Mark Senak
Mark Senak

After months of social distancing—and for many, economic distancing as well—and with over 200,000 Americans dead and many more ill and infected, people are understandably craving liberation from the COVID-19 pandemic and a return to normalcy. But, in fact, the only obvious means to that end is one where the population achieves “herd immunity,” where so many people become immunized that the virus has nowhere left to go.

Herd immunity can be achieved only in one of three ways: one, millions upon millions get infected and we suffer with a high level of associated mortality; two, a large portion of the population gets vaccinated; and three, a combination of the two. The least costly to human life by far is the second. It’s also the most difficult to achieve.

Under normal circumstances, a true medical breakthrough doesn’t require a great deal of prompting and promoting to drive use by the affected population. Take the AIDS epidemic: after a decade and a half without any effective treatment for HIV disease, protease inhibitors and other antivirals were swiftly adopted upon arrival and brought dramatic change to a bleak circumstance.

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

But a COVID-19 vaccine faces particular hurdles to adoption. Sure, there’s the vocal anti-vaccination movement working in the background, but the challenges for a COVID-19 vaccine are even greater than for other vaccines. People who would normally be vaccinated are skeptical for myriad reasons including distrust of the pharmaceutical industry, concern over the speed at which COVID-19 vaccines are being developed and, very importantly, the profound political interference in the process that has undermined credibility and confidence in the principle organizations charged with protecting public health.

All this means that the challenge we face on our road to normalcy isn’t only a scientific one, but one in which highly effective communications must play an essential role.

As with any public health effort, one can readily divide the stakeholder audience into three groups. First are those who will not be convinced under any circumstances to take a vaccine. On the other end of the spectrum are those who are anxiously waiting in line for the vaccine now (including the tens of thousands who have participated in the sizable clinical trials now underway). And in the middle are those who are cautious and concerned, those who are prone to wait and see what happens. This middle group is the key audience that we must focus all our time and resources on.

Right now, the focus on this critical audience is, at best, fuzzy. In the past few weeks, there have been several surveys with varied outcomes defining the population’s intent to take a vaccine when one becomes available. In early August, a Gallup poll was published that said one in three Americans would not get a vaccine; in mid-August NBC published a survey that said less than half would get a vaccine; and in the first week of September, CBS published a survey that said that only one in five would get a vaccine as soon as possible. These findings should alarm us all. We need to know much more about what these millions of hesitant people are thinking and feeling. We should know them better than we have known any audience. And we should know what the most convincing and persuasive messages are and who should be delivering them.

With respect to the “who,” we already have some insights. According to the annual Gallup poll that ranks the regard the public has for various sectors, it isn’t the pharmaceutical industry and it isn’t government: both rank poorly and have for two years in a row. Yes, the healthcare industry has experienced a bump in reputation this year for the first time according to Gallup, but it’s all relative. And the lack of credibility of government—including the FDA and CDC—has only been exacerbated by political circumstances as evidenced by recent news reports of pressure brought to bear on CDC to restrict content and question science by political appointees in the Trump Administration.

It’s increasingly clear that the white coats may also be the white hats in this mix.

In addition to the messenger comes the question of the medium. Social media and influencers— “people like me”—have greater sway on the outlook of individuals than news from institutional sources. The role of social media platforms—and of strategies—is obvious in political campaigns and should be no less obvious in a campaign to get people onboard with vaccination.

In short, for all of the billions that have been invested in research and development of a COVID-19 vaccine—the pathway to our normalcy—there must also be large investments in the science behind the art of communications. This investment can’t wait until the vaccine arrives. Research should be taking place now into the key audience who needs to be engaged. The effort will have to involve not only skilled strategists in communications but will also require the coalescence of many healthcare stakeholders: medical societies, providers, payers and patient organizations. Moreover, it will take a sustained campaign that masterfully utilizes social media strategies, both paid and organic.

We can’t afford to see the trend in surveys on vaccination continue on the current trajectory. There must be coordinated planning now and flawless execution as we head into even stiffer political headwinds, or else the investment made in research and development is at risk, and, as a result, our pathway to normalcy detoured.


Mark Senak is a Senior Vice President and Partner in FleishmanHillard’s Global Healthcare Practice.