Given the high degree of hesitation between Republicans and rural Americans, a coalition of health groups and foundations turned to Frank Luntz, a prominent Republican Party researcher and message creator. He found that giving lectures, embarrassing or even appealing to abstract notions of doing what is right does not change minds. What resonated was to emphasize how vaccines can make people and their loved ones safe – and how they can help life get back to normal.
“The family is by far the most powerful motivator for accepting the vaccine,” reported Luntz. “Significantly more Americans said they would be more willing to get the vaccine for their families as opposed to ‘their country’, ‘the economy’, ‘their community’ or ‘their friends’. preference for the word “vaccine” instead of “vaccine”.)
Military veterans provide a glimpse of the challenge. The Department of Veterans Affairs has been administering injections almost as fast as it can, but has difficulty connecting with rural veterinarians.
By mid-February, the department had vaccinated about 29 percent of white veterans, but only 4.8 percent of those in rural areas. The low acceptance can be partially explained by logistical problems in relation to the transport and storage of the first two authorized vaccines, which must be kept extremely cold, but the department is also trying to change attitudes towards the injection. The VA plans to convene focus groups and partner with veteran service organizations to get the message out.
“We are trying to convey a deliberate message around this,” VA Secretary Denis McDonough told reporters recently.
The vaccine’s opinion does not fall directly into two fields – “hell, yes” or “hell, no”. There is a large group in the middle, nervous or unsure about vaccines, but not irrevocably the opposite. This is what public health messengers believe they can achieve – and need to achieve more in order for the immunization campaign to be successful, said Mollyann Brodie, executive vice president of the Kaiser Family Foundation who oversees their research.
Kaiser’s most recent survey last month detected an encouraging shift in the “wait and see” group. Those who reported being “anxious” to be vaccinated increased to 55%, compared to 34% in December.
But there was little movement between hardline “no” groups. For example, the proportion of Republicans who said they would not stand a chance under any circumstances, or only if forced to work, dropped slightly, from 24 percent to 22.
This represents a challenge to achieve collective immunity, which experts project will happen when 70 to 85 percent of the population is vaccinated.
Rural clinics also have practical barriers. Pfizer and Moderna vaccines are more difficult to transport and store than most traditional vaccines and are not suitable for small rural communities. Johnson & Johnson’s latest injection is easier to handle and is the first to require just one dose, so it can be a blessing for rural areas and places where people need to travel long distances to get vaccinated. The downside is that the J&J injection may be perceived as less desirable than Pfizer and Moderna, which had higher overall efficacy rates in clinical trials. However, health officials have tried to emphasize that J&J offers excellent protection against hospitalization and death by Covid-19.
No matter what kind of disclosure the government and health departments conduct about vaccines, health professionals said they recognized that the personal relationships they establish with patients are one of the best ways to alleviate people’s fears about vaccination. However, this is not always easy for many of the uninsured or underinsured.
“We talked a lot,” said Beth Ann Wilmore, director of nursing at Mercy Community Healthcare, which runs clinics south of Nashville, Tennessee, serving diverse populations of low-income patients. “I taught myself and the team and our providers and nurses about what the vaccine is, why we are giving it and what it does,” added Wilmore, who said she was initially nervous about getting a whole new vaccine. But she now uses experience to calm patients, who recently included a fear young man who came to get the vaccine he needed to work safely in his educational work.
At Scenic Rivers in rural Minnesota, everything is proactive. Holmes, the longtime CEO, said the team is calling all eligible patients to make appointments, stepping up efforts to build trust – and avoiding the pitfalls of irregular internet in the state’s Iron Range.
Melody Weaver, president of the Idaho Rural Health Association and a family nurse, also had to calmly correct the misinformation about the supposed risks of vaccines.
“We see vaccination hesitation with the flu vaccine every year – every year,” she said. “And with the virus – because of the enormity of this pandemic, and the mix of messages and politicization … you end up with trust issues.”
Despite this, more people showed up for the flu vaccine this year. This, she said, is a promising sign.
Darius Tahir contributed reporting