How Health Care Organizations Can Counter Vaccine Hesitancy

The advent of the COVID-19 public health crisis has surfaced many challenges—both old and new—for the health care industry. It’s catalyzed us to re-examine the disparities in health care for minority groups; the future of telehealth as a viable delivery of care; most notably, however, it’s engendered a long-standing conversation regarding inoculation and a hesitancy to vaccinate against dangerous, infectious diseases. In the face of a virus that has taken hundreds of thousands of lives around the world in a matter of months, why isn’t the uptake of a vaccination a self-evident solution? Further, how can health care organizations more effectively encourage nonbelieving “antivaxxers” to realize the value of these therapeutics?

The State of Vaccine Hesitancy

While the health care community has made significant progress towards the creation of an effective COVID-19 drug, experts are fearful that universal uptake will bear challenges—particularly from the antivaccine community. This collective group has been fomenting misinformation since the inception of vaccines; in fact, it was a paper published by the disgraced researcher Andrew Wakefield—which famously claimed the link between the measles, mumps and rubella (MMR) vaccine and autism in children—that really propelled this movement and its propagation. Despite the fact that it became known that Wakefield was secretly receiving payments from antivaccine litigants, and that his conclusions were repeatedly disproven over the years, the antivaccine ideology burgeoned until it eventually rose to the World Health Organization’s top 10 threats to global health in 2019.

What are the consequences of the antivaccine movement? In the United States, we spend almost $27 billion a year treating adults for vaccine-preventable diseases (VDPs). To put that in perspective, measles was pronounced extinct in 2000; yet between 2014 and 2019 there were roughly 1900 cases in the United States. The cost of care and containment was an estimated $140,000 per case—totaling $266 million over a 5-year period. Inoculation, according to estimates, has a very compelling case: vaccines given to children born in the United States. between 1994 and 2013 will prevent 322 million illnesses, 21 million hospitalizations, and 732,000 deaths. Over their lifetimes, this will save $295 billion in direct costs and $1.38 trillion in total costs to society.

What Health Care Organizations Can Do

Yielding success to a complex issue requires a strategic approach, and to mitigate vaccine hesitancy, health care organizations must understand why it exists in the first place. Generally, individuals who are hesitant about vaccinations are concerned for a variety of reasons, including efficacy and safety of the drug, impression that the disease is no longer a threat, and perceived overstepping of the government. All these rationales must be taken into an account when communicating with health care consumers through educational public health outreach programs, in addition to the various demographics involved (eg, ethnicity, age, barriers to care, education-level, geographic location, household income, underlying health conditions, etc). To many people’s surprise, vaccine hesitancy groups are effective because they use behavioral science techniques to spread misinformation. Cognitive bias, for example, enables individuals the proclivity to be attracted to information that agrees with an already held belief; the result creates the “bandwagon effect”. If health care organizations are resolute in their goal to address vaccine hesitancy, they must use the same behavioral science techniques as those deployed by the vaccine hesitancy groups.

An effective consumer health engagement strategy will include targeted outreach campaigns that incorporate methodologies for optimizing behavioral interventions such as the Health Belief Model (HBM), which predicts an individual’s health-related behaviors. For example, when communicating about the benefits of flu vaccination, the following elements should be addressed:

• Perceived susceptibility of self or others to influenza (“do I need the shot?”)
• Perceived severity of influenza to self or others (“flu’s not so bad”)
• Perceived benefits of influenza vaccination for self or others (“is it worth getting the shot?”)
• Perceived barriers to influenza vaccination (“it’ll cost too much, how will I get there?”)
• Cues to action (“my doctor said I should get it/my brother says it’s important”)

Addressing COVID-19 and the Upcoming Flu Season

As efforts to develop a COVID-19 vaccine progress, experts are fearful of widespread vaccine hesitancy—causing confusion, misinformation, and potentially lower inoculation rate when and if a vaccine becomes available. While we may not have protection against COVID-19 today, we do have the ability to protect against the risks of seasonal flu. This year, it is perhaps more important than ever that individuals get their flu vaccination. For the health of our country, and all countries, it’s critical that health care organizations prepare for the fall and winter months ahead. Once flu season begins, the United States will likely have to worry about not one, but two contagious viruses. By proactively communicating with key stakeholders through health outreach programs, organizations can ensure patients and members have accurate information from trusted sources to address vaccine hesitancy. We must inoculate against the virus and misinformation altogether. 

Maria Perrin is chief growth officer for HMS, where she is responsible for client engagement, business development, corporate strategy, marketing, and government relations teams.