When the Covid-19 pandemic hit, few mechanisms to generate vaccine demand were built into pandemic preparedness and response plans. Vaccine marketing, communications and community mobilization models were outdated and underfunded. And for most experts and public health officials, the volume and intensity of misinformation unleashed by the pandemic – and its impact on vaccine demand – came as a surprise.
Amid the rapid pace and competing tasks and priorities of the pandemic response, understaffed and overwhelmed authorities and nonprofit institutions have struggled to meet the massive information needs of American communities. There was simply no playbook for anticipating and combating how factors such as the rapidly evolving political climate and deep disparities in the healthcare and social systems affect vaccine demand.
As a result, key opportunities to encourage demand were missed, and continue to be overlooked. For example, without clear explanations of staggered vaccine priority, younger Americans were told early on that they didn’t need vaccines as urgently as older people, only to then be suddenly asked to get vaccinated immediately. Some did so happily, others reluctantly, but too many young Americans ended up confused and remain unvaccinated and unconvinced that they need a Covid-19 vaccine.
Similarly, underserved Americans were told the vaccines would be distributed equitably. But then vaccinations were initially not available in ways that fit their needs – for example, without support for sick days or childcare, or translated into their language – confirming for these communities that authorities might not really understand — or worse, not care about — them; which in turn contributes to a lack of confidence in authorities and vaccines.
“Most experts struggle with a simple truth about human communication: A story doesn’t have to be true to change minds and it doesn’t have to be accurate to change behaviors.”
In the absence of more proactive and effective vaccine communications, in each new information cycle in this pandemic, information spaces are crowded with contradictory, inaccurate, polluted and highly emotionalized information rather than clarifying, accurate, compelling information. This leaves millions of Americans confused about important concepts such as vaccine technology, development and efficacy. And it leaves people mistrustful, feeling unsafe, and vulnerable to the manipulative tactics of mis- and disinformation, profiteering and politicization. It’s a phenomenon that transcends vaccines and applies to other key response measures such as therapeutics and non-pharmaceutical interventions. In spring 2022, for example, Ivermectin — an antiparasitic drug that is ineffective against Covid-19 but has been widely publicized by disinformation agents as a cure — was well known and driving policy, while Evusheld — an effective antiviral that prevents infection and can save the lives of unvaccinated or immunocompromised people — was hardly known by both doctors and patients.
Recognizing such shortcomings, the U.S. government and philanthropic organizations started investing in summer and fall 2021 in efforts to apply insights from community and faith leaders, behavioral scientists, communications and misinformation researchers, equity experts and others to support efforts to increase vaccine access and demand. Such interventions have now shown how vaccine demand work can overcome the barriers described above and lead to increased vaccine uptake and better outcomes especially for vulnerable populations. It is why demand work needs to be a cornerstone of vaccination efforts – from the start.