Inside the $250 million effort to convince Americans the coronavirus vaccines are safe

Health advocates promote safety of COVID vaccines despite skepticism

The federal official in charge of a $250 million marketing blitz to build trust in the coronavirus vaccines' safety says the campaign will forego trying to convince so-called "anti-vaxxers." Instead, it will focus on swaying those who are simply unsure about the new coronavirus inoculations.

The U.S. Department of Health and Human Services calls the campaign's target group the "movable middle," said Deputy Assistant Secretary Mark Weber, who is overseeing the initiative. 

Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, has said if 75% of the U.S. is vaccinated the country could reach herd immunity within months. Sixty percent of respondents in a national survey conducted in November by the Pew Research Center said they would definitely or probably get vaccinated, while 39% said they "definitely or probably" would not. However, just under half of that group, 18%, said it's possible they could change their minds once others were getting vaccinated and more information about the shots became available. That's the group the campaign needs to sway.

Dr. Anthony Fauci says he feels "quite good" after getting COVID vaccine

Weber says the "movable middle" is neither committed to getting the shots nor adamantly opposed. They are skeptical of coronavirus vaccines for reasons varying from concerns about the speed at which they were developed — less than a year — to politics, or even being "just not sure," Weber said.

"So these are the folks who can be, with additional information, potentially motivated to move into the 'yes' category," Weber said. The agency is running focus groups to fine-tune messaging for the "movable middle" within groups hit hardest by the pandemic, including Black, Latino and Native American communities.

As for anti-vaxxers — the approximately 16% of Americans who, according to a pre-pandemic Gallup poll, oppose all vaccines — Weber said trying to change their minds isn't cost-effective.

"We want to be smart with our money," Weber said. "That's a chunk of people who are saying, 'I'm not going to do this, like, period.' And so, really, no amount of advertising is going to persuade them or motivate them to become vaccinated."

The administration is right to focus on those who are merely skeptical, said Harvard public health professor Jay Winsten, a doctor who led the Designated Driver campaign, a 1988 initiative widely credited with popularizing the now-commonplace drunk driving prevention measure.

"You want to go for the low-hanging fruit, those that are easiest to pick and harvest. Those who are open to vaccination in general, but are currently hesitant about this vaccine," said Winsten, who advised Presidents Bill Clinton, George W. Bush and Barack Obama.

"I think a lot of people in that group may be worried about potential side effects and they're taking a wait-and-see approach, and it's not that they need further explanation at this point. They need some additional data on the basis of millions of people having taken the vaccine. They often say in interviews, 'I don't want to be the guinea pig. I'm going to wait a bit and see how it goes,'" said Winsten.

There are currently two coronavirus vaccines cleared for use in the United States. The first to be approved was developed by Pfizer and BioNTech. It was tested in clinical trials with more than 40,000 participants and shown to be about 95% effective. The second to be approved, developed by Moderna, was tested in clinical trials involving 30,000 people and shown to be 94% effective.

Weber said the government is running focus groups geared toward finding spokespeople who are respected within different groups. It has already begun placing radio spots focused on continuing to "slow the spread" until vaccines are more widely available, as well as social media ads. A much wider push with television commercials and public service announcements, and radio and online ads, is planned for early 2021.

"Communication science says you need a messenger who is someone who resonates as trusted," Weber said. 

On the national level, Winsten believes Fauci fits the bill — and he is currently appearing in HHS' digital ad campaign as well as Ad Council promotions, primarily digital and social media video ads — but Weber cautioned, "while many of us like and trust Fauci, it is clear from our focus groups not all feel the same way."

Dr. Anthony Fauci gets the coronavirus vaccine

Winsten said the more intensive campaign geared toward smaller groups should focus on finding people who are locally influential.

"People trust their own doctors, their own nurses, their own pastors, their own social networks. That's very, very different from a distant figure. And these can be local celebrities as well. If you're in the Boston market, you want Patriots players who have gotten the shot and come from different ethnic and racial backgrounds, who have tremendous followings," Winsten said.

The government's original marketing effort was scrapped this fall after congressional Democrats revealed that Weber's predecessor, Michael Caputo, proposed making "Helping the President will Help the Country" a theme of the initiative, and that the administration rejected celebrities for potential public service announcements based on their opposition to the president or support for causes considered liberal. Caputo began a medical leave in late September, shortly after accusing CDC staffers of sedition and making other unfounded claims about liberals in a live Facebook video on his personal page. 

The public information initiative was paused in October and early November after HHS Secretary Alex Azar ordered an internal review focused on Caputo's plans. Despite the delay, Weber said the campaign's messaging will be well-timed with a wider rollout of the vaccines in early 2021. Weber said the incoming Biden administration, which will oversee the bulk of vaccine distribution, has been briefed on the effort.

"The trickiest part about this campaign is lining up the advertising with vaccine availability," said Weber. "If we were to go out and generate demand today for a vaccine, I think that would be a disservice to the public. We have to time it so those people questioning whether they want to do it, when they get to the 'yes' category and they go to get the vaccine, it's available when and where they're told it is."

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