Ensuring strong demand for the COVID-19 vaccines is critical to achieving herd immunity, protecting the most vulnerable populations, and reopening social and economic life. But about 31% of US adults are hesitant to get a vaccine.1 Public engagement and clear and transparent messaging play a central role in building COVID-19 vaccine confidence.It will take a variety of strategies at the national, state, and local levels to engage with the public, address vaccine hesitancy, and build trust. At the local level, listening to community members to identify and understand concerns will help determine what messaging, delivered by whom, will be most effective.

The public’s opinions on vaccination fall along a continuum, ranging from those who fully accept vaccines, to those who are vaccine hesitant, to those strongly or unequivocally opposed to vaccination (a very small minority of the population).2 The vaccine hesitant group is most likely to respond to efforts to build vaccine confidence. For these individuals, resources, information, and support are needed. This rapid expert consultation highlights strategies for engaging with the public and communicating effectively to ensure demand and promote acceptance. These strategies are informed by five principles for effective risk communication:

Do not wait.
Begin communicating immediately.
Once formed, attitudes are difficult to change. COVID-19 vaccination programs will need to develop their communication strategy as soon as possible. Use cues from people’s previous experiences, such as childhood vaccination, to characterize the COVID-19 vaccine as something with which they are already familiar.
Be credible.
Be consistent and transparent.
Acknowledge what is known and unknown about the vaccines. Greater transparency about the vaccine authorization and distribution process, for example, could potentially address concerns about the politicization of the process.
Be clear.
Use accessible, jargon-free messages.
Use messages tailored to the health literacy and numeracy levels of the target audience. Remove difficult biological or chemical terms from messages and explain terms that have technical meanings (e.g., whether “significant” refers to statistical or substantive significance).
Express empathy and show respect.
Avoid Dismissing Concerns.
Ensuring that people feel heard is important because if people do not feel heard, they are unlikely to listen. Listen to people’s concerns, rephrase and restate those concerns, and present relevant new information with empathy.
Acknowledge uncertainty and manage expectations.
Acknowledge Uncertainty.
During a pandemic, what is and is not known changes constantly, and policy and programs change accordingly. Prepare the public for changes with such statements as, “While we’d like this to move faster, we cannot always predict how many doses we will have each week, and our limited doses mean it will take longer to vaccinate people.”

Don’t Overreassure. Honestly sharing realistic projections of the timeline could help manage people’s expectations, while overpromising how quickly progress will occur could undermine trust. Provide clear guidance on how to sign up for vaccine appointments to help manage expectations and reduce frustration.


1 As of January 22, 2021. For more information on public attitudes towards vaccines, visit

2 Current data are available from the SEAN Survey Archive at

Learn More

These rapid expert consultations were produced by SEAN (supported by the National Science Foundation and the Alfred P. Sloan Foundation) and the Standing Committee on Emerging Infectious Diseases and 21st Century Health Threats (Supported by the Department of Health and Human Services and the Office of Science and Technology Policy).

Read the guidance online at

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SEAN is a network of experts in the social, behavioral, and economic sciences poised to assist decision makers at all levels as they respond to COVID-19. The network appreciates any and all feedback on its work. Please send comments to