Combatting Vaccine Hesitancy with Personalization, Empathy, and Storytelling

Asian man wear face mask receive Coronavirus vaccine injection jab by nurse or general practitioner at hospital or healthcare clinic service. People on vaccination or Covid-19 pandemic relief concept

By RaeAnn Grossman and Roberto Arce

When it comes to communications with members, one message cannot be applied to all populations. That is especially true when it comes to engaging members around vaccination, from the COVID-19 vaccine to annual flu shots. Personalization builds credibility with members and empathy builds trust.

Throughout the pandemic, COVID-19 vaccination rates by race and ethnicity have been uneven. An analysis of vaccination data in 38 states found that among those receiving at least one dose of the COVID-19 vaccine, the vaccination rate among Black residents totaled 57%, compared with 85% for Asian residents, 65% for Hispanic residents, and 63% for whites. Data also shows that while the percentage of American Indians and Alaska Natives who received at least one dose is extraordinarily high—72% as of March 28—far fewer have chosen to receive boosters (44%).

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Meanwhile, even before the pandemic, misconceptions related to the flu and the flu vaccine were especially prevalent among millennials and Black Americans, a survey revealed. As a result, 55% of respondents in these groups had not received a flu shot by mid-January 2020, and one-third had no plans to get vaccinated during the 2019-2020 flu season. Common misconceptions included fears that the flu vaccine would make people sick and assumptions that the flu “isn’t that serious.”

But for some populations, efforts by health plans, providers and community groups to reduce vaccination rate disparities are making a difference. 

For instance, experts credit culturally sensitive campaigns in combatting distrust of the COVID-19 vaccine among Native Americans. Further, Americans who are Black and Latino make up a higher percentage of those who recently received the vaccine than their share of the total population, CDC data shows. While the data still present an incomplete picture, as the CDC does not have race and ethnicity data for approximately a quarter of those who have been vaccinated against COVID-19, such gains could demonstrate the success of highly targeted campaigns to engage specific populations. 

How can health plans craft communications that cut through obstacles to vaccination—including misinformation and distrust? Again, personalization builds credibility and empathy builds trust. Therefore, key considerations in crafting targeted messages that resonate with members include the following:

Understand that different communities face different challenges.

This is the primary reason why health plans that attempt to engage members using a single message across populations struggle to achieve the desired results. Dig deep into the factors that may influence vaccination rates for specific populations, from social determinants of health—like neighborhood access to vaccinations and health literacy—to historical causes of distrust. Then, seek ways to overcome these barriers through communication and program design. 

For instance, in many Native American communities, distrust in the federal government and healthcare system more generally runs high due to a significant history of negative experiences. A collaboration with well-established groups such as the Indian Health Service and tribal organizations helped members overcome fears about the COVID-19 vaccine. Thus, a community champion is a critical key to success and credibility. The result: vaccination rates that were higher than those recorded by any other race or ethnicity. Later, when members showed reluctance toward getting the COVID-19 booster shot, the Reno-Sparks Indian Colony found that financial incentives sparked renewed interest. 

Apply an understanding of cultural nuances when selecting language for communications.

It’s not enough to simply translate a message from English to Spanish, for example. Motivating a specific population to take action requires that the language be tailored to their needs, preferences, and culture. A message for a Latino population, for example, should provide context and emphasize why the reader should be vaccinated (“It’s very important that you take this action to protect your loved ones”), rather than simply telling the reader, “Make your appointment today! Here’s how.” 

Ensuring that members can access information that answers their questions in a language they understand also is vital to boosting vaccination rates, given the spread of misinformation around many viruses and vaccines. Such information also should be easy to access, whether via in-person experts who speak the same language or share the same culture or from their smartphone. One recent study found that it takes more clicks to access COVID-19 information in Spanish from public health departments than it does to access materials in English, creating a potential barrier to engagement.

Breaking past vaccination myths by population also is key. In Virginia, one initiative found that young people feared the COVID-19 vaccine could threaten fertility. The State Council of Higher Education of Virginia worked to dispel this myth through conversations with college students.

Lean on trusted members of the community to help spread the word.

Nearly seven out of 10 Black adults say it is frustrating to see political disagreement on topics related to science, including the COVID-19 vaccine, a recent Pew Research Trust survey found. While 73% say they rely on experts for information on the coronavirus and the COVID-19 vaccine, 57% also say they rely on close friends and family for information. That is one reason why leveraging trusted people in the community to strengthen COVID-19 vaccination engagement—especially among late adopters such as those who have not yet had their first dose—is a powerful tool in closing vaccination gaps. 

Amid recent studies that show COVID-19 vaccine hesitancy is declining among Black adults—contributing to higher vaccination rates in recent weeks—health plans should continue to explore opportunities for authentic community engagement. Examples include training not just community and religious leaders on how to initiate discussions around COVID-19 vaccination, but also barbers, stylists and community advocates.

A Culturally Savvy Approach to Vaccine Messaging

Throughout the pandemic, misinformation and distrust have been driving factors in the spread and impact of COVID-19—and it has had deadly consequences, particularly for Black, Latino, Native American and Alaskan Native individuals. By tailoring vaccine communications and engagement initiatives to specific races and ethnicities—not just for COVID-19 vaccinations, but a wide array of vaccinations, including flu shots—health plans can more effectively advance vaccine adherence for those most at risk. They can also apply the lessons learned to engage members in a variety of other programs for better health. 

RaeAnn L. Grossman is Executive Vice President of Risk Adjustment, Quality, and Population Health Management for Cotiviti.

Roberto Arce is Senior Vice President of Consumer Engagement and Health Equity for Cotiviti.

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