Recommendations for promoting COVID-19 vaccine acceptance

Members of The Lancet's Commission on Vaccine Refusal, Acceptance, and Demand in the U.S. have issued their recommendations for increasing COVID-19 vaccine uptake, focusing on one key factor: individual intention to receive the vaccine.

"We need to focus on trying to understand what leads every individual to choose to vaccinate or not, and just as important, we need to identify the strategies that are most effective at getting individuals to vaccinate," said Timothy Callaghan, an assistant professor in the Texas A&M University School of Public Health and a member of The Lancet commission.

In their first report, published last month, Callaghan and co-authors outline the following six strategies:

• Clearly and continually communicating pre- and post-marketing vaccine surveillance needs to the public, media and government leaders
• Providing technical expertise to local and national media and working to communicate accurate and non-sensational messaging about vaccination
• Making it as straightforward as possible for people who intend to get vaccinated to do so
• Working with community leaders to increase access to COVID-19 vaccines for disadvantaged groups and supporting accurate and culturally-based messaging about vaccination
• Engaging with politically conservative groups and leaders
• Establishing interagency government task forces to explore options for countering anti-vaccine disinformation

The recommendations address behavioral interventions, sociodemographic inequities and promoting accurate public health communication.

"For many individuals, vaccine uptake is spurred by a public health intervention," Callaghan said. "That could mean providing reminders of when individuals need to vaccinate, that could be an incentive, or some sort of mandate. It could also include talking to a trusted person in that individual's life who could provide them with information to overcome whatever concerns they have or disinformation they might have encountered."

Some behavioral interventions could include issuing vaccine reminders to keep vaccination on people's minds, reducing barriers by automatically scheduling appointments, and providing on site vaccinations at workplaces and schools. Government actions in this category could include allowing vaccinated people and communities with low rates of transmission to resume more social activities, and enforcing reasonable vaccination mandates.

The commission state that sociodemographic inequities have already created a substantial burden on ethnic minorities and socially vulnerable groups during the pandemic, and vaccination access has been no exception. Outreach to community centers and engagement with local leaders and organizations to develop and promote accurate and culturally tailored messages about vaccination should be prioritized to address unequal access and vaccination uptake disparities, the report says.

Public health communication is also key to each recommendation. Analyzing all forms of media to better understand what makes messages more effective would help researchers and communicators better reach target audiences, according to the report, and countering communications against vaccination is also essential to slowing or stopping the spread of misinformation.

The authors conclude the report by emphasizing that a national vaccination campaign built around behavioral interventions and public health communication is needed to end the pandemic and let Americans resume normal life.

Callaghan said the commission continues to work on a variety of topics related to COVID-19 as well as general vaccine hesitancy in the United States.