Considering Emotion in COVID-19 Vaccine Communication: Addressing Vaccine Hesitancy and Fostering Vaccine Confidence

"Given that emotions are found to influence vaccine risk perceptions and intentions more strongly than statistical information..., future COVID-19 vaccine education efforts must move beyond presenting factual information to address emotions surrounding COVID-19."

To date, a sizable proportion of the United States (US) population has reported they either do not plan to, or are unsure about the decision to, get vaccinated against COVID-19. Such hesitancy may be due to the novelty of the disease, the rapid speed of vaccine development, and some groups' mistrust in science and health experts. This article highlights several ways both negative and positive emotions may be considered and leveraged in efforts to foster vaccine confidence.

As argued here, part of the reason attention to emotion in vaccine communication is appropriate and necessary is that the COVID-19 pandemic has intensified the public's collective emotions due to dramatic societal changes, such as closures (e.g., of schools and businesses) and cancellations (e.g., of events and gatherings). Heightened negative emotional responses to the pandemic have included fear/anxiety, anger, uncertainty, and negative attitudes such as racism and xenophobia. Conversely, constant news updates and politicisation of the pandemic may have also contributed to detachment and dampened emotional responses to the crisis, causing some to underestimate the risk and severity of COVID-19.

The authors observe that vaccination has long been an emotionally charged issue in many communities - in large part due, they suggest, to "coordinated anti-vaccination groups manipulating emotions to promote misinformation and conspiracy theories, sow confusion, and create division." Also, emotional engagement has historically played a central role in the research and practice of health behaviour change, with emotional appeals having been used in health message design for behaviour change (e.g., fear appeals).

In light of this analysis, possible approaches to leverage emotions in COVID-19 vaccine communication efforts include:

• Counteracting negative emotions: The authors caution that the use of certain negative emotional appeals to encourage vaccination may instead activate further fear and actually backfire. Instead, they advise framing vaccination as a concrete, actionable strategy to reduce COVID-19 risk to increase self-efficacy and highlight feelings of control/ability to mitigate potential threats. In contrast, when dealing with audiences that may be emotionally disengaged or even apathetic about vaccination, communicating the risk of contracting COVID-19 may be an important part of the vaccine education message. The key message: Avoid generic messages and instead consider the emotional states of different audiences in targeted and tailored vaccine communication efforts. Moreover, given that anti-vaccine groups frequently employ negative emotional appeals in their campaigns, it may be helpful to bring public awareness to the tactics used by these groups; doing so may provide the public with needed literacy to identify misinformation tactics and make informed choices about COVID-19 vaccination.
• Activating positive emotions: Consider appealing to altruism and the positive impacts of vaccination on the wider community. Prosocial message framing has been shown to elicit positive emotions such as hope or joy, which may counteract passivity and message avoidance. Research that has found prosocial appeals to be effective in increasing willingness to practice COVID-19 preventive behaviours may be applicable to messages designed to enhance COVID-19 vaccine intentions and uptake.

Thus, "Acknowledging fears, anger, and other negative emotions while emphasizing the stringent safety and efficacy standards of COVID-19 vaccine development process and fostering individuals' self-efficacy through vaccination may help to increase vaccine confidence." The authors conclude by suggesting that attention to emotion can complement other approaches to vaccine dissemination and education, such as building trust and credibility of health agencies and scientific experts, conveying the safety and standards enforced in the vaccine development process, and facilitating equitable dissemination of vaccine information (and vaccines).