Six recommendations for promoting COVID-19 vaccine acceptance

With nearly 50 million cases of COVID-19 and approximately 790,000 deaths attributed to the virus in the United States since the beginning of the pandemic, the need for widespread vaccine acceptance has never been clearer. However, despite these ever-growing case and death totals and the recent emergence of the Omicron variant, approximately 1 in 5 adults in the United States still refuses to be vaccinated unless required for employment, or refuses to do so for any reason.

Reasons for hesitancy and outright refusal are numerous and depend on individual circumstances, but the extreme political polarization that has affected so many Americans’ responses to the pandemic has been a major adversary for vaccine uptake as well. The anti-vaccine and health freedom movements, and state actors such as Russia, have further exacerbated anti-vaccine sentiments and muddied the digital and social media waters with misinformation.

The end result of these various efforts is inadequate vaccine uptake (particularly in African American and Latinx communities) that in turn allows the virus to continue circulating within the United States and provides it with opportunities to spawn more variants. What, then, is the treatment for these societal ailments that are sustaining an actual disease?

In a recently published report in The Lancet, Timothy H. Callaghan, PhD, assistant professor in the Department of Health Policy and Management at the Texas A&M University School of Public Health, and his fellow members of the Lancet Commission on Vaccine Refusal, Acceptance, and Demand in the USA outlined six recommendations that can be used to encourage COVID-19 vaccination:

• Clearly and continually communicate pre- and post-marketing vaccine surveillance needs to the public, media and government leadership
• Engage, work with and provide technical expertise to local and national media to communicate accurate and non-sensational messaging about vaccination
• Make getting vaccinated as straightforward as possible for people who already intend to get vaccinated
• Engage and work with community leaders to increase access to COVID-19 vaccines for disadvantaged groups and support accurate and culturally-based messaging about vaccination
• Reach out to and engage with politically conservative groups and leaders
• Establish interagency government task forces to explore options for countering anti-vaccine disinformation from U.S.-based groups as well as state actors

The authors’ recommendations focus on improving one key factor for increasing vaccine uptake: individual intention to receive the vaccine. Suggested strategies to achieve this central goal include using behavioral interventions, addressing sociodemographic inequities and promoting public health communication.

Behavioral interventions include issuing vaccine reminders to keep vaccination on people’s minds and reducing barriers by automatically scheduling appointments, and providing onsite vaccinations at workplaces and schools. Government actions in this category include allowing vaccinated people and communities with low rates of transmission to resume more social activities and enforcing reasonable vaccination mandates.

Sociodemographic inequities have already created substantial burden on ethnic minority and socially vulnerable groups during the pandemic, and vaccination access has been no exception. Outreach to centers of community life such as churches or hair salons, and engagement with local leaders and organizations to develop and promote accurate and culturally tailored messages about vaccination should be prioritized to address unequal access and vaccination uptake disparities.

Public health communication is a critical aspect for all of the Commission’s recommendations. Analyzing all forms of media to better understand what makes messages and content more effective would let researchers and communicators know how to better reach target audiences. Countering communication weaponized against vaccination is also essential to slow or stop the spread of misinformation.

The authors conclude their report by emphasizing that a national vaccination campaign built around behavioral interventions and public health communication is needed to end the pandemic and let Americans resume normal life.

– by Kelly Tucker