources of information
• Leverage community networks and influencers: Working with community networks is a vital part of building trust as these groups can create authentic connections through which information can be shared and accepted. In the UK, the NHS has proactively engaged with community leaders to deliver vaccine information.  For example, faith leaders have addressed fears and concerns because they are trusted community voices and can authentically acknowledge worries while sharing facts. This means that public health professionals must keep respected community leaders up to date with information they can share with their communities. Educating other community influencers with large social media followings can also help to overcome misinformation and doubts, as we’ve seen with the recent Adil Ray video.
• Use social media responsibly: Research shows that many vaccine hesitant individuals are less likely to consume, and trust, information from “traditional” media and are more likely to obtain information from social media channels. This highlights the need for not only public health officials but also individual physicians to share information via multiple media channels to reach vaccine hesitant individuals. Messages should focus on the personal benefits of COVID-19 vaccination to them individually, their families and their immediate communities. Content posted on social media should be factual and friendly, acknowledge that people have concerns and signpost them to resources that can provide clear, visual, simple, and positively orientated answers.
• Connect the Community: While rising hesitancy and the rapid spread of misinformation are alarming, so is an increasing lack of confidence in the ability of Government to solve problems. That opens up a powerful role for employers, community-based organisations and NGOs to step forward to care for the communities in which they work and live. This means emphasizing community resilience and connectedness, taking the best of science and medicine, and combining it with compassionate locally led efforts. For example, a local pharmacy can build confidence by presenting their pharmacists on local media outlets. The goal is for private enterprise to work with public health to promote collective commitment to community well-being and health equity.

In short, addressing concerns about the value and safety of vaccines requires a focus on both rational and emotional appeals. Engaging communities and individuals in authentic, community specific conversations about health concerns should be the first step in overcoming anxiety and mistrust.

Author

Avril Lee is Head of Healthcare Europe at Zeno Group and Chair of the CIPR’s Diversity and Inclusion Network.  To find out how we can help with your communications needs email hello@3monkeyszeno.com