Op-ed: How to cover vaccine hesitancy

March 5, 2021

For months now, the Covid vaccine story has been largely about scarcity—who is eligible for the limited supply; who qualifies as an essential worker, or for which “tier” or age bracket; and how soon can we get more. Given President Biden’s recent announcement accelerating the timeline for broad vaccine supply, that storyline is about to evolve as availability grows and eligibility expands to the general population. American newsrooms will be tested as the narrative moves from who can’t get the shot to who won’t get the shot.

Poll after poll shows a stubbornly large percentage of Americans who say they will not get the vaccine when it’s available. In some communities, such as the military, a majority of respondents say they will resist. The reasons for such opposition are complicated and diverse, and highly correlated to individual exposure to information found online.

Over the past three months, Aspen Digital—the Aspen Institute’s media and technology program—hosted multiple gatherings of experts and news executives at the national and local levels to help newsrooms explore how to responsibly report on the vaccine. Joining our briefings were disinformation researchers including Claire Wardle, founder of First Draft, and Renee DiResta, of the Stanford Internet Observatory; public-health experts such as Anne Schuchat, principal deputy director of the Center for Disease Control, and Rick Bright, former head of the Biomedical Advanced Research and Development Authority during the early stage of pandemic; and thoughtful observers of community dynamics, including Helene Gayle, the chief executive  of Chicago Community Trust, and Jonathan Jackson, founding director of CARE Research Center at Massachusetts General Hospital.

Drawing on their expertise, and input from journalists all over the country, we extracted lessons whose seeming simplicity gives way to massive complications: Words and story framing matter greatly.

Vaccine resistance is a challenging story for news organizations. Ordinary journalistic practices can unintentionally exacerbate the public health crisis by amplifying the very mis- and disinformation it seeks to counter.

Here’s what we’ve learned about the keys to reporting this critical story:

  1. It’s critical to address the unfounded public concern that the speedy development of Covid vaccines means they’re not safe. One of the great global achievements of the last year has been the rapid development, production, and release of multiple highly effective Covid vaccines. Yet that speed has enabled false narratives—for instance, that critical safety steps were skipped to meet the audacious timeline of the unfortunately named Operation Warp Speed. Taken together, decades of research informed the development of these breakthrough gene-based vaccines, which have been shown to be remarkably effective, and come with comparatively low levels of risk.
  2. Varying vaccine-effectiveness data is causing mistrust. Context makes all the difference. Drug companies are reporting efficacy rates ranging from the 60-percent range into the 90-percent range, causing confusion and concern that some vaccines might be less effective than others. However, as the New York Times recently noted, “just because one vaccine ends up with a higher efficacy estimate than another in trials doesn’t necessarily mean it’s superior.” Precise comparisons between vaccines aren’t possible, due in part to differences in tests, which have measured different groups of people at places in different stages of the pandemic for different outcomes. Experts agree that all three vaccines currently in the market are effective at protecting the public against infections, and especially serious illness. While the fine print is important, overemphasis on the minutiae can undermine trust unnecessarily.
  3. Overemphasizing the rare instances of adverse reaction undermines trust. Every vaccine, even those that have eradicated diseases such as smallpox, can result in adverse reactions in a vanishingly small percentage of the population. The temptation to blare headlines based on rare instances of fainting, anaphylaxis, or death is irresponsible and provides fodder for those who seek to undermine trust. (As an analogy, look at how bad-faith actors weaponized the rare reports of limited, identified voter fraud in the recent presidential election to undermine legitimacy of the entire election, which government leaders concluded actually was the safest and most secure in US history.) Even among the rare cases of recipients who face adverse reactions, the side effects are minor, temporary, and easily addressed by health officials at vaccine sites. Reporting on possible side effects is a public service, but it’s imperative to provide context to show how rare they really are, report on possible underlying conditions of the vaccine recipient, and balance those side effects against the overwhelming benefits that individuals and communities receive as a result.
  4. Vaccine hesitancy is normal and natural. Respond with compassion and information. After a year of mixed messages—many of which came from the highest levels of government and were amplified through social media—it’s entirely reasonable for people to have legitimate questions and concerns about the Covid vaccine. The key is to debunk claims without repeating them. As Wardle, of First Draft News puts it, “The first rule of reporting on mis/disinformation: don’t talk about the mis/disinformation.” Avoid headline questions like “Do vaccines cause miscarriages?” which entertain hypotheses that can reinforce falsehoods.
  5. Don’t conflate “vaccine hesitancy” with “anti-vaxxers.” One is a reasonable emotion; the other is a harmful ideology. The “anti-vaxx” movement, decades in the making, takes advantage of the attention given to vaccine science and confusion over messaging from officials. Anti-vaxx narratives introduce bogus conspiracy theories—ranging from chip implants to permanent gene alterations and beyond—into communities with other valid medical concerns, which may increase hesitancy. Coverage of such conspiracy theories should focus on debunking their false claims  without giving them oxygen. Be wary of letting your coverage of “vaccine hesitancy” amid populations be weaponized to further the corrosive ideology of anti-vaxxers.
  6. When it comes to marginalized communities, look at the culpability of systems, not people. Polling consistently indicates higher levels of vaccine hesitancy among communities of color than in the general population. That hesitancy exists for good reason: The American government and the medical community has a shameful history of medically abusing racial and ethnic minorities. When reporting on such “hesitancy,” it is critical not to inadvertently blame the affected population. For instance, a lede about high levels of vaccine hesitancy in the Black community should be framed with the historical context that the health-care system has consistently violated the trust of Black and Indigenous people. If the goal of journalism is to dispel vaccine misinformation and guide audiences through hesitancy, then it is important for journalists to acknowledge historical injustices while reporting on current science. It’s important to put extra effort in these stories to ensure they’re framed correctly, respect that minority populations aren’t monoliths, and that they don’t exacerbate community fears or prejudices.
  7. Leverage trusted, local voices. Americans trust their neighbors and their local leaders more than national sources of news when it comes to the pandemic, according to the Pew Research Center. This is especially so for Black Americans, who were more likely than other adults to trust local news outlets. All news outlets should consider voices beyond national public health experts who can build trust and acceptance of the vaccine, such as clergy members, veteran groups, service clubs, and other community leaders. Varying your sources of reliable information can be more persuasive for wary populations. Building vaccine trust with audiences means trying and sharing new ways to engage.
  8. Beware false equivalence when reporting on popular alternative treatments. While vitamins, minerals, and other medicines have been used as therapies to treat symptoms of Covid-19, these treatments will not—and cannot—do what a vaccine can do. Ensure that your news coverage features perspectives that follow and respect the science and avoid those that try to equate vaccine science with holistic alternatives. Highlighting medical experts with untested “alternative” views can have serious public health consequences. Addressing concerns, confusion, and misconceptions with a variety of informed sources is possible without amplifying harmful information.
  9. Don’t accidentally undersell the vaccine’s effectiveness. Warnings from public health officials that vaccinated individuals shouldn’t alter their pandemic routines—social distancing, wearing masks, avoiding indoor spaces— may inadvertently encourage vaccine hesitancy, as the advice appears to conflict with the benefits touted around the vaccine. . There are, in fact, different reasons for the seemingly conflicting advice: The science is still unsettled on whether vaccinated people can transmit the disease to the unvaccinated, which is why scientists are encouraging people not to immediately return post-vaccine to their pre-pandemic lifestyle. The message needs to be: Get the vaccine for your own protection—and the sooner enough of us make that critical, individual decision, the sooner all of us can go back to something approximating our pre-pandemic lives.
  10. Fill the data voids. News organizations might consider the practice of “pre-bunking”—that is, actively debunking or anticipating public questions and concerns rather than only reacting once false narratives have been popularized. Publish explainers in advance to protect against misinformation; explain the safety of the vaccine for children or pregnant women; share the commonality of side effects that most people experience, especially after a second dose. There is a growing body of evidence that it works. In addition to providing a reliable source, these “prebunks” have a secondary benefit: they give Google’s search engines something to populate when people enter more obscure queries into a search bar, solving for data deficits. One advantage conspiracy theories have online is that if “respected” news outlets and websites avoid writing about a subject, then people reading about that off-the-wall subject will only be led down dark rabbit holes. Filling those voids will provide critical public services while driving traffic.
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Vivian Schiller is executive director of Aspen Digital, a program of the Aspen Institute.