US states’ initiatives to address vaccine hesitancy include engagement of community leaders, mass media campaigns, making vaccination convenient, training healthcare professionals, and increasing general knowledge and awareness.
Engagement of Community Leaders
- According to WHO engaging community leaders is one of the strategies of addressing vaccine hesitancy.
- US states are also collaborating with the healthcare system in targeting vaccine hesitancy within local communities. For example, the state of Connecticut and the Yale New Haven Health System (YNHHS) are collaborating to ensure that the most vulnerable communities in the state can access the COVID-19 vaccine.
- According to Brita Roy, co-chair of the YNHHS COVID-19 taskforce, “the YNHHS’s outreach initiatives to address worries about the COVID-19 vaccine within these communities will involve leveraging the Yale Center for Clinical Investigation’s cultural ambassador program, which engages local community leaders to promote peer-to-peer discussions about the vaccines and facilitate communication between clinicians and the wider public.”
- The president’s National Strategy for the COVID-19 Response and Pandemic Preparedness also intends to engage community leaders and local states in order to address vaccine hesitancy.
Mass Media Campaigns
- US states are also using mass media campaigns to address vaccine hesitancy. For example, the Michigan Department of Health and Human Services launched a paid media campaign in January to inform the public that the COVID-19 vaccine is safe and effective.
- According to Dr. Joneigh Khaldun, MDHHS’s chief medical executive and chief deputy for health, the aim of the campaign was to inform Michiganders the facts about the vaccine and the steps that were taken to develop it.
- The cost of the campaign was $1.5 million and “was developed after conducting a statewide survey and six focus groups among key target audiences.” It included “television, connected TV, radio, streaming audio, YouTube, search, print in inority publications, social media and digital media.”
- Texas has also used mass media campaigns to address vaccine hesitancy. In early February, the Texas Department of Health Services released video ads that aimed at encouraging Texans to take the COVID-19 vaccine.
- According to the Texas Tribune, Texas has set aside $2.3 million for the public awareness campaign. “Most of the state’s efforts, including TV, radio and print buys, are in development amid ongoing market research, but won’t be rolled out publicly until more vaccine supplies are available.”
Efforts to Make Vaccination Convenient
- Efforts to make vaccination convenient is one of the initiatives taken by US states to address vaccine hesitancy. States such as Delaware, Illinois, and California have set up Drive-thru sites to make COVID-19 vaccination convenient.
- The State of Delaware has announced that it “will offer multiple drive-thru locations for individuals to receive the vaccine statewide. The drive-through clinics are appointment-only events, and in the early stage will be focused on vaccinating individuals 65 and older.”
- Illinois is also offering drive-thru COVID-19 vaccines. According to WebMD, people prefer drive-thru vaccination because it is comfortable, convenient, and safe.
Training of Health Care Professionals
- According to WHO training and education of health care professionals is one of the strategies of addressing vaccine hesitancy. States such as Minnesota, Indiana, California, and Michigan have trained healthcare professionals to administer the COVID-19 vaccine.
- The state of Minnesota is “hosting a series of webinars for anyone who works in health care to learn about COVID-19 vaccine.” This training is mandatory for vaccine providers.
- Indiana is also offering training to health professionals via the CHIRP platform.
Increasing General Knowledge and Awareness
- US states have launched campaigns and programs that are aimed at increasing the general knowledge of the public about the vaccine and vaccinations. According to WHO, increasing the general knowledge and awareness about vaccines and vaccination is one of the strategies of addressing vaccine hesitancy.
- The New York governor Andrew M. Cuomo has launched the #VaccinateNY campaign to help educate New Yorkers about the COVID-19 vaccine. The aim of the campaign is “to build trust in the vaccine, get out the facts and help generate enthusiasm around the COVID-19 vaccines.”
- The #VaccinateNY campaign makes use of social media, printable stickers that are worn by those who have received the vaccine, and a website with resources such as list of providers, frequently asked questions, vaccine explainer, COVID-19 vaccine guides, vaccine benefits, and explanation of development process.
- According to the president’s National Strategy for the COVID-19 Response and Pandemic Preparedness, the United States government will work with the states and local communities in launching public education programs to address vaccine hesitancy.
Common Reasons for Vaccine Hesitancy
The common reasons for vaccine hesitancy in the U.S. include concerns that there is a connection between vaccines autism, and a general distrust of the government and the pharmaceutical industry. Americans are also concerned that vaccines contain harmful added materials, and that they may cause illnesses/side effects. Below is an overview of the common reasons for vaccine hesitancy, as well as factors that contribute to it.
Connection to Autism
- According to 2016 statistics, the latest available, the main reason that was given to U.S. healthcare professionals for vaccine hesitancy was concerns that vaccines may cause autism, especially in children. An overwhelming 77% of U.S. families believed that there is a connection between vaccines and the autism spectrum disorder. This led to vaccine refusals or requests for alternative schedules.
- This misconception originated from a well-known study by Andrew Wakefield et al. that suggested that vaccine for “measles, mumps, and rubella (MMR)” may cause autism among infants. The paper caused sharp drops in MMR vaccination rates in the U.S. since the parents were concerned that their children may develop autism after vaccination. Although the study has since been debunked several times, and was redacted in 2011, the hesitancy stemming from the study has persisted.
- Also, anti-vaccine celebrities have contributed towards this reasoning. For example, Jenny McCarthy, has been vocal for over 10 years about her claim that vaccination caused her son’s autism.
- Based on the aforementioned statistics, the second most common reason for vaccine hesitancy among Americans is the concern that vaccines contain harmful added materials. About 71% of vaccine-hesitant people had this concern.
- The widespread safety concerns were driven by the use of a “mercury-based preservative” called thimerosal to prevent vaccine contamination. According to the New York Health Department, concerned Americans are not aware that thimerosal is an organic form of mercury different from methylmercury, which is associated with nervous system damage.
- Despite the FDA removing thimerosal from most vaccines two decades ago, the concerns still prevail. Again, celebrity campaigns have also exacerbated the concerns, with celebrities such as Jim Carrey claiming that vaccines are not tested for safety.
Concerns Over Side Effects/Illnesses
- About 70% of people who refused or postponed vaccination in the U.S. were worried that their children may develop complications following vaccination. Also, 56% of U.S. families were worried that vaccines may overwhelm a child’s immune system, and a further 41% were concerned that children may develop the illness, or other illnesses, from vaccination.
- Misinformation is the factor that contributes the most towards these health concerns. Since over a century ago, anti-vaccinationists have made claims that vaccination may cause a wide spectrum of illnesses, including smallpox, syphilis, tuberculosis, typhoid, and cholera. The ‘Vaccine Roulette,’ a 1982 film that falsely linked the “diphtheria, pertussis, and tetanus vaccine” (DPT) vaccine to neurological disorders further fueled the modern anti-vaccine movement and galvanized many individuals.
- Conspiracy theorists have also contributed to the misinformation regarding the health implications of vaccines from as early as the 19th Century. In 1885, a leading anti-vaccinationist published and distributed propaganda pamphlets against smallpox vaccinations. Conspiracy theorists still exist to this day, and social media has given anti-vaccinationists a platform for spreading vaccine misinformation.
Distrust for Vaccines/Pharmaceutical Industry
- About 44% of Americans are hesitant to be vaccinated because they have a distrust for the pharmaceutical industry. Over 35% of U.S. adults who have hesitated or refused COVID-19 vaccinations said that they do not trust the U.S. healthcare systems.
- The Tuskegee study is considered to be among the main reasons why a portion of Americans, especially from the minority communities, do not trust vaccinations, as well as the overall pharmaceutical industry. The infamous 1932-1972 study gave placebos to African-American men instead of penicillin to allow government researchers to study the disease’s progression.
- Latino and African-American communities are the most affected with only 54% and 39% of Hispanics and African-Americans in New York, respectively, reporting that they would take the COVID-19 vaccine. Notably, about 47% of African-Americans who hesitant about getting the COVID-19 vaccine said that they have a general distrust for vaccines.
- Conspiracy theorists also play a significant role in the promotion of this distrust. According to industry experts, conspiracy theorists believe that pharmaceutical companies control the government, despite which administration is in power, and they are very vocal in spreading their messages on social media.
Reasons for COVID-19 Vaccine Hesitancy
- The reasons for COVID-19 vaccine hesitancy have been provided as a separate insight because they differ from the common reasons for overall vaccine hesitancy in the U.S., to some extent. While most reasons for both overall and COVID-19 vaccine hesitancy are similar, their order of importance/prominence differs in the two studies.
- Statistics for both are sourced from Statista, and screenshots have been added in the attached Google document. The second Statista data (on COVID-19 vaccine hesitancy) was sourced from a December 2020 Kaiser Family Foundation (KFF) study.
- According to the study by KFF, the major reasons for COVID-19 vaccine hesitancy in the U.S. were concerns about side effects (59%), distrust of the government’s ability to ensure effectiveness and safety (55%), concerns that the vaccine was too new (53%), and worries that politics had played a major role in the development process (51%). The fifth most prominent reason was that COVID-19 risks were being exaggerated (43%).
- Based on a CNBC article, politics and misinformation have been instrumental in the widespread hesitation towards the COVID-19 vaccine. Many medical/healthcare experts believe that the messaging/language on vaccine development that was used by President Donald Trump’s administration contributed towards the belief that the new vaccine is unsafe because its development was rushed.
- Conspiracy theorists have contributed significantly to the miscommunication about the COVID-19 vaccine, and social media platforms such as Twitter and Facebook have provided them with big audiences. One conspiracy theory postulates that the COVID-19 vaccine will alter people’s DNA, and another claims that the vaccines will be used to implant trackers in billions of Americans.