Fall 2023 will mark the first time that vaccines for three respiratory illnesses – COVID-19, influenza (flu), and Respiratory Syncytial Virus (RSV) – will be simultaneously available. State, local, tribal, and territorial decision makers can be prepared to promote the trio of vaccines to mitigate against an increase in cases, hospitalizations, and deaths that may strain the healthcare system over the coming months.
Many lessons learned from earlier COVID-19 vaccine campaigns – and design principles from previous Rapid Expert Consultations still apply for the fall 2023 season. Success in promoting vaccine uptake in fall 2023 will likely come from addressing complex challenges, including:
The updated vaccine will be available in a context where the uptake for the vaccine booster of 2022 has been low. There is a need to communicate the value and benefit of the updated vaccine and efforts to facilitate access since the ending of the COVID-19 Public Health Emergency.
Emphasize systemic issues, facilitate access, and reinforce why people should get vaccinated through highlighting the associated risks and benefits of vaccinating or not vaccinating.
The RSV vaccine is new, and there is a need to educate the public about its value, risks and benefits, communicating about how well it works, its safety, and also facilitate access.
While many strategies apply to all three vaccines, in some cases, there is a need to use strategies that are clear in the differences between the three illnesses and the benefits of vaccinations. When designing campaigns, the following principles can guide how to tailor outreach:
Public engagement and transparent communication about the vaccine development process, safety, efficacy, and updates are critical for fostering trust and boosting vaccine acceptance, even if such transparency involves communicating negative aspects that might momentarily affect vaccine acceptance.
Highlighting new events or evidence to urge a change in vaccination status can influence change without derogating people's previous decision to avoid vaccination. It's crucial to frame information in line with the target audience's worldview, emphasizing infection susceptibility and the consequences of not getting vaccinated.
Sources of information play pivotal roles in shaping perceptions. Engaging trusted community figures, from healthcare providers to local leaders like faith leaders, has proven effective in promoting vaccine uptake, as their long-established trust within communities can make their recommendations highly influential.
Effective countermeasures against misinformation and disinformation involve disseminating consistent, clear, visible, and accessible information through trusted channels, optimizing online content for easy discovery, and highlighting medical consensus on vaccine safety.
Effective communication alone is insufficient for increasing vaccinations. Historically, access and structural barriers have resulted in disparities in vaccine distribution and uptake. These barriers range from logistical hurdles like lack of transportation and multiple appointments to vaccination site accessibility, language barriers, and socio-cultural and attitudinal impediments such as mistreatment, mistrust, and misinformation. Decision makers can consider the following to support vaccine promotion campaigns:
Ensuring equity in vaccine accessibility is key to increasing confidence and uptake, especially among those who are historically and currently marginalized and may be at higher risk of negative outcomes. This effort includes addressing health disparities and structural barriers, such as making vaccines available beyond traditional healthcare settings. As insurance coverage may vary, advise that checking in advance is wise and provide information on locations where free vaccinations are available.
Healthcare providers and systems can significantly influence vaccination rates through multifaceted interventions that can include patient reminders, provider education, utilization of electronic health records, and the implementation of standing orders.
Community demand for vaccines, especially among marginalized populations, can be achieved through culturally sensitive community-based campaigns and educational interventions delivered by trusted community leaders.
The convergence of the flu, COVID-19, and RSV respiratory illnesses demands a comprehensive and coordinated approach focused on providing clear, transparent vaccine information that addresses each vaccine's unique characteristics while considering questions of access, particularly among communities that have been historically marginalized and bear a disproportionate burden of these diseases.
Trust in vaccines can be fostered by acknowledging and working to address structural inequalities, engaging with communities in a culturally responsive manner, and implementing community-based initiatives. Collaboration with trusted community leaders and healthcare providers can foster vaccine confidence among marginalized populations, working towards equitable vaccine distribution and uptake.
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The Societal Experts Action Network is an activity of the National Academies of Sciences, Engineering, and Medicine that is sponsored by the National Science Foundation. SEAN links researchers in the social, behavioral, and economic sciences with decision makers to respond to policy questions.
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