Katherine M. Nicol
Katherine M. Nicol

The World Health Organization named vaccine hesitancy—the reluctance or refusal to vaccinate despite available vaccines—one of the top 10 global health threats in 2019. At that time, the United States was experiencing an outbreak of measles, which had been declared eliminated from the U.S. in 2000, and the perpetuation of vaccine misinformation had reached a tipping point. Or so we thought. Then came COVID-19.

Today, in the midst of a global pandemic the likes of which haven’t been seen in a century, in addition to vaccine hesitancy and misinformation we’re experiencing a compounding public health crisis: that of Americans’ eroding trust in our public health agencies. As we enter the fall and anticipate the risk of what many health experts are calling a “twindemic”—the possibility of a severe flu season coinciding with a surge in COVID-19 cases—vaccines have been politicized like never before and an unprecedented number of lives are at risk. While we await the arrival of a safe and effective COVID-19 vaccine, we’re faced with the looming reality that vaccines are only effective if people are actually vaccinated. We currently have a safe and effective influenza vaccine, but despite urgent pleas from the public health community, we’re seeing a concerning increase in vaccine hesitancy among American adults. Add to that the plummeting rates of childhood vaccinations in recent months, which the American Academy of Pediatrics has described as a national emergency, putting children at risk for contracting life-threatening, yet preventable, diseases. Now more than ever, health communication has an essential place at the forefront of the national agenda.

As health communicators, we not only have the opportunity to play a critical role in addressing this unprecedented public health crisis, we have an absolute responsibility. What can we as health communicators—especially those of us working in the vaccination space—do to help stem the tide of vaccination misinformation and hesitancy and rebuild trust in our public health agencies and experts?

This article is featured in O'Dwyer's Oct. '20 Healthcare & Medical PR Magazine (view PDF version)

Take an audience-centric approach. No matter how creative dissemination strategies and tactics are, if a message doesn’t resonate with the audience it won’t be heard. Specific audience insights must be considered if we’re going to tap into their motivations effectively to inform their immunization attitudes and change behaviors. The time for formative research is now, so that we’re prepared to immediately deliver not just clear and accurate, but also tailored messages when the COVID-19 vaccine becomes available. Another important element of the audience-centric approach is to identify meaningful opportunities to engage with audiences more directly. Public health agencies can and should leverage targeted media and related platforms to engage more directly with the American public in sharing potentially life-saving vaccine information.

Translate the science. As Paul Offit, MD, director of the Vaccine Education Center at the Children’s Hospital of Philadelphia often states, science doesn’t speak for itself. As noted in his book, Bad Advice, “Scientists are often unable to package their insights into the neat narratives that the public requires.” As health communicators, we’re by nature, communicators of science. As such, our role must include effectively and accurately translating complex scientific, regulatory, and medical information into clear, plain-language content that our audiences can comprehend. Given the misperceptions that exist around vaccines, it’s vital that all vaccine-related messages and materials deliver clear, science-based information in a manner that is both credible and relevant to specific audience segments.

Research published in the journal Human Vaccines and Immunotherapeutics finds that when it comes to combating vaccine misinformation among vaccine-hesitant audiences, it may also be worthwhile for clinicians and health communicators to consider implementing “storytelling”—i.e., communicating science through the lens of compelling and personally relevant experiences and narratives. Coupled with and based on credible, fact-based vaccine information, storytelling can be an effective tool for engaging vaccine hesitant audiences. In the vaccination space in particular, it can be challenging to balance the depiction of the emotional elements experienced by the subject of the story with the most important, evidence-based information that is at the core of the call to action. This can, however, be carried out in effective ways when, for example, pediatricians who are also parents share personal stories about vaccinating their own children and clinicians share anecdotal narratives about cases of vaccine-preventable disease that they have observed during their careers. Incorporating storytelling into health communications with vaccine hesitant individuals, in a non-threatening and non-judgmental manner, can be an effective way to increase and normalize conversations about vaccines and, ultimately, inform attitudes and change behavior.

Use trusted sources to deliver the message. Science that’s clearly and accurately translated, including evidence-based storytelling, is further amplified by credible and trusted messengers. Given the complex landscape and perceptions that surround vaccination, now more than ever, it’s imperative that the channels and messengers chosen to communicate and disseminate messaging invoke a high level of credibility among target audiences. Highly credible sources that are trusted by audiences will increase the likelihood that the messages they deliver will be attended to, understood, and internalized as true, versus dismissed as unbelievable. The audience must trust the source delivering that message, be it an entity or an expert.

According to WHO, “… health workers, especially those in communities, remain the most trusted advisor and influencer of vaccination decisions.” As health communicators, we have a responsibility to engage and include clinicians and health workers in our strategic planning and to provide them with clear, science-based, credible information to deliver to their patients. In doing so, we can indirectly begin to rebuild public trust in our national health agencies as the source of overarching guidance, scientific information and public health leadership for those already trusted sources at the local and community levels. Messengers should also span both public and private sectors. Research emphasizes the need for science communicators to bridge the gap between science and society.

Be respectful of the audience. For many, it can be difficult to empathize with those who choose not to vaccinate. But for health communicators, empathy and understanding are imperative. We need look no further than to the example of 18-year-old Ethan Lindenberger, who testified before the Senate Committee on Health, Education, Labor and Pensions about his decision to catch up on missed vaccinations against the wishes of his mother, who chose not to vaccinate Ethan or his siblings. He drove home the point that anti-vaccine individuals do not, “root their opinions in malice, but rather a true concern for themselves and other people.” Messages related to vaccine hesitancy should always be respectful and empathetic in tone, while specifically addressing barriers and concerns in a manner that is reassuring to vaccine-hesitant individuals.

The sea-change we all hope for when it comes to vaccinations can’t and won’t occur without clear, accurate, effective communication and the dedicated commitment of health communicators to accept the responsibility and the critical role we can play in combating the perpetuation of vaccine misinformation and building trust in our agencies and our experts. The opportunity is here. The time is now. Let’s get to work.


Katherine Nicol is a Senior Vice President at Hager Sharp.