As the world watched the first Briton receive her coronavirus vaccine this week, Operation Warp Speed officials appeared bewildered by questions about whether such a prominent rollout was planned for the first dose in the US.
Asked by a reporter if there was a plan to publicize the milestone in the US, Health and Human Services Secretary Alex Azar said, “You make me feel as if we should.”
“We probably do need to make a plan for, you know, who’s going to get it first visibly,” said Army Gen. Gustave Perna, chief operating officer of Operation Warp Speed.
The exchange offered the latest example of the lack of coordinated communications plan from the federal government just days before the first Americans could begin receiving a coronavirus vaccine.
As videos of first Britons receiving the vaccine were replayed on televisions and cell phones across the United States this week, Dr. Georges Benjamin, executive director of the American Public Health Association, said it was “one of those Sputnik moments.”
“We’re way behind the curve,” Benjamin said, lamenting the lack of communication from the federal government. “We really need to begin very aggressively working to give people a better understanding of the vaccination needs and the trade-offs.”
A senior administration official noted the US doesn’t have a centralized health care system akin to Britain’s and said federal officials didn’t want a ceremonial event to delay the distribution of vaccines elsewhere.
Michael Pratt, an Operation Warp Speed spokesman, added the administration’s communications plans are already underway and will be well-timed with the Food and Drug Administration’s anticipated emergency use authorization (EUA) of the Pfizer vaccine.
“In perfect lockstep – as the EUA is set to be announced – the paid messaging campaign has already begun,” Pratt said.
Lack of messaging at the federal level
Operation Warp Speed’s latest press briefing highlighted how the federal government is lagging in creating trusted, public channels of information about a vaccine that often has been treated as a political prize – and has been greeted with unusually high skepticism from the American public. Experts say for the vaccine to potentially reach herd immunity, some 70% of Americans will need to take it.
Although the percentage of Americans willing to take the vaccine is climbing, public health experts said a strong and reliable public education campaign is needed to combat distrust that remains, especially for the overwhelming skepticism that people of color have. Building public trust and creating the proper channels of communication also will help dispel misinformation.
On top of skepticism, people are craving more information about when the vaccine will become available to them. Pharmacies have posted signs to not to expect it when the first shipment goes out, an indication of how the private sector has tried to fill the information void.
Dr. Uche Blackstock, an emergency medicine physician who founded a company focused on health care equity, outlined the outreach needed on CNN earlier this week, especially when it comes to communities of color.
“We need really expansive public health campaigns that are engaging community-based organizations and trusted leaders and Black communities. I also think there needs to be significant transparency around the vaccine development process. People have so many questions,” Blackstock said.
First national advertising campaign planned against backdrop of shortfalls
For months the Trump administration insisted a public relations campaign was just ahead. But its plans were plagued with controversy from the start.
House committees launched an investigation into the administration’s public relations plans and, after an internal investigation at HHS, the government canceled a $15 million deal for an influencer-based ad campaign.
The investigations also stalled work on a separate $250 million contract for a public awareness campaign with Fors Marsh Group, according to a person familiar with the deal. After assurances that the company would root its campaign in scientific principles and research rather than celebrities, work on the project resumed in November.
The person familiar with the contract acknowledged that pressure has been building on the administration and its partners to deliver on its paid advertising campaign.
“There’s a need for clear consistent public education around pretty complicated things right now,” the person said.
Despite the holdups, the federal government is planning to release a more robust campaign soon. CNN reported the campaign began last week with a modest $150,000 ad buy on YouTube.
The national advertising campaign is slated to begin next week across print, social media and radio, said Mark Weber, a spokesman for HHS. The campaign is designed to address Americans hesitant to take a coronavirus vaccine.
From there, “We will be phasing in tailored messaging to groups who are disproportionately affected and areas of the country with the highest infection rates,” Weber said.
The administration and its contractors are testing messages slated for a second advertising blitz in January.
“For those who are hesitant, the moveable middle, including multicultural communities, the timing must align with availability and the message must be credible,” Weber said. “We are rapidly conducting research with key audiences to ensure the message and the ads are effective.”
A senior administration official added that the paid messaging campaign was only one part of the government’s communication efforts. The official pointed to top health officials participating in media interviews, White House events about the vaccine, and events with private-sector stakeholders and community organizations.
‘No funding:’ where things stand with state communication and outreach efforts
Even with a federal ad campaign, states said they face a daunting burden to educate their own residents about the vaccine, and inform them about when doses will be available for different populations.
With only $340 million allocated to states from the federal government to handle vaccine distribution and administration, many states said they do not have the money to build the kind of media campaign needed.
Testifying before the Senate Commerce Committee Thursday, Pennsylvania Secretary of Health Dr. Rachel Levine said states do not have the money to achieve the kind of educational messaging necessary to raise awareness of the vaccine’s safety and dispel vaccine myths.
“We currently have no funding to accomplish that part of our mission,” Levine said.
Although states submitted their preliminary communication plans to the CDC as part of their vaccine distribution playbook in October, some gave more information than others.
Only 23 states specifically mentioned how to target minorities or vulnerable populations when building their communication strategies, said Josh Michaud, associate director for global health policy at the Kaiser Family Foundation. He analyzed all of the state vaccination distribution plans available and only 18 states included a specific mention of how to address misinformation about the vaccine.
“I haven’t seen a whole lot of evidence that states are really robustly rolling out these communications messages,” Michaud told CNN. “You’re going to have those messages ready to go and that groundwork laid, and the partnerships built for that to be effective.”
Even for the states that have planned ahead, a lot of work remains.
The Louisiana Department of Health outlined in October that it would launch a campaign with Feigley Communications through a CDC grant, more than most states had outlined at the time. But when asked Thursday how far along they are in the ad campaign, communications director Alyson Neel told CNN, “We’re still very much in the early stages.”
Neel also described the state’s progress on engaging with stakeholders and community leaders about how to communicate about the vaccine as “a work in progress.”
Dr. Bernard Ashby, a Miami-based cardiologist associated with hospitals in South Florida, said the communication he has received from his affiliated hospital is inadequate.
“It’s disappointing. They only gave us the bare minimum under pressure,” Ashby told CNN, referring to the first communication about the vaccine he had received Thursday. “We have yet to see the strategic proactive planning and clear communication that we have been pleading for.”
Outside group stepping in
Private groups and non-profits have started to fill the void left by the federal government.
The Ad Council, a non-profit founded in 1942 that creates and distributes national public service advertising, is responsible for campaigns that have been a part of American life for decades. The council created the character Smokey the Bear for the campaign to prevent forest fires, and it produced a major campaign promoting the polio vaccine when it was released in the 1950s.
The Ad Council has begun developing content and will begin releasing it as soon as the end of December, a representative told CNN.
This campaign focused on the vaccine is the council’s “largest and most critical communications effort in our history,” the representative said.
The campaign, funded by philanthropic and private donors, is being created with input from the US Centers for Disease Control and Prevention and HHS. It will include traditional radio, television and digital ads as well as more targeted messaging from key individuals from different communities in the US, according to the representative.
For most Americans, the prospect of receiving a coronavirus vaccine is still months away, leaving a window of opportunity to educate the public.
But from Ashby’s perspective, there is already concern about missed opportunities to start sending these messages early and sway health care workers who may have doubts.
“Something that we don’t speak enough about is vaccine hesitancy within the health care worker population. Now, it may be lower than general population but it’s still there and it’s still very significant,” Ashby told CNN.
“There’s been no efforts whatsoever to get any feedback of how do we feel about getting the vaccine. It’s based on way too many assumptions and that’s basically a recipe for issues, down the road.”