The Covid-19 vaccine will need to have a flawless PR strategy
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There is, as you probably know by now, a very long list of things that need to happen before a coronavirus vaccine can be rolled out across the country: raw materials need to be sourced, a sub-zero, Brexit-proof distribution system needs to be designed and implemented, and difficult decisions about who should get the first, scarce doses need to be made.
But so far, one of the most important aspects has been largely overlooked. The British government has been under fire over the last week for its lavish spending on PR and communications. Kate Bingham, the head of the vaccine task force, was criticised for spending £670,000 of public money on a “boutique PR” firm, whose services included a bespoke podcast. And at Prime Minister’s Questions this week, Labour leader Keir Starmer hammered Boris Johnson, alleging that £130 million had been spent on public relations by the government since the start of the pandemic. “It was to raise awareness,” Johnson mumbled – as if the news of Pfizer’s mRNA vaccine and its apparent 90 per cent efficacy would have passed under the radar otherwise.
Now that it looks like we will have a vaccine sooner rather than later, it’s becoming clear that the PR and comms surrounding it could be just as important as the logistics of distribution – both in terms of reassuring ordinary members of the public that the vaccine is safe, and also for reaching out to those who are reluctant to take it, either because of health concerns, or because they’ve been drawn into the vortex of fake news.
According to public health experts, up to 70 per cent of the population would need to be vaccinated to achieve the holy grail of herd immunity. But a global survey of more than 13,000 people across 19 countries reveals widespread ‘vaccine hesitancy’. Overall, 71.5 per cent of people surveyed said they would take a proven safe and effective vaccine – but 14 per cent said they would refuse it outright, and another 14 per cent said they would be hesitant to take it. In the UK, 36 per cent of people have said they are uncertain or unlikely to be vaccinated against Covid, and in the US that figure rises to 51 per cent.
According to a recent report from the Royal Society, there are five key factors determining vaccine uptake: complacency, trust, convenience, information, and socio-demographic characteristics. Given the severity and all-consuming nature of the pandemic, complacency is unlikely to be a problem, and you would hope that the rollout of the vaccine is made as convenient as possible – although with the Pfizer approach the necessity for two separate doses presents a potential stumbling block.
It’s on ‘trust’ and ‘information’ where a clear communications strategy will be really important. “I think we need to bring the public along on the journey,” says Heidi Larson, director of the Vaccine Confidence Project, and an anthropology professor at the London School of Hygiene and Tropical Medicine (LSHTM). “We’re at a very low trust level with our populations more broadly, and they don’t just want to know how good the product is, they want to know about the process. Now is the time to talk about the process, and deciding who gets it first and why.”
Bringing trusted figures on side could be one way of reducing vaccine hesitancy in certain groups. “I think bringing on board the health professionals and scientists to support them, but also people who have a standing in communities – community leaders, religious leaders, media personalities – they can all be helpful sending out messages on support in public health,” says Samantha Vanderslott, a social sciences researcher in the Oxford Vaccine Group. You could see that approach playing out in comments by Jonathan Van-Tam, the United Kingdom’s Deputy Chief Medical Officer earlier this week, in which he said he’d be at the front of the queue for a vaccine if he could be.
The flow of information will also be critically important. And on this point, the way that Pfizer presented its preliminary results – in a simple press release – arguably presents a problem. The headline figure was great, and sparked a huge rise in the stock market as traders anticipated a return to normality, but it lacked any of the detail that’s really required before we can be truly confident in its success. There’s a risk of things changing when further results are released – the efficacy rate may drop, for instance – that could muddy the waters.
It’s also important to note that the Pfizer candidate is just one of many competing vaccines – it’s likely that we’ll be using a mixture depending on what’s available, and the way the news is filtering out one trial at a time may make it hard for members of the public to develop a clear picture of what vaccines are out there, how they work, and who is getting them first.
But the biggest communication challenge could be in the immediate aftermath of something going wrong. With a vaccine rollout of this scale it is almost certain that there will either be complications in a small number of cases, or apparent complications that are actually completely unrelated. When you’re vaccinating this many people – particularly people who are already elderly or with underlying health conditions – it’s a statistical inevitability that some of them will fall ill shortly after receiving a vaccination, for some completely unrelated reason.
Larson points to the case of Natalie Morton, a 14-year-old who died just a few hours after being given the HPV vaccine in 2009. Her case sparked national concerns about whether the jab was safe – until it turned out that she actually had an underlying condition, a huge undetected tumour that had spread across her chest. In that instance, the real cause of Morton’s death was very quickly communicated to the public, and it’s vital that the same thing happens with any Covid vaccine complications. “I think if there are any reported side effects they have to be investigated,” says Vanderslott. “The best thing that the government can do is address those and not dismiss them, and follow whatever protocol is in place.”
The media landscape has changed quite a lot since 2009, however, and the spread of fake news on social media presents a real threat to public health. Preprint research unveiled this week by Larson and colleagues at the LSHTM surveyed 4000 Brits and found that a 6.4 per cent drop in willingness to take a Covid vaccine when people were exposed to some of the most frequently circulating anti-vax posts on social media. On the other hand, it’s also possible to ‘inoculate’ people against conspiracy theories by plying them with the facts, says Daniel Jolley, a senior lecturer in psychology at Northumbria University. His research has found that anti-conspiracy arguments increased willingness to vaccinate, but only if they were delivered before conspiracy theories. Afterwards, it was hard to convince people to change their mind.
There are legitimate reasons to be hesitant about taking a vaccine that don’t involve vast conspiracy theories about 5G and Bill Gates. Genuine hardcore anti-vaxxers are a small group, who may be beyond reach, but there’s also a danger of swelling their numbers by paying them too much attention. Already, news broadcasters are slipping into their old, dangerous patterns of false equivalency. Yesterday, the Today programme on Radio 4 ran a segment that was ostensibly about members of the public putting their questions to experts, but which began with a minute-long clip of people raising unfounded concerns: ‘The vaccine has been rushed,’ ‘It hasn’t been tested on old people,’ ‘It’s going to change my DNA’.
It’s also an unhelpful label for people who may be genuinely scared, says Larson. “This terming ‘anti-vax’ has really contributed to creating this extreme polarisation,” she says. “You’re either ‘pro’ or you’re ‘anti’ and it’s crowded out a lot of people that are fence-sitters.” People who are scared or concerned fear being labelled an anti-vaxxer, she says. “They feel like they can’t even ask a question anymore without even being judged.”
The problem, from a PR perspective, is the same one that has plagued us all throughout the pandemic – a lack of clear information. It’s vital that people are given certainty if the vaccine rollout is going to be successful. “The more you give a gap for the public to fill it, the more you’re giving an opportunity for rumours to form,” Larson says. “It’s certainly one of our challenges with the Covid situation because it’s hyper uncertainty, it’s constant uncertainty, which is a perfect storm.”
Amit Katwala is WIRED’s culture editor. He tweets from @amitkatwala
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