Halfway through the pandemic, University of Alabama epidemiologist Bertha Hidalgo realized her Covid communications strategy needed a makeover.
She was skipping basic biology classes in favor of just telling people the best ways to moderate their behavior in response to the virus. Instead of helping people understand the virus better, her approach sometimes backfired, introducing more doubt instead of less.
“My method was, ‘Here are the facts and here is what you need to do,’” she said. What she quickly learned was that people didn’t have enough background knowledge to accept what she was presenting as fact.
“A lot of people have forgotten what they learned in science in high school or college,” she said.
One of the most important – albeit least discussed – challenges of the pandemic has been effective public health communication. Giving people too little information and risking anti-vaccine forces rushing to fill the information void with lies. On the other hand, too much information without the necessary context can also create confusion.
“Communications are still the forgotten cousin of public health,” said Angus Thomson, a social scientist at the United Nations Children’s Fund who studies the demand for vaccines. “We’re just not investing in it at all. “
Disinformation and context
In general, public health entities have not focused much on education on topics such as vaccine side effects or efficacy rates. The result of this lack of investment is an information vacuum that may unintentionally provide an opportunity for anti-vaccine narratives to take hold.
Take the Vaccine Adverse Event Reporting System, or VAERS, a government-run clearinghouse for potential vaccine issues that has become a hot topic of discussion among anti-vaccine groups.
VAERS is a crucial surveillance system that helps both the Centers for Disease Control and Prevention and the Food and Drug Administration spot vaccine-related problems early on. The deployment of the Johnson & Johnson Covid shot was halted, for example, after just six cases of blood clots were reported to VAERS out of nearly 7 million doses administered.
To access the database, you must first agree to have read a long list of disclaimers: anyone can report an adverse reaction, and it has not been checked or verified. In fact, vaccine suppliers are encouraged to report any health problems that arise after vaccination in the database, whether or not it seems likely that the vaccine is the cause.
The existence of VAERS is little discussed by leading figures in public health. If you are already familiar with the database, you may have learned it through anti-vaccine propaganda, which falsely asserts it as evidence that vaccines have harmful effects.
On Facebook, videos of people reading lists of reported side effects have gone viral. Children’s Health Defense, an organization led by Robert F. Kennedy Jr., one of the internet’s most influential anti-vaccines, regularly touts VAERS statistics in its daily newsletter and encourages its readers to report their own side effects.
It doesn’t take much to twist the facts out of context. Children’s Health Advocacy typically cites accurate statistics from the VAERS database in misleading newsletter headlines. But headlines often omit or distort context, touting the numbers as evidence of harmful vaccine side effects when they are not.
“VAERS Covid vaccine data shows increasing reports of serious injuries, as 5-year-olds start getting vaccinated,” read one earlier this month. “VAERS reports of deaths after Covid nearly 16,000,” reads another.
The statistic on the number of deaths in the VAERS, for example, also does not state that a person who died after vaccination does not mean that the vaccine actually caused their death. (It is also suspected that anti-vaccine campaigners have intentionally inflated the number of reports in the database.)
“Like shark attacks”
Transparent communication is particularly essential to gain the trust of people who are skeptical or hesitant about vaccines. And trust, much more than facts, is essential to change mentalities.
“We could do a lot better with transparency around vaccines,” says Christopher Martin, professor at West Virginia University School of Public Health. “It’s something that we struggle with. “
Vaccines, he said, are like shark attacks – something we naturally and inexplicably tend to fear more than all the data suggests.
“That will never change,” he said. “And our approach to hesitant people is to walk towards them on the beach and show them the data and tell them you have nothing to fear. “
Thomson, at Unicef, said communicating with people about the risks of vaccines can be just as important as communicating about their positives.
“No one will take a lack of information or silence as a positive,” he said.
The tricky part, he said, is that not only do people tend to overestimate the risks, but they also tend to have what’s called omission bias: they’re more afraid of the slim risks of harm if they vaccinate than a much more realistic risk of harm if they do not. This means that it is crucial not only to be transparent about the possibility of a vaccine side effect, but also to frame it against other risks.
In doing so, however, Thomson said public health must also take a page from the anti-vaccine groups and do a better job of getting the messages out where people can actually see them. The VAERS website lists a plethora of warnings regarding the data it contains, but people are more likely to come across a misleading headline on social media regarding the number of serious side effects reported in the database without any context.
“We have to get information in the right format for people,” he said.
In Bertha Hidalgo’s case, she found that sharing more in-depth details often helped people be more open to the facts about the virus.
“My approach has become the demolition of science. Like, “It’s just like cells. This is how the vaccine is made and this is how the vaccine works, ”she said.
Advocating for the masks, she found that she got more buy-in from people when she explained how the virus gets trapped in particles of saliva and mucus, and therefore these particles could also be trapped in the weaving of a mask.
“I’ve had so many aha moments from people after sharing information like that,” she said.
As Hidalgo embraced the new strategy, a vaccine-hesitant Instagram follower began directing her messages with questions about the virus and the vaccine. Sometimes they shared wrong information with her. Hidalgo would always respond. Eventually his disciple was vaccinated, as was their significant other.
“It was a real big win,” she said.
© 2021 Bloomberg LP