WASHINGTON — In late July, officials with the administration’s Operation Warp Speed said that when Covid-19 vaccines were imminent, there would be a tightly targeted four- to six-week national campaign to encourage Americans to get the shots. Now, with multiple vaccines finally on the horizon, state health officials tell NBC News they have not yet seen materials from the federal government.
Data shows there’s reason to be concerned about the American public’s willingness to sign up for shots. While recent polls indicate an increasing number of Americans willing to take the vaccine, the latest STAT/Harris poll shows at least 42 percent are still reluctant.
The federal government recently shifted its public health education strategy, amid media and congressional scrutiny related to alleged politicization of the message. Following a review ordered by the secretary of the Department of Health and Human Services, the department canceled a $15.1 million contract that included work with members of the entertainment industry.
HHS forged ahead with a different contract with Virginia-based public relations firm Fors Marsh on Aug. 31, for a $250 million campaign called “Covid-19 Public Health Re-opening America: Public Service Announcements and Advertising Campaign,” according to the federal government purchase order.
According to a statement from an HHS spokesperson, Fors Marsh will focus instead on vaccine acceptance and use “public education to move folks who are vaccine hesitant to accept the vaccine when it is widely available by building trust, supporting healthcare providers and engaging communities and individuals.”
It’s unclear when exactly the campaign will launch. The Fors Marsh CEO Ben Garthwaite told NBC News in an email statement that science-based radio ads will be airing “shortly and expand to other platforms in the coming days and weeks.” HHS told NBC News it is planning a “major push using digital/social media channels as early as next week.” HHS pointed to promotional efforts for an October Youtube video explaining how vaccines are developed.
The HHS spokesperson did not provide a timeline, saying, “Timing is critical and we are still working through the market research.”
“I don’t think it’s happening, I see no evidence of it having gone out there and there are any number of people who have said we should have been doing this already,” said Dr. William Schaffner, an infectious disease specialist at the Vanderbilt University Medical Center, who sits on the CDC’s Advisory Committee on Immunization Practices.
The HHS spokesperson said the agency’s work would build upon previous CDC work including the rubric of “Vaccinate with Confidence” that was used for previous vaccine education campaigns. But the CDC website dedicated to that effort does not yet mention efforts to boost confidence in the COVID-19 vaccine. And on an FAQ page for Covid-19 vaccination, the agency said it is not leading a national campaign to address concerns people may have about getting a COVID-19 vaccine. Officials did not respond to inquiries about whether the website’s information was up-to-date.
Some immunization experts have criticized the slow approach by the federal government.
“We know that among some segments of our country, there exists a dangerous skepticism about the value of vaccination,” said Jenny Rosenberg, who ran communications for the Office of the Surgeon General during the Obama administration. “Overcoming this hurdle — which for some people may be completely rational, given our nation's mixed history with some misguided policies of the past — should already be well underway.”
Dr. Saad Omer, director of the Yale Institute for Global Health, has been critical of the Trump administration’s delayed approach to launching a vaccine acceptance campaign.
“I would have liked to have seen a science-based strategy for communications and education, not just mass communications,” Omer said.
Omer said he’s reassured that HHS has repurposed the money for the Fors Marsh campaign to focus on vaccine persuasion but says education with providers also should have started earlier. “In terms of preparing health care providers we need to have a [continuing medical education] module that can be scaled up at the national level," he said. "We are dipping our toe in the water to have a conversation. We do not have a specific approach to listen to communities of color and that requires effort and resources.”
The states move forward on messaging
States are not waiting for federal materials. At least two, Delaware and Washington, are already rolling out public relations campaigns to urge residents to take the Covid-19 vaccine when it becomes available.
Other states are conducting focus groups, testing messages and working with local leaders to develop strategies, according to state health officials who responded to a query of all 50 states by NBC News.
At least 15 states told NBC News they are planning their own extensive communications campaigns to encourage the public to take the shot.
Washington state is out in front with mobile video ads that explain the science behind the vaccine. Delaware began running social media graphics this week according to a state spokesperson.
Gov. Andy Beshear of Kentucky said last week he would take the shot himself, telling reporters, "I'm going to be willing to take it, my wife, Britainy, is going to take it, and when it is approved for children, my children will take it too. And listen, I love those three more than life itself. I wouldn't say that and I wouldn't do that if I didn't believe that it was safe." Kentucky officials say they plan to kick off a seven-figure ad buy later this month.
Alabama is planning to roll out TV video ads on gas pumps among other platforms according to state officials. Florida proposed Youtube ads, radio spots and bus wraps as tools for vaccine messaging, according to its state distribution plan, while Nebraska's suggestions include billboards, box trucks, Facebook live and robo calls.
States addressed their communications strategies in distribution plans submitted to the CDC last month, but some of these strategies were more developed than others, a Kaiser Family Foundation brief found. Roughly a third of states mention the need to address misinformation, but most of those do not provide specific strategies for doing so. Only about half specifically mention communicating with vulnerable or minority populations.
Time is running out to formulate these kinds of campaigns, experts say.
"You don't write your flight plan after takeoff," Omer said. "You don't have to implement it while you're on the tarmac. You can be ready."
Omer has been testing messages on vaccine acceptance with his team and measuring the effectiveness of different vaccine endorsers such as President Donald Trump, House Speaker Nancy Pelosi and Dr. Anthony Fauci.
He said despite criticism of Dr. Anthony Fauci leading up to the election, he has found in his research that Fauci remains the most important endorser of the vaccine. "Tony himself is a standard for science," Omer said.
Dr. Marcus Plescia, chief medical officer at the Association of State and Territorial Health Officials, said it would make sense for the CDC to get materials out there so states could tailor the materials for their own populations.
"I have heard that there are some actual talking points and some media materials that will come out imminently but I haven't seen anything yet," Plescia said.
Plescia expressed some concern that the focus on vaccine distribution has distracted from a message of vaccine acceptance and that could be exacerbated in communities of color that have been hardest hit. "We have to start to pivot about how we are going to reach these communities, otherwise we are going to see the same disparities," he said.