Currently, COVID-19 vaccine demand exceeds supply, so the challenges public health officials face are mainly logistical in nature. They’re doing an admirable job with those tasks, with the rate of vaccination doubling since Biden’s inauguration.
But the nature of their challenge is about to quickly change. But before long, vaccine supply will start to exceed demand. Then the public health leaders’ challenges will be more about persuasion than logistics.
Here’s hoping public health officials are prepared for that very different kind of challenge. Very soon, they must make a swift and dramatic pivot.
The people who are getting vaccinated now are obviously the “low-hanging fruit.” They’re motivated. They’re much more likely to try to cut in line than avoid the line. Little to no persuasion was necessary for them.
But persuading the “high-hanging fruit,” those skeptical about the vaccines, will be necessary to get to the 70% to 90% vaccination rate that experts tell us will give society the holy grail, “herd immunity.” That won’t be easy.
Up until now, public health officials like Dr. Anthony Fauci have only needed to communicate public health facts. For most of us, that worked.
But by now, the fence-sitters have repeatedly heard the Fauci facts and they have stayed on the fence. At this stage, it’s illogical to think that a new surge of epidemiological fact-sharing is going to suddenly convince holdouts to buck up and get their Fauci Ouchy.
Public health officials should look to what has been successful in other public health campaigns. I’m talking about bite-sized, unvarnished, and visually-driven ads. These are TV, radio, online, social media, and outdoor ads that make appeals to emotions, including fear. In terms of messaging, vaccination holdouts need shaking, not hugging. They need a scare, not a seminar.
After all, smoking rates didn’t decrease dramatically because of inspirational Surgeon General fact sheets. They finally decreased as smokers and their loved ones saw raw emotional ads that portrayed the living hell associated with tobacco-related illnesses.
Similarly, our parents didn’t all start wearing seat belts after pouring over safety studies or having a spontaneous fit of conscience. Instead, many finally started to buckle up because they couldn’t stop daydreaming about difficult-to-watch ads like this.
Finally, the incidence of drunk driving didn’t decrease because we all were moved by well-crafted CDC spreadsheets. Many of us changed our ways because of searing images of victims’ and perpetrators’ lives being destroyed in the blink of an eye.
These campaigns offered brutal testimonials and images that cut through the information clutter of modern life and stuck in our memories in a way the epidemiological sermons couldn’t.
And they worked. They changed individual behaviors, and, just as importantly, they fueled passage of laws and policies that further changed behaviors.
In my career, I’ve sat through many focus groups reviewing these kinds of ads. I can assure you, almost everyone hates seeing these ads, because they make us feel horrible. Focus group participants will inevitably tell you that such ads are completely ineffective for them.
Yet whenever and wherever these kinds of ads run, behaviors change.
Facing the worst pandemic in a century, we can’t treat this final crucial stage of pandemic management like a popularity contest. We have to do what works, not what is popular.
By late summer and early fall, we will need public health messaging campaigns that show vaccine fence-sitters what it feels like to slowly suffocate to death from COVID. They need to feel what it would be like to live with chronic COVID long-hauler conditions. They need to feel what it would be like to inadvertently infect and kill someone.
We need to see ads that make us feel these things in our guts, because adding another data point in our brains isn’t going to be sufficient.
These are the kinds of jarring emotional images that will push at least some vaccination fence-sitters out of the comfort zone that is preventing them acting. These are the kinds of portrayals that will show them that the downsides of vaccinations – scheduling hassles, needles, sore arms, short-term aches and fevers – pale in comparison to the downsides of failing to vaccinate.
Surprisingly, the use of jarring imagery is still a matter of debate in public health circles. To their credit, public health decision makers tend to be nurturers and fact-driven. Therefore, many still make the mistake of assuming that everyone is like them, and therefore can be persuaded by messages that inspire, reassure, and educate. They’re right about many people, but not all people.
The impressive achievements from the tobacco control, seatbelt, and drunk driving campaigns, among many others, tell the tale. For the group of Americans who still aren’t sure about whether they want a miraculous life-saving vaccine, facts and inspirational messages alone just aren’t going to cut it. For people who are still holding out in late summer, it’s time to get real.
I don’t think we need a fear campaign for vaccine holdouts.
I think a more positive message regarding receiving the vaccine is needed. A ray of hope that you will be able to enjoy life again.
Now all you hear is “you will still have to mask and distance after the vaccine.” It seems like nothing will change, so why do it?
That certainly is what most people would say. I’ve worked on these issues for a few decades, and this is what I’ve seen. Positive issues work well for many, but not the hardcore holdouts who have already shrugged off the positive messages. On vaccines, that’s where we will be this summer and fall. The high-hanging fruit don’t pay attention unless the new messaging pushes them out of the comfort zone that has prevented them from acting.
Joe: I often wonder what $500 million of Mike Bloomberg-like money could do for PSA campaigns on a variety of topics. Gun control. Plastic waste. Police reform. But I agree, what you’re talking about certainly could not hurt and may well be what it takes to get the “hesistant” off the fence. Beyond them of curse lie the “religiously opposed”, who I’ve come to regard as lost causes on a number of other matters as well. Ideally, there’d be a non-counterfeitable card or app you’d have to show to gain maskless, normal access to restaurants, bars, concerts, sporting events, etc. Don’t have one? Like a rube trying to get into Studio 54 in the day, the bouncer turns you away.
I’m thinking it should run starting in mid-summer, when it apparent that positive, factual messaging isn’t persuading the remaining holdouts. We should target these more pointed ads efficiently . Right now the demographic looking like the biggest holdouts are Republicans. If that holds up, that’s pretty easy to target audience to target with ads.
As with chronic smokers, drunk drivers and seat belt haters, these are the hardest folks to persuade, so it will be very difficult. But we can’t keep repeating the same positive, factual messages to the holdouts. We’ll need to try something jarring to make them and their family/friends/influencers feel the stakes at a gut level.
Bloomberg believes in unsettling public health messaging, so that’s a good thought. But with the amount of money flowing to the states soon to support vaccine deivery and promotion, there should be money to do this, particularly if it’s well-targeted to the holdouts.
I think a “vaccine passport” is a bad idea. Surprised to hear Mr. Lambert propose such a authoritarian measure.
Jeffrey: I don’t think there’s a way to create a “vaccine passport” tha can’t be counterfeited or gamed by anyone with the means to do it. But I don’t see it as any more “authoritarian” than a driver license. You’re simply showing/proving to — the security checkers at baseball games, music venues, restaurants, public buildings, etc. — that you’ve followed scientific protocools and are now less of a problem to yourself and others.
You need a driver’s license to prove that you have been trained to safely operate a motor vehicle. Driving is a privilege, not a right.
Needing a “vaccine passport” to participate in life feels like the command of “papers please” in a totalitarian society.
Just as children need proof of vaccination to go to school….which is also required by law (both going to school, and the vaccinations for doing so).
Not certain I’d classify that as totalitarian. Requiring some things by law is not the same as requiring all things by law. That is a totalizing world view
Um, why am I just learning about this blog??? Hi, Joe. 🙂
This is a very good article. Never thought about it in this way or saw it in the media. I think a little of this happened in the Dakotas but was spread through accounts of families and neighbors. What are other PSA? Is there one for the opiate epidemic?