Will $5M and ‘social influencers’ convince wary SC residents to get a COVID-19 vaccine?
Editor’s note: Read vaccine survey responses here.
It won’t be an easy trek to the pandemic’s end in South Carolina.
The Palmetto State’s health leaders already face speed bumps, hiccups and massive logistical issues as they race to deploy coronavirus vaccines to health care workers and seniors through a patchwork system that relies on overwhelmed hospitals handling the state’s latest COVID-19 surge.
But those early distribution challenges pale in comparison to the massive task of persuading a majority of South Carolinians to get vaccinated against the novel pathogen, health experts say, which is crucial to any hopes of achieving COVID-19 herd immunity.
The state is working on a $5 million communications campaign to promote the vaccines, including through billboards, ads and “social influencers.”
“The most important thing over the coming months, regardless of what goes on with distribution of the vaccine in the earlier phases, is getting the public primed toward accepting the vaccine, because that’s where the biggest impact is going to be,” said Lior Rennert, a biostatistics professor at Clemson University.
It’s not a predicament exclusive to South Carolina. Officials around the United States must grapple with vaccine hesitancy, misinformation and conspiracy theories.
The Pew Research Center in late November found that 39% of Americans say they would absolutely or probably not get vaccinated against COVID-19, although 18% of adults also say they might eventually get a shot after others are inoculated before them.
The stakes are high. While experts’ predictions vary, anywhere from 60% to 80% of Americans will have to be resistant to COVID-19 to achieve herd immunity, according to some estimates.
Michael Schmidt, a microbiology and immunology professor at the Medical University of South Carolina, in an interview last Tuesday said the S.C. Department of Health and Environmental Control will confront that reality soon.
But absent state-specific polling in South Carolina, The Island Packet and Beaufort Gazette recently set out to better understand residents’ thoughts on the mass vaccination campaign.
The newspapers asked hundreds of people from around the state to weigh in via an online form last month, receiving about 850 responses. The majority of respondents said they would gladly roll up their sleeves once eligible.
At least 725 respondents said they would get vaccinated, but some offered caveats. Several people said they would get a shot only if Dr. Anthony Fauci, the nation’s leading expert on infectious diseases, or other scientists recommended they do so (Fauci has received the first dose of Moderna’s vaccine). Some also said they wanted a green light beforehand from their primary care providers.
“I’ll take the inoculation to keep me safe,” wrote Rod Martin, of Murrells Inlet, on Dec. 10. “I didn’t get to 70 years old by being stupid.”
About 70 other survey respondents, meanwhile, said they wanted more data before making a decision, were unsure of what they would do later this year or were adamantly opposed to getting vaccinated.
“(My) concern is that (by) skipping long term testing, there may be side effects which occur long term that are unknown today; NOW I say NO but as things roll out around the world, we may see results that change my opinion PLUS IF Covid 19 continues to explode, the LT risk might be minimized to make it worthwhile to get it now?” wrote Bluffton resident Jim Christie on Dec. 10
Dozens of respondents provided unclear answers.
The survey, though, which was not a scientific study or actual poll, did confirm one thing: DHEC will have to address confusion, wariness and politicized vaccine beliefs across the state.
Many Phase 1a members have already declined to get vaccinated, and as of Thursday only 60% of South Carolina’s 195,200 Pfizer-BioNTech doses had been administered.
“It’s natural for people to be skeptical,” said Angela Shen, a visiting research scientist at the Vaccine Education Center at Children’s Hospital of Philadelphia and a retired captain of the U.S. Public Health Service. “Listen to what people’s actual concerns are, because they’re going to be different ... address what those are. Be very honest about what we know and what we don’t know.”
What did S.C. residents say in the survey?
Several respondents told the newspapers they would trust the vaccine pending clearance by the Centers for Disease Control and Prevention or U.S. Food and Drug Administration (both the Pfizer and the Moderna vaccines have been authorized for emergency use).
Others expressed confidence in the shots because President Donald Trump’s administration has helped spearhead the sprawling vaccination effort.
Respondents in multiple cases, though, were troubled by the vaccines’ fast development or were waiting for further advice on the matter.
“Absolutely Not. (Too) dangerous and NOT ENOUGH studies gone into a vaccine that took less (than) a year to come up with. Plus I have MAJOR Allergies,” wrote Lisa Simms-Allison, of Anderson, on Dec. 11.
“Only if my personal physician recommends it,” wrote John Atkinson, of Saluda, on Dec. 10.
One person on Dec. 10 added that she distrusted the vaccines due to the Tuskegee Study, among other things.
That infamous experiment began in 1932 after researchers at the U.S. Public Health Service, working with the Tuskegee Institute, recruited 600 Black men in rural Alabama for a project to study syphilis. Roughly 400 of them had the disease.
But after penicillin was recommended as syphilis’ standard treatment in the 1940s, doctors continued to give the men only placebos, and let some of them go blind, die or suffer from other serious health complications.
“There are some very real and understandable reasons for why some people do have vaccine hesitancy,” Dr. Brannon Traxler, DHEC’s interim director of public health, told reporters on Dec. 18. “You can look at the Tuskegee, you can look at Henrietta Lacks, and those events we definitely need to acknowledge. … They did lead to a lot of the safety processes in place now.”
‘Media blitzes’ and influencers
Here’s what we do know about DHEC’s public messaging campaign for the vaccine rollout, according to the state’s distribution plan and spokeswoman Laura Renwick.
Renwick in a statement last Thursday confirmed the campaign’s budget is $5 million.
The agency is planning to use billboards, signs at gas stations and “essential” businesses, fliers in utility bills, TV, radio and social media PSAs and print and digital ads to provide vaccine information during different phases of the state’s distribution plan.
PSAs could be recorded by elected officials, sports figures, “social influencers,” faith leaders or health care workers, according to the plan. An “influencer campaign” will likely begin in the coming weeks, Renwick wrote. Several people have expressed interest in participating, she wrote, but haven’t confirmed yet whether they will.
DHEC will also issue news releases, hold press briefings, monitor social media “for rumor control” and conduct “regional media blitzes.”
Agency officials in Phase 1, which is ongoing, will hold virtual meetings and town halls with community groups and sit for interviews with Latino radio stations, according to the plan.
“Address safety, hesitancy” and “How it works” are some of the vaccine messages DHEC wants to focus on, the plan says.
Prior to the initial round of inoculations, Dr. Linda Bell, the state’s top epidemiologist, Traxler or other officials were also planning to meet virtually with faith groups to discuss vaccines.
Renwick wrote that DHEC is using a network of more than 860 faith-based organizations to “reach a minimum of 85,000 congregational members and community residents” with vaccine information.
DHEC was going to compile and address “common misinformation trends” before the rollout began, too, according to the distribution plan. It’s unclear exactly what that means.
What should S.C. do moving forward?
Experts in interviews stressed that officials can take several steps to prepare for wide-scale bewilderment and vaccine skepticism as the rollout continues.
Kasisomayajula Viswanath, a professor of health communication at the Harvard T. H. Chan School of Public Health, said national research on COVID-19 vaccine hesitancy reflects an interesting dynamic: while the percentage of people willing to get Pfizer or Moderna shots is well below childhood immunization rates, it’s higher than the annual uptake for flu vaccinations, which hovers below 50% among U.S. adults, according to the CDC.
Coronavirus vaccines, though, remain more politicized than other inoculations, Viswanath said.
“That divide is what is unusual,” he said, “compared to what we have seen in the past. Whether that’s flu, H1N1, childhood immunization.”
The Pew Research Center in late November found that 69% of Democrats or people leaning toward the Democratic Party want to get vaccinated in the U.S., while only 50% of Republicans or people leaning toward the Republican Party share that sentiment.
Public health messaging last year has not helped the situation, Viswanath said, pointing to widespread confusion around the United States about later stages of distribution in 2021, when most residents will be eligible for injections.
“We are unprepared. Why are we discussing these things today? ... The fact that we don’t know where we will administer in Phase 2 or Phase 3 or Phase 4, after two rounds of essential workers, how do we do this? I mean we should have known all of this and people are confused,” he said. (DHEC has not detailed how Phase 2 will exactly work in South Carolina.)
But, Viswanath stressed, it’s not too late for the country’s health officials to right the ship.
Viswanath said vaccine messaging should focus on the individual. The “community,” he said, is somewhat abstract. Vaccine communications would carry far more weight if directed at residents’ personal fears of COVID-19.
The medical establishment, he added, should be at the forefront of addressing questions.
“‘At the end of the day, I trust my PCP, my primary care provider,’ that’s what people say,” Viswanath said.
Public debates, he said, about whether to change the dosing schedule of Pfizer and Moderna’s vaccines are counterproductive, too. (Britain has opted to front-load doses in its rollout to quickly inoculate as many people as possible, opting to modify vaccines’ two-dose regimen.)
“Anti-vaccine forces love this,” Viswanath said. “They like the confusion.”
Rennert, of Clemson University, meanwhile, said health officials should continue to emphasize the vaccines’ safety.
Pfizer and Moderna’s vaccines were more than 94% efficacious in 2020 during Phase 3 clinical trials. That’s exceptionally good, health experts say. The trials have included tens of thousands of people. And serious allergic reactions are rare, according to the CDC.
“There is a lot of misinformation out there about why it was processed so fast,” Rennert said.
Shen, of Children’s Hospital of Philadelphia, added that public health leaders have to understand that each community has a different perception of COVID-19, and primary care providers from physicians to dentists will be an important part of messaging.
PSAs may also be helpful, she said, but that depends on who’s speaking.
“If you see a number of ads with a middle-aged Caucasian, white man who’s highly respected, of course he’s going to be pro-vaccine. He invented a vaccine,” Shen said. “These advertisements may not resonate with the African American community. ... Mass media messages can and do work if the messages are properly tailored to the communities you’re trying to get at.”
This story was originally published January 15, 2021 at 5:30 AM with the headline "Will $5M and ‘social influencers’ convince wary SC residents to get a COVID-19 vaccine?."
