NIH Releases Report Summarizing Research on Vaccine Communication

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The FDA is poised to approve two new vaccines for coronavirus this month, and advance preparations have been made to deploy these vaccines as rapidly as possible once approved. It is a triumph of science that less than a year from identifying the SARS-CoV-2 virus, vaccines have been rigorously developed, evaluated, and deployed to protect against the virus.

As these vaccines become available, however, the latest polling data show that only about half of Americans want to get vaccinated, a quarter are unsure, and a quarter indicate they will not get vaccinated. Among Black populations, 40 percent indicate that they will not get vaccinated, potentially exacerbating already serious COVID-19 disparities. This same Associated Press-NORC poll showed that about a third of respondents are not confident that the vaccines have been properly tested for safety and efficacy, will be distributed equitably, or will be distributed rapidly and safely.

Our infectious disease colleagues have done their job to deliver safe and effective vaccines in record time, now the behavioral and social sciences need to do our job to encourage broad vaccine participation to protect the population from infection and address concerns about getting vaccinated. Fortunately, this is not the first time that we have faced the challenge of vaccine hesitancy and misinformation regarding vaccinations. A substantial body of prior research can be applied to our current effort to encourage vaccination against the coronavirus.

To respond to this challenge, a NIH-wide planning workgroup led by Sylvia Chou at the National Cancer Institute and Christine Hunter at the Office of Behavioral and Social Sciences Research convened an expert panel of leaders in the social and behavioral sciences and in public health to summarize evidence-informed communication strategies in support of national coronavirus vaccine distribution efforts across federal agencies and their state and local partners. Today, this expert panel released its report titled, “COVID-19 Vaccination Communication: Applying Behavioral and Social Science to Address Vaccine Hesitancy and Foster Vaccine Confidence.”

As its basis, the report reinforces key foundational principles of health communications, such as coordinated and consistent messaging, building trust through partnerships, tailoring messaging to differing levels of health literacy, and prioritizing equity in all communications efforts. Based on the research summarized in this report, several actionable strategies are outlined, including:

  • Accurate, truthful, and transparent messaging (no exaggeration to make a point).
  • Messages that provoke positive (self-worth), not negative (fear, shame) emotions.
  • Use trusted sources of the targeted population.
  • Messaging tailored to the values of the targeted population.
  • Frame vaccine acceptance as a social norm.
  • Use choice architecture to make vaccination the default choice while respecting people’s self-determination to make their own health decisions.
  • Reach out early to those hesitant about vaccination while their views are less well formed.
  • For those who mistrust vaccines, a balanced, empathic, and compassionate approach may not lead to immediate vaccine acceptance but may build trust and rapport that could result in greater willingness to consider vaccinations in the future.

The key do’s and don’ts are summarized in a one page fact sheet.

The report also provides guidance for vaccine communications with specific groups, including health care professionals, essential workers outside the healthcare system, older adults, individuals living in congregate care settings, and communities of color. Guidance on how to respond effectively to vaccine miscommunication based on prior research also is addressed.

I want to thank the NIH-wide planning committee and all the expert panelists who came together and rapidly generated this report. Our hope is that this empirically based guidance will be used to encourage more people to get vaccinated, both for their own protection and for the protection of those with whom they come in contact.