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Challenge

Even as vaccines become more widely available, restrictions lift and policymakers declare independence from COVID-19, the virus remains a significant public health risk for communities in the United States and beyond. 

A large proportion of people living in the U.S. have hesitancy about the vaccine. This is particularly true in communities of color, where both historic and contemporary experiences of discrimination and experimentation by the government and medical community spark distrust of vaccines today. 

Widespread and equitable uptake of the vaccine by both adults and children is important to ensure that lives are saved and the pandemic ends.

The Colorado Health Foundation (CHF) engaged Wonder: Strategies for Good and Goodwin Simon Strategic Research to conduct public opinion research and develop messaging strategies for the vaccine-hesitant in Colorado, focusing on people of color. The research included landscape analysis; 19 online focus groups with 93 Black, Native American, Asian Pacific Islander, white and Hispanic Colorado residents; and an online dial test survey of 1,506 Colorado adults to understand the mindset of the vaccine-hesitant and to test messaging to build confidence in the vaccines. 

Much of the work was conducted in Spring of 2021, which meant that our focus was on those who were eligible to receive a vaccine but had not yet been vaccinated. 

Heartwired Insight and Strategy

People’s beliefs, values, emotions, identities and lived experiences shape their decisions around vaccination. While each conversation, like each individual, will be slightly different, in our research, we found that a three-step approach to conversations with vaccine-hesitant individuals can help move people along their journeys. This approach is to first build trust, then answer questions and inspire hope.

Our test messages and narrative messenger videos that utilized this approach moved people, even when presented alongside anti-vaccine messaging, suggesting that our recommendations work in the real world.

We learned that for many, the decision to get vaccinated is not a simple yes or no, instead it encompasses multiple emotionally-complex factors. People are coming into their conversations about COVID-19 vaccines with a high level of information. People mix information, personal experiences and emotion to weigh risks and benefits, and their emotional states are often already distrustful and drained from the virus.

However, despite these challenges, familiarity and relatability can help to calm fear and anxiety experienced by vaccine-hesitant individuals. Messengers can build trust by:

  • Taking a friendly, nonjudgmental tone
  • Presenting the motivations for their work to support communities of color
  • Sharing their own initial hesitancy about the vaccines and what information helped them overcome that hesitancy
  • Acknowledging that it is understandable to have questions and concerns about the vaccine

Vaccine-hesitant people also respond positively to people who are able to answer their questions – and who do so with respect, transparency, integrity and honesty.

People react most positively to details and information that help calm their concerns. However, at times, too many details or too much information can confuse individuals, distracting them and creating additional emotional hurdles. It is important to answer the question at hand in a straightforward manner.

Finally, we found that messages that inspire hope by helping people draw the connection between getting vaccinated and being able to experience the things in life that we love – hugging, sharing a meal, seeing grandma – have been well received. When people talk about their own reasons for getting vaccinated, they emphasize similar themes – safety, seeing family, protecting community and returning to how life was before the pandemic.

Results

These recommendations work. 

After viewing one of our Heartwired messenger videos, 51% of Black poll respondents who were unvaccinated reported being somewhat (30%) or much more (21%) comfortable with getting vaccinated. 

 “I absolutely felt every part of that video. During the pandemic, racism has been at its all time high. And being a Black woman in America, we are easily stereotyped. I am very cheerful and outgoing, and the fact nobody can see my smile because its hidden by a mask is a problem for me.”

“I too have experienced some sort of racism due to not being able to have my face fully exposed. It makes a difference in my image as a Black woman and people’s ability to recognize my positive attitude. I also am very family oriented and very much a people person, so I’m looking forward to everyone being able to live happy and healthy lives and being amongst one another again!”

 — Reactions from unvaccinated Coloradans to a Heartwired narrative video 

 

Overall, we achieved a five-point increase in likelihood of vaccination among unvaccinated poll respondents as well as a seven-point increase in those who said they would get vaccinated along a faster timeline — within two months. 

These results are particularly striking given how difficult it was to achieve movement among unvaccinated people in general. 

Now, our recommendations are being rapidly disseminated and utilized by those working in the field. 

Get your free copy of the COVID-19 Vaccine Confidence Messaging Guide.