Vaccine acceptance and uptake are essential to control the spread of COVID-19 Behavioural interventions
Omer, S. B., Benjamin, R. M., Brewer, N. T., Buttenheim, A. M., Callaghan, T., Caplan, A., ... & Hotez, P. J. (2021). Promoting COVID-19 vaccine acceptance: recommendations from the Lancet Commission on Vaccine Refusal, Acceptance, and Demand in the USA. The Lancet, 398(10317), 2186-2192.
Resume 1:
Public trust is a fundamental element of vaccination interventions and policies that achieve high coverage.22
Resume 2:
The anti-vaccine movement in the USA is undermining public health. When COVID-19 was declared a pandemic, in 2020, many anti-vaccine groups were already organised and ready to campaign against masks, contact tracing, physical distancing, and other measures essential to pandemic control.
, 15 Subsequently, the anti-vaccine movement in the USA has expanded its ongoing activities against both science and scientists.
Resume 3:
Promoting public health communication
Social media is an important channel to disseminate science-grounded messages about COVID-19 vaccination. Analytics tools and other methodologies enable researchers to assess the spread and reach of memes and narratives targeting distinct communities on social platforms. Videoclips from broadcast media and article weblinks from news sites provide additional visibility into mass-media messages that communities are sharing on social channels. Data on sharing behaviours, content, and reach can provide an understanding of what emerging narratives are gaining in popularity within specific communities or on distinct platforms. These data provide an opportunity to tailor a response or debunk
Resume 4:
We herein present evidence-based provider and health-care system interventions to promote vaccination, and unique considerations in their applicability to COVID-19 vaccination (table 2). We organise our discussion according to a key factor for uptake: individual intention to receive the vaccine.
Addressing sociodemographic inequities
Considering the devastating burden of COVID-19 on minority ethnic and socially vulnerable communities, guaranteeing equitable access to COVID-19 vaccines means ensuring even application of the approaches previously described, as well as of approaches used for other health promotion foci, such as pharmacist-administered vaccinations 52 and outreach to community sites (eg, hair salons and churches).
Resume 5:
Recommendations
To address the gaps outlined in this report, the Commission presents some recommendations to national, state, and local governments, as well as to other public and private entities.
First, pre-marketing and post-marketing vaccine surveillance needs to be communciated clearly and continually to the public, press, community organisations and leaders (especially for populations experiencing social and economic disadvantage), and health-care providers who will be engaging with distrustful or hesitant patients. Communication must adapt to reflect emerging situations, such as extent of community spread, safety events, level and durability of protective immunity, availability of new vaccines, requirements for boosting, and need for targeted campaigns based on the best evidence from behavioural science. Messaging and framing are also key: experts who communicate on local and national platforms should have relevant expertise in infectious diseases, epidemiology, vaccinology, immunology, social and behavioural science, and public health.
Second, science communication and knowledge translation outreach and partnership efforts should engage with local and national press and journalistic organisations to educate journalists, news editors and production staff, and social media staff to communicate accurate and non-sensational vaccine messaging; and offer technical advising (eg, regarding topics, issue framing, and graphics or visualisation) to news outlets and social media platforms to produce news content and public service announcements. This content should be designed to effectively educate and reassure broad, diverse audiences regarding key vaccine-related topics. Ideally, these media engagement efforts to build public trust on vaccines should be formulated and implemented as soon as possible.
Third, the most effective way to increase COVID-19 vaccine uptake is to make it straightforward to act on existing intentions to vaccinate. We recommend behavioural interventions with evidence of improving vaccine uptake for other immunisations, including reminders, strong clinician recommendations, and onsite clinics.
Fourth, once provided with the clear evidence that minority ethnic groups are disproportionately affected by the COVID-19 pandemic, community leaders should engage with local organisations to increase access to COVID-19 vaccines by implementing additional community-based vaccination sites with health-care staff who are culturally competent (ie, who integrate knowledge about individuals and groups of people into practices that are used in appropriate cultural settings to increase the quality of care). Additionally, this engagement could support accurate vaccine messaging that is culturally based and catered to such communities and other populations experiencing social disadvantage. Special focus, interventions, and response efforts to ensure equitable access and uptake should be a priority.
Fifth, outreach to politically conservative groups around the urgency of vaccinating all US residents, which includes engaging conservative leaders willing to serve as COVID-19 vaccine champions, should be promoted.
Finally, interagency government task forces need to be established to examine options for countering coordinated disinformation from both national anti-vaccine activist groups and state actors. Beyond the Health and Human Services agencies, such as the CDC, all government agencies must recognise the impact of anti-vaccine activities on homeland security, commerce, and justice, and consider representation from these branches of the federal government. Efforts must also include the Department of State to address the weaponised health communication around COVID-19 vaccines.
Conclusions
COVID-19 vaccines present the most plausible intervention to sustainably control the pandemic. However, surveys suggest that a substantial number of individuals might not seek the vaccine. Furthermore, because of vaccine hesitancy and refusal linked to politics, the USA is at high risk of having regions with considerably low vaccine coverage, such as the southern and Mountain states, where sustained COVID-19 transmission is underway, and which might also promote the ongoing emergence of variants of concern. Fuelling vaccine refusal are programmes of anti-vaccine disinformation. Therefore, a national communication and behavioural intervention campaign is essential to ensure a high enough COVID-19 vaccination coverage to effectively control the COVID-19 pandemic and thus allow a return to normal social and economic activity in the USA. Interagency government efforts must be simultaneously implemented to examine options to further defuse anti-vaccine disinformation
https://www.thelancet.com/article/S0140-6736(21)02507-1/fulltext
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