The American Hospital Association and its Society for Healthcare Strategy and Market Development (SHSMD) July 15 hosted “Addressing COVID-19 Vaccine Hesitancy in Your Community,” a webinar centered on examining the root causes of vaccine hesitancy and how health care organizations can tailor their messaging to these groups to promote confidence.
The webinar began with a presentation of the findings of a Kaiser Permanente-led study on people’s attitudes toward the COVID-19 vaccines. They found that most people fell into one of eight archetypes – Steadfast Opponents, Healthy Independents, Concerned Skeptics, Indifferent Individuals, Cautious Supporters, Reluctant Vaxxers and Vaccine Advocates. The reasoning behind the attitudes of each group was also examined, with a focus on what tactics would best for each archetype.
“The intention and purpose of an archetype is fundamentally to understand human behavior and to make sense of that behavior at scale,” said David Grandy, Kaiser Permanente’s vice president of delivery system design and innovation. “It’s also important to know that these archetypes cut across every demographic factor that you could imagine: age, gender and race.”
These archetypes can be more broadly defined as such:
- Steadfast opponents: Those who are staunchly against getting vaccinated. “Often this is because it deeply opposes their beliefs and systems around politics, religion and ingrained values,” said Caroline Franz, system designer at Kaiser Permanente’s Office of Transformation. “Because of this, they do not trust the vaccine or the efforts behind it.” This group may be more susceptible to being convinced by religious figures or trusted members of their community.
- Healthy independents: Members of this group trust in their immune systems, leading them to be less likely or uninterested in getting vaccinated. Grandy suggested incentivizing this group through non-health-focused means, such as traveling or engaging with vulnerable family members.
- Concerned skeptics: “This group is fearful of side effects,” Franz said. “And that could be long term, short term, middle term — they're just really worried about the health implications, and what that specifically would mean for their unique health condition.” Moving this group toward vaccination will require proper health communication, updated information on vaccine efficacy and making the vaccine easily accessible.
- Indifferent individuals: Members of this archetype do not have vaccination as a “top of mind” mentality. Additionally, members are typically younger or disinterested in political or expert figures. “We really want to de-emphasize government officials, and what we may perceive as experts,” Grandy said. “These are messengers that indifferent individuals tend not to resonate with.” Grandy and Franz also suggested making vaccines more convenient and accessible for this group as an incentive.
- Cautious supporters: Though this group believes that the vaccine is helpful, many have concerns regarding side effects for themselves or loved ones. Ways to help this group include clear answers about the vaccine’s effectiveness, risk messaging and emphasis on medical experts.
- Reluctant vaxxers: While this group plans to get vaccinated, concerns may be raised regarding the speed of the vaccine to market or potential side effects. Communication to this group involves stressing the process of research and development of these vaccines, as well as highlighting data of clinical trials.
- Vaccine advocates: This group is enthusiastic about getting the vaccine, and can likely be used as community motivators or within the volunteer space to inspire others to get vaccinated.
Following the presentation, panelists from different professions delved into these archetypes further and how that information helps guide strategy at their health organizations.
Kathy Brown, the senior vice president for pharmacy at Kaiser Permanente, said that her team took the data provided and built a toolkit asking markets to assess their community’s hesitancy toward vaccines. That information was then analyzed, with tactics for specific demographics, with the biggest tactics centering on engagement.
“How do [health care organizations] think about our engagement strategy — from social media, to employer campaigns, to just tailoring your information at the pharmacy counter?” Brown said. Brown also expressed how building trust and having easy access to vaccines was also critical to addressing vaccine hesitancy.
For Alan Shoebridge, director of marketing and communication at Salinas Valley Memorial Healthcare System in Salinas, Calif., his focus is on the “movable middle,” or Concerned Skeptics, Indifferent Individuals, Cautious Supporters and Reluctant Vaxxers. Shoebridge discussed how his organization has utilized Facebook Lives and mobile clinics to get people informed.
“[We’re] targeting that sort of indifferent, reluctant and cautious group,” Shoebridge said. “If we give them the right information at the right time, or the right opportunity operationally to get the shot, they will do it.”
Marcos Pesquera, vice president of community benefit, health equity, diversity & inclusion at CHRISTUS Health, said their major concern is the steadfast opponent. For his organization — a Catholic, faith-based health system — tactics included partnering with trusted clergy leaders in the community and focusing on the “bigger picture.”
“It’s about painting a picture in people's minds about, ‘Hey, let's get back to normal.’ Or at least a sense of normal,” Pesquera said. Pesquera also discussed ideas his team has used such as Q&As with local clinicians, local testimonials from those who have taken the vaccine and framing the vaccine as “a way of taking care of your temple.”
Regardless of archetype, Brown said it’s on both health care systems and communities to work together and know the tough path toward speeding up vaccination numbers.
“It's a journey. And I think it's understanding that it isn't over yet.”