Put the science into COVID communications

President-elect Biden’s transition team for his administration’s COVID-19 Task Force is a major step forward to dealing with the coronavirus pandemic in the United States. However, a critical area of expertise is lacking — members who can provide the expertise and experience to craft a science-based approach to public health communication. This guidance is especially needed given the complexities and challenges associated with COVID-19 vaccines and vaccination recommendations. Communicating that a new vaccine is safe, effective, and highly beneficial is not enough to achieve high and broad acceptance.

Extensive and sustained evidence-informed vaccine education and communication are needed to achieve even modest immunization rates. This is particularly important for strengthening the knowledge and confidence of the physicians, nurses, and others who will be involved in administering these vaccines. To achieve maximum success, efforts to communicate with health care providers and the diverse segments of the U.S. population about COVID-19 vaccines should be based on the evidence and experience base that has been developed in vaccination education and communication.

For these reasons, we strongly recommend that the COVID-19 Task Force be expanded to include members with public health communications and education expertise, particularly in the domain of vaccine confidence and acceptance.

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The current U.S. National Vaccine Advisory Committee Vaccine Confidence Subcommittee is good example of how to execute such an approach. The 31-person multi-disciplinary subcommittee includes members with extensive experience in applying social, behavioral, and health communication science to foster vaccination confidence and acceptance.

The subcommittee’s efforts to strengthen vaccination confidence in the U.S. have greatly benefited from members who can convey how much has been learned about vaccine communication challenges and issues including how best to address hesitancy and build confidence. We believe having such expertise and experience represented on the Task Force would greatly increase their abilities to enhance public understanding and compliance with public health recommendations.

The recent announcements of the high effectiveness of the Pfizer/BioNTech and Moderna vaccines, and the steady stream of results from other trials that will come over the next few months, means that COVID-19 vaccines will soon dominate the national conversation. There will be a multitude of questions and concerns from multiple and diverse groups and stakeholders.

We have one chance to get this right. Vaccine communication and education must be one of the Task Force’s highest priorities. Once the Food and Drug Administration authorizes or approves one or more vaccines, limited supplies of vaccine doses will be ready to ship in as little as 24 hours and important communication opportunities will have already passed.

Communications will need to go beyond simply providing information about vaccine benefits, risks, and availability. Communication efforts need to anticipate concerns, proactively assuage doubts, and make a compelling, credible case about the value and importance of vaccination. Multiple national surveys highlight that there are — and likely will continue to be — the need for communications to address differences in perceptions, beliefs, and intentions related to COVID-19 vaccines and vaccination recommendations. These differences are often related to gender, age, education, race and ethnicity, where one lives, socio-economic status, occupation, and sources for health information.

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Other COVID-19 vaccine communication challenges will arise from the many uncertainties the first available vaccines will bring, especially their safety, effectiveness, duration of protection, and availability. In addition, the use of two-dose COVID-19 vaccines with unique dosing schedules and the likelihood of multiple, noninterchangeable vaccines being available, each having unique administration requirements and safety and efficacy profiles, will pose additional hurdles for communications by health care providers and public health agencies.

We will also need proactive, well-focused communications to increase and maintain vaccine confidence and acceptance while manufacturing and distribution ramp up. Even if supplies of the vaccine were suddenly unlimited, General Gus Perna, who leads Operation Warp Speed, poignantly described the vital role of communication: “We get vaccines to the American people and they don't take them. Shame on us. ‘Hey, I was already sick, I don't need it.’ Shame on us. ‘Hey, I don't believe in vaccines.’ Shame on us.” The effectiveness of COVID-19 prevention and vaccination efforts in the U.S., and around the world, rests on the behavior of the those who may choose to accept, oppose, or delay adopting them. Using science-based and evidence-informed health communication principles and practices can help us understand the realities of diverse groups, shape communications to fit their realities, and deliver them where and when they will move people to action.

R. Craig Lefebvre, Ph.D., is Lead Change Designer in the Center for Communication Science at RTI International, a non-profit research institute. In addition to developing numerous communication activities and campaigns for federal health agencies, he is the author of "Social Marketing and Social Change". Glen Nowak, Ph.D., is a professor and Director of the Grady College Center for Health & Risk Communication at the University of Georgia. He is a former director of communications for the U.S. Centers for Disease Control and Prevention (CDC) national immunization program and former director of CDC media relations.