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Opinion: We need careful messaging from Government - the 'vaccine hesitant' will not respond well to coercion

DCU communications expert Dr Padraig Murphy says Government must get the vaccine messaging right.

Image: Shutterstock/PalSand

VACCINATION STRATEGIES ARE way up on the political agenda at this stage in our global collective fight against the coronavirus.

After an unprecedented year of social and economic shutdowns, the very existence of a vaccine has brought the glimmer of hope that an end to this pandemic could be on the horizon. It will be crucial that we get the vaccine rollout right, and public health messaging is a huge part of that.

Our neighbours in the UK have already begun their rollout of the Pfizer/BioNtech vaccine. Things are moving here too, with freezer lorries brought in, ready to be mobilised.

The High-Level Task Force on Covid-19 Vaccination recommendations will be discussed by Health Minister Stephen Donnelly and the Cabinet today and if approved, will be published. This should give detail on how the vaccine will be brought in, distributed and administered in Ireland.

Getting the message out

Authorisation of use of the first vaccine, from the European Medicines Agency (EMA), is now awaited. But a lot of work has already been done to get to this stage, and there is now a fifteen-step plan for the vaccine roll-out, from over-70s to healthcare workers to children.

The system is taking shape, but challenges can be expected.

It is likely that the Government faces both scepticism and fear among the public, as well as comparisons with international efforts. It is absolutely critical that the Government and the HSE get the communication right on this vaccination strategy. 

A wide engagement approach needs to be adopted in tandem with the publication of the strategy and its implementation. The anti-vaxxer lobby has used social media effectively to spread debunked conspiracy theories and disinformation and these need to be fought.

However, the content of anti-vaxxer campaigns should not be conflated with various types of vaccine hesitancy among the public. Questions will naturally be raised following a world-changing pandemic and will warrant humility in responding to them.

A preaching tone will not work and PR-style messaging also has limited value. Such questions and areas of interest are likely to include: 

  • information about which vaccine(s) will be used, and the funders;

  • clear, concise transparent information about the clinical trials, and about the efficacy of the vaccine under lab conditions and the effectiveness in the real world; 

  • further details on why pregnant women and children are last on the prioritisation list;

  • clear explanation on the constituents of the vaccines, including safety thresholds and the active ingredient (messenger RNA in Pfizer/BioNtech);

  • possible reactions and side effect risks;

  • religious objections (Catholic bishops have already weighed in on this);  

  • timescales for the arrival of vaccines and for vaccinating the allocated groups; 

  • where the vaccine will be administered, by whom, and implications for using retired medical staff and GPs for the vaccine administration;

  • immunisation memory period, the strategy for extra boosters if needed at a later date and up-to-date information on the possibility of herd immunity;

  • continued and sustained use of face-masks, other PPE and hand-washing;

  • questions about research integrity of ‘Big Pharma’, based on past lawsuits.

This is by no means an exhaustive list, but these are all questions that can be easily answered. Conversations need to steer away from the conspiracies and polarised toxicity of social media.

Challenging and debunking mis- and dis-information is part of the strategy but this also needs to be handled sensitively. Any hint of coercion or forced vaccinations is likely to have a negative impact.

Engagement

A second part of the strategy involves what HSE CEO Paul Reid called “influential groups” that can help the HSE in its engagement. While this might seem to be an important part of the strategy, what does “influential groups” mean?

Using influencers or ambassadors has been mooted previously by the Government but this engagement needs to go further than that. 

Beyond this, the government needs to ensure it works with local community groups, local health centres, as well as Irish Travellers advocacy groups, immigration support organisations, those in direct provision, the homeless and others who have been marginalised within society.

The Government and HSE cannot ignore or downplay the importance of creating a sense of involvement and ownership from the various communities in Ireland. At no stage should inequalities be evident, perceived or otherwise.

An immediate step towards this strategy of deeper engagement is a communication approach that observes physical and social distancing by using new and traditional media effectively.

This means operating chat software such as Pubble and smartphone app services to answer questions on-demand, as well as via text and free phone lines operating around the clock; routine home support visit staff accompanied by one of a number of professionals associated with vaccinations; staff at clinics and pharmacies with the sole task of information provision. 

Each of these services, coordinated centrally with robust-but-rapid training provided, would result in varying types of experts speaking from their own areas of expertise including epidemiologists, vaccine experts, policymakers, front-line health workers, GPs, science communicators and academics. 

Widening the conversation

In the event of restrictions being lowered to Level 1 as we move into vaccination stages, it would be possible to run socially distanced “knowledge exchange hubs” in connection with the proposed vaccinations hubs, where NPHET, HSE, Department of Health representatives and medical professionals, including retirees and volunteers, engage directly with smaller groups and communities.

This part of the communications strategy would represent a shift away from traditional one-way, top-down communication campaigns to one that speaks with and listen to the public.

There could be real knowledge exchange where the HSE gains insights about concerns and solutions from the public as well as reciprocating up-to-date information on vaccine science and full details of the rollout plan.

This would be what the Sense About Science think-tank call ‘public led, expert fed’. It is crucially important to allow engagement build through informed communities, not to talk down, coerce or scare, but to take concerns seriously and work with the public calmly and transparently.

Testimonial adverts of success stories internationally will be helpful, but over-reliance on marketing these may only go so far in getting buy-in. A combative tone will not work, but stark realities need to be faced in a positive manner. Scientists, together with policy-makers and health professionals, will enrich the decision-making process by describing the uncertainties that will continue to persist and how to best deal with them.

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And then, what next? Above all, the message needs to be clear that, while providing hope and reassurance, the vaccine will not be a magic bullet. We will need to continue working together to deal with and control this virus for some time yet. 

Dr Padraig Murphy is Assistant Professor at the School of Communications in Dublin City University (DCU).

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