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[COMMENTARY] COVID Vaccine Messaging: No Shame, No Smugness, No Mandate

The only thing perhaps more important than the apparent COVID-19 vaccine’s efficacy is the public’s willingness to get the vaccine. After the politicization of masks became a reality in this country, it is critical to rethink the strategy of vaccinations to avoid making the same mistakes on the rollout of vaccines as the country did on masks.

 Research shows that after President Donald Trump dismissed mask usage it might have cost lives. Masking also became a political issue

 Later in the summer, he pushed to open schools which magnified the already contentious topic along party lines. There is evidence that school openings correlated more with the local politics of the area rather than health policy. 

 With a new vaccine already approved in Canada and the United Kingdom, the plan for vaccine rollout has already begun. The Centers for Disease Control have noted high-risk groups and health care workers will be first to receive the vaccine. 

 Though the country remains divided on political values following a disputed presidential election, public health measures with scientific backing need to remain non-partisan. Prior to the national rollout, the messaging about vaccinations needs to begin now. 

 The approach to administering vaccines must be carefully nuanced with a goal of maximum compliance. According to a recent Pew Research study, between 40-50% of people state they would not get the vaccine. This means public messaging about the vaccine becomes absolutely critical. 

 I have seen the delicate balance of vaccine messaging nearly daily in my own practice. Patients bring their own experience with previous vaccines, their own fears of side effects, and preconceived notions from the media which can make discussions easy or difficult. 

 Some patients respond to a blunt recommendation, while for others it must be an honest, timid discussion. Many times it fails. From my experiences, combined with previous failures of masking and school openings, there are some possible approaches. 

 Getting a vaccine cannot be framed as an act of altruism. To assume that someone does not care for other people usually alienates the audience. This is something I learned early on in my career as a resident physician. 

 An alternative is to frame the act of getting vaccinated as getting back to work or protecting oneself and family. The messaging needs to assert that controlling the pandemic with vaccination is an important first step to rebuild the economy. 

 COVID-19 vaccines also need to be optional. It is an individual’s right to choose to take it. The World Health Organization recommended vaccines not be mandatory at this time. 

 Supply will be limited, so there is no point in considering a mandate as 100% compliance of the population isn’t necessary to curb the pandemic. Any amount of vaccination will get us closer to projected herd immunity of 50-70%. 

 People who opt out of vaccinations cannot be shamed. COVID-19 is a devastating disease and people are scared. This fear will easily shift to the fear of receiving a novel vaccine. Shaming could possibly lead to further alienation of those who are resistant.

 The combination of shaming people who refuse and creating a smugness or sense of superiority for those who take it may just lead to further politicization, as has been the case with mask-wearing. 

 If possible, individuals can avoid self-congratulatory social media posts about receiving the vaccine, as it can amplify echo chambers. Vaccination is an important tool to curb spread but not the only tool. The widely touted “Swiss Cheese Model” for COVID-19 risk management illustrates there are multiple layers to reduce COVID-19 risk. 

In a society where anti-vax movements are present, amplifying those messages is not helpful. Coupling COVID-19 vaccine fears with anti-vax movements that already has a strong foothold in social media could be catastrophic. 

 It is critical to acknowledge the fear of taking an unknown vaccination. Understandably people can be nervous about the unknown and side effects. But this risk must be counter-balanced by the unbelievable damage COVID-19 has done and will do. 

 As the United States nears 300,000 deaths, the rollout of the COVID-19 vaccine carries both the hope of ending this pandemic, but also the possibility of continued public health policy mismanagement. 

 To be sure, the goal of any vaccination program is to vaccinate as much of the population as possible. Early messaging must allow for the best chance of success. Lives depend on it. 

 Caspian Kuma Folmsbee, MD, is a practicing internal medicine physician at Rush University Medical Center with 10 years of experience treating patients with various medical diseases, including COVID-19. He is a Public Voices Fellow through The OpEd Project.



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