Guide to COVID-19 Vaccine Communications

"It is tempting to think that if we simply share consistent information about the availability and efficacy of the vaccine, people will trust that information and behave accordingly. However, this information deficit model of communication is not enough."

In light of the uncertainty and complexity surrounding novel coronavirus (2019-nCoV), it is not surprising that hesitancy regarding a potential COVID-19 vaccine is rampant. This guide offers a set of principles for sharing vaccine information that can help increase trust, acceptance, and demand for vaccination. It was prepared by the Center for Public Interest Communications at the University of Florida College of Journalism and Communications in partnership with Purpose and the United Nations Verified initiative.

The process began with an information-gathering scan of peer-reviewed research on vaccine hesitancy, through which organisers identified a group of scholars with expertise in issues such as trust and science communication. Over a period of 5 days in August 2020, they held a series of conversations with these scholars around topics including: What makes people resilient against misinformation? What drives vaccine hesitancy? Which frames will be most effective? What kinds of message strategies have been effective with specific communities? How can we make taking the vaccine a norm within particular communities?

The series of principles that emerged in turn informed the development of a survey that was conducted in France, Germany, the United States (US), and the United Kingdom (UK) from October 4-18 2020. The online survey garnered more than 1,600 respondents, of whom 301 people (18%) reported they were vaccine hesitant. Other data from the survey are shared in the guide, such as the fact that, across the 4 countries, most people want to receive information on a COVID-19 vaccine from people in their communities.

This process illuminated some of the factors driving the lack of trust within certain communities, which are elaborated in the report. In short, they include: inconsistency (sharing health advice as our understanding of the science evolves), false balance (when a story or news account gives equal weight to 2 perspectives), messages of harm due to vaccines (sometimes shared as personal stories), abstraction (vague messages that cause us to fill the void with our own assumptions), issues with the messenger (e.g., who appears to have ulterior motives), and timing (e.g., contextual factors like elections).

Recommendations grounded in the principles issues include:

• Work within worldviews, identity, and moral values:
  • Take the time to understand what people see as right and wrong, and discuss vaccines in the context of what you know is most important to them.
  • Focus your message on those who are most resistant to vaccine uptake.
  • Build clear calls to action that resonate with the moral values, worldviews, and identities of those whose mindsets you hope to shift.
• Use timing to your advantage:
  • Identify content areas where you have an opportunity to be the first to articulate a message, considering that people are most likely to trust the version of information they hear initially.
  • Consider what else is happening at the same time and how that might affect how much people trust your message.
  • Repeat the message: It is important that people continue to hear the same message from a variety of sources.
• Use the right messengers for your audience:
  • Understand which sources of information trusted messengers are citing within the communities you are trying to reach.
  • Recognise that there are trusted messengers in both offline and digital communities, and identify and listen to those people as you create and share messages.
• Make your content concrete, and build a narrative:
  • Overcome abstraction with messages that situate the importance in terms of local threat, likelihood, timeliness, and possible harm.
  • Use definitions and details rather than acronyms and jargon.
  • Identify messages that are consistent even as knowledge evolves.
  • Situate facts within stories of individuals reclaiming control of their lives through vaccination to make them believable and relatable.
  • Flip the themes of choice, regret, and control, framing them in a positive way to increase vaccine uptake.
• Recognise that communities have different relationships with vaccination:
  • Understand whether the community in which you are communicating has a low/high tolerance for deviance or strong/weak social norms.
  • Take into account the relationship people in your community have with authority and frame the message accordingly.
  • Where possible, get deeply immersed in both online and geographic communities to understand their specific fears and concerns.
  • Be aware that particular communities have significant and valid reasons to be fearful of new medical interventions, and address these transparently.
• Change social norms to help gain acceptance:
  • Shift perceived norms with messages that highlight others within a community's social network who are getting the vaccine, not those who aren't.
  • Work with influencers to shift these perceptions.
  • Move away from the information deficit model and toward frameworks that acknowledge that our choices and behaviours are also shaped by our emotions, worldviews, moral values, identities, and perceptions of what people like us are doing.
• Evoke the right emotions: Avoid using shame, fear, or sadness in calls to action, instead tapping into hope, pride, and parental love to motivate people to act and affirm their positive sense of self.
• Be explicit and transparent about your motivations; we are less likely to trust a vaccine if we question the motives of the people advocating for us to take it.

The guide includes brief summaries of 17 theories from the published literature on vaccine hesitancy and concludes with bios of the 16 scholars that participated in the project.