How to Combat COVID-19 Vaccine Hesitancy

CHEAT SHEET

Hesitancy. Whether because of skepticism of the healthcare industry or misinformation, a lot of employees aren’t in a hurry to get the shot.

Safety. The sooner a population reaches herd immunity, when the virus is unlikely to spread between individuals, the safer the employee population will be.

Trust. Each community has specific concerns about vaccines. Find trusted sources that can establish trust in each community.

Encourage. Eliminate obstacles (access, cost) and consider incentivizing employees (paid time off) to get a COVID-19 vaccine.  

To say that the COVID-19 virus put the world on its heels is an understatement. The virus brought forward frightening aspects that left experts and regular citizens struggling with the realities of a global pandemic and trying to comprehend how contagious the virus is, how far it has spread, asymptomatic infected individuals, economic impacts on individuals and industries, symptoms ranging from mild to devastating, and, tragically, death. Scientists and researchers worked around the clock to find a vaccine to this devastating virus as quickly as possible… and they did. 

However, the relative speed in the development of a vaccine combined with a growing mistrust of vaccinations, the news, and the US healthcare system has left many reluctant to get the shot. 

Many employers have been struggling to find a way to return to normal, even if it’s a new normal, while the disease continues to rage. And the only long-term solution to return employees back to the workplace together is for the workforce to be vaccinated from the virus. Now that the medical researchers have done the hard work of quickly finding an effective vaccine; public health officials are left with their own tough task of convincing enough people to get vaccinated. And employers can play an important role to help spread the word.

What is vaccine hesitancy?

Vaccine hesitancy is the reluctance or refusal to accept recommended vaccinations. In a Kaiser Family Foundation survey conducted on Dec. 15, 2020, 71 percent of respondents said they would definitely or probably get a COVID-19 vaccine if it was determined to be safe by scientists and available for free. About 27 percent said they probably or definitely would not get the vaccine even if it were available for free and deemed safe by scientists. The survey found that vaccine hesitancy was highest among Republicans (42 percent), those aged 30-49 (36 percent), and rural residents (35 percent). Notably, 35 percent of Black adults (a group that has been disproportionately impacted by the pandemic) said they would definitely or probably not get the vaccine.

The role of systemic racism and healthcare inequality

In large part, people who are vaccine hesitant are not simply trying to be contrarian and they’re not unaware of the vaccine’s purported benefits. For many people, particularly in Black and Latinx communities, their concerns stem from a long history of systemic racism and healthcare inequality.

The healthcare inequities for Black and Latinx people are not just historical, they are still rampant today. There is substantial evidence that Black and Latinx patients continue to be subject to implicit bias in the healthcare industry and receive lower quality and less healthcare than white patients. And negative stereotypes persist. Two French doctors recently suggested testing the efficacy of the tuberculosis vaccine on COVID-19 on African prostitutes.

This pandemic has highlighted the health inequities as Black Americans have been hospitalized with COVID-19 at a 3.7x higher rate and died at a 2.8x higher rate than white Americans. Similarly, Latinx and Hispanic patients have a 4.1x higher hospitalization rate and 2.8x higher death rate due to COVID-19. 

Although Black and Latinx communities have been disproportionately devastated by COVID-19, a recent data analysis of 14 states showed that Black and Latinx Americans are receiving the vaccine at a significantly lower rate than white Americans. 

Why should employers tackle vaccine hesitancy?

Herd immunity occurs when a large enough portion of a community (the herd) becomes immune to a disease, making the spread of the disease from person to person unlikely. Consequently, the whole community becomes protected — not just those who are immune. According to Dr. Anthony Fauci, the top infectious disease expert and the director of the National Institute of Allergy and Infectious Diseases in the United States, the country will need 70 to 85 percent of the population to be vaccinated to reach herd immunity.

For employers, the number one reason to tackle vaccine hesitancy is to provide a safer workplace for their employees — whether that’s for the workforce that is working on site or to allow the remote workforce to start to return. The actual safety and the employees’ sense of safety in the workplace are invaluable to an employer. And, sadly, COVID-19 is a threat in almost every place where people gather.  The vaccine significantly reduces the probability of contracting the virus and can keep people from getting seriously ill even if they do get the virus. Widespread inoculation will be key to ensuring the safety of the workplace.

The interim COVID-19 safety measures have also come at a direct financial cost to businesses. In 2020, some large companies spent over US $1 billion on higher salaries, benefits, testing, plexiglass, safety equipment, extra cleaning, and other COVID-19 measures. While widespread vaccinations do not mean that these measures can immediately be removed, over time they will become less necessary as we approach a more normal-looking work environment.

In mid-January, Dr. Fauci said, “The only way [COVID-19] will stop is when you have a combination of fairly substantial universal adherence to public health measures rather than fragmentation, but also the proper execution and implementation of the vaccination program.” Put simply, widespread inoculation is key to stopping the pandemic. 

How to tackle vaccine hesitancy

Vaccine hesitancy has been on the rise for decades. In January 2019, well before the COVID-19 pandemic hit, the World Health Organization (WHO) declared that vaccine hesitancy was among the top 10 threats to global health. Vaccine hesitancy exists in developing countries and wealthier countries, and among all demographics of people. However, countries are quite varied in their level of vaccine hesitancy. For example, in Australia, 88 percent of people polled said they intended to get the COVID-19 vaccine if recommended to them. In the United Kingdom, 72 percent said they were willing to be vaccinated. In Russia and Poland, approximately 50 percent of people were willing to get the vaccine. As stated previously, in December in the United States, 71 percent of people said they would definitely or probably take the COVID-19 vaccination if recommended, which is an increase from 63 percent polled in a September 2020 survey.

Globally, public health experts agree that combating vaccine hesitancy is imperative and their approach for doing so effectively is largely the same. While common, vaccine hesitancy is a highly localized issue with each group or community having their own unique concerns and bases for those concerns. The best practices for combating vaccine hesitancy are:

  1. Identify your vaccine hesitant employees and establish trust.
  2. Provide factual information about both the risks and benefits of vaccination, as most people are looking for balanced information.
  3. Give the facts before addressing the myths.
  4. Use visual aids.
  5. Test the communication material prior to publishing it.

Helping individuals overcome their vaccine hesitancy will not be a simple task. Employers can help support this public health initiative by supporting the messaging and employing similar methods. 

1. How many employees have vaccine hesitancy? And why?

To effectively combat vaccine hesitancy, it’ll be important to understand how widespread the hesitancy is among your employee population and their specific concerns about getting the vaccine. It’s likely that some people cannot be persuaded to get the vaccine, but many are on the fence and can be convinced. But employers must lead these conversations with compassion, sensitivity, and respect.  

Because vaccine hesitancy is very localized, be sure to understand the specific groups and their concerns in the different parts of your organization. For example, a workforce that is predominantly Black or Latinx may have different concerns than a workforce in a predominantly white, rural location. For greatest effect, the communications need be tailored to the population’s specific concerns. Start by listening in a judgment-free way and speak with empathy and concern. 

2. Find local or familiar influencers to address specific concerns and provide accurate information

Employers can recruit influencers to speak about the vaccine. For example, executives in your organization could agree to be pictured while receiving their vaccine and share why they chose to get a vaccine and any concerns they had beforehand. Storytelling is a powerful and persuasive tool. If the story is told by someone the audience knows or can relate to and elicits emotions, that can be more effective than statistics. For example, some pastors have used their platform to promote the vaccine. Similarly, many Black physicians have been using social media and other means to increase vaccine acceptance among Black patients since studies have shown that Black Americans are more receptive to information if it comes from Black doctors.

Empower your employees to share their personal stories and reasons for getting the vaccine. Although employers won’t want employees feeling unduly pressured, if they are not mandating the vaccine, when people hear and see that peers and colleagues are getting the vaccine and having positive experiences, that can give them the confidence to get the vaccine themselves.

3. Provide credible resources about the vaccine

The 24-hour news cycle has left many people feeling overwhelmed and exhausted. In addition, studies have shown that social media and online misinformation have significantly contributed to vaccine hesitancy. Employers can help filter out the noise for employees and direct them to the credible, fact-based sources, such as the CDC, the FDA, Johns Hopkins University, the Mayo Clinic, and the National Institute of Allergy and Infectious Diseases.

Is there a local hospital or university who could provide literature about the vaccine or a local doctor who could field some questions about the vaccine? Although COVID-19 has impacted the lives of almost every person in the world, vaccine information from a trusted, credible source may be what’s needed to help combat people’s fears.

4. Eliminate obstacles to getting the vaccine

Access and cost are often barriers for people to get vaccines. While vaccine doses purchased with taxpayer dollars will be given out at no cost, some vaccination providers can charge an administration fee, which is reimbursable by the patient’s insurance company. 

Employers can support vaccine acceptance by providing their employees with simple, straightforward information about where and how they can get the vaccine, and by removing any obstacles for payment or reimbursement. So far, in the United States, states and counties have been managing the vaccine rollout and who is eligible to get the vaccine. As a result, the roll-out varies by geographic area and will continue to change as the supply increases. Employers can direct their employees to the local county public health sites for up-to-date information. The benefits group may also be able to provide helpful information specific to the employer’s specific insurance plans. If employers eliminate or reduce the legwork involved in getting the vaccine, employees will be more inclined to get it.   

5. Consider incentivizing employees to get the vaccine

Some corporations are offering their employees incentives to get the vaccine. For example, Trader Joe’s and the Aldi grocery chain are offering employees two hours of paid time off for each of the two vaccine doses. Dollar General is similarly offering their frontline hourly employees with a one-time payment equivalent of four hours of regular pay after they receive the COVID-19 vaccination. And Instacart, the grocery delivery service, is offering a US$25 stipend to workers who get the vaccine. Other employers are offering paid time off, separate from regular paid sick time, if the employee experiences side effects from the vaccine.

The immediate task is not to vaccinate 100 percent of the population. United States public health officials are striving for 70-85 percent to reach herd immunity. If roughly 71 percent of Americans are definitely or probably going to get the vaccine, then only 14 percent of “willing skeptics” need to be persuaded to get the vaccine for us to finally envision an end to this pandemic. At the time of this publication, the demand for the COVID-19 vaccine is far greater than the supply. But with vaccine supply production expected to increase, the tables will soon turn with vaccine doses ready and available to those who may be adopting the “wait and see” approach. The time is now to start encouraging people to feel comfortable with getting the vaccine and to dispel their fears and concerns. As this virus and 2020 have taught us, time is of the essence, and we are all eager to let the sunshine back through the clouds.