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MAY2021
WhyVaccineConfidenceMatterstoNationalSecurity
areportofthecsis-lshtmhigh-levelpanelonvaccineconfidenceandmisinformation
CO-CHAIRS PROJECTDIRECTOR
HeidiJ.Larson KatherineE.Bliss
J.StephenMorrison
MAY2021
WhyVaccineConfidenceMatterstoNationalSecurity
areportofthecsis-lshtmhigh-levelpanelonvaccineconfidenceandmisinformation
CO-CHAIRS PROJECTDIRECTOR
HeidiJ.Larson KatherineE.Bliss
J.StephenMorrison
AboutCSIS
TheCenterforStrategicandInternationalStudies(CSIS)isabipartisan,nonprofitpolicyresearchorganizationdedicatedtoadvancingpracticalideastoaddresstheworld’sgreatestchallenges.
ThomasJ.PritzkerwasnamedchairmanoftheCSISBoardofTrusteesin2015,succeedingformerU.S.senatorSamNunn(D-GA).Foundedin1962,CSISisledbyJohnJ.Hamre,whohasservedaspresidentandchiefexecutiveofficersince2000.
CSIS’spurposeistodefinethefutureofnationalsecurity.Weareguidedbyadistinctsetofvalues—nonpartisanship,independentthought,innovativethinking,cross-disciplinaryscholarship,integrityandprofessionalism,andtalentdevelopment.CSIS’svaluesworkinconcerttowardthegoalofmakingreal-worldimpact.
CSISscholarsbringtheirpolicyexpertise,judgment,androbustnetworkstotheirresearch,analysis,andrecommendations.Weorganizeconferences,publish,lecture,andmakemediaappearancesthataimtoincreasetheknowledge,awareness,andsalienceofpolicyissueswithrelevantstakeholdersandtheinterestedpublic.
CSIShasimpactwhenourresearchhelpstoinformthedecisionmakingofkeypolicymakersandthethinkingofkeyinfluencers.Weworktowardavisionofasaferandmoreprosperousworld.
CSISdoesnottakespecificpolicypositions;accordingly,allviewsexpressedhereinshouldbeunderstoodtobesolelythoseoftheauthor(s).
?2021bytheCenterforStrategicandInternationalStudies.Allrightsreserved.
AbouttheCSISGlobalHealthPolicyCenter
Since2008,theGlobalHealthPolicyCenter’sgoalhasbeentogenerateindependent,forward-thinking,andmultifacetedanalysesthatreachabipartisanaudienceandshapeU.S.policyapproachesonglobalhealth.Wedothisbyundertakingpolicy-relevantresearchandbringingtogetherdiversestakeholders—U.S.policymakersfromacrosstheaisle,globalhealthexperts,andglobalhealthandforeignpolicypractitioners—todiscusscriticalissuesanddeveloprecommendationsregardingU.S.globalhealthleadership,policies,andprograms.Todothis,wecapitalizeonourexpertiseinhealthsecurity,infectiousdisease,andwomen’sandfamilyhealth,aswellastheexpertiseofthebroaderCSISexpertcommunityonregionalpolitics,nationalsecurity,anddevelopmentchallenges,toexaminethegeopoliticalissuesaffectingcurrentandfutureglobalhealthactivities.
CenterforStrategic&InternationalStudies
1616RhodeIslandAvenue,NW
Washington,DC20036
202-887-0200|
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whyvaccineconfidencematterstonationalsecurity
AbouttheLSHTM
VaccineConfidenceProject?
TheVaccineConfidenceProject?(VCP)wasestablishedin2010tomonitorpublicconfidenceinimmunizationprogramsbybuildinganinformationsurveillancesystemforearlydetectionofpublicconcernsaroundvaccines;byapplyingadiagnostictooltodatacollectedtodeterminetherisklevelofpublicconcernsintermsoftheirpotentialtodisruptvaccineprograms;and,finally,toprovideanalysisandguidanceforearlyresponseandengagementwiththepublictoensuresustainedconfidenceinvaccinesandimmunization.TheVCP?alsodevelopedaVaccineConfidenceIndex?asatoolformappingandmonitoringconfidenceglobally.
LedbyProf.HeidiJ.Larson,theVCP?teamisaninterdisciplinaryandinternationalgroupofresearcherswithexpertiseinanthropology,digitalanalytics,epidemiology,policy,psychology,riskcommunications,andmathematicalmodelling.Vaccineconfidenceisnotaone-dimensionalissue,andsotheVCP?cutsacrossdisciplinestoproduceinnovativeresearchandpolicyrecommendations.
WhiletheVCP?isaglobalnetworkofresearchersandanalysts,thecoreteamisbasedattheLondonSchoolofHygiene&TropicalMedicine(LSHTM).Foundedin1899,theSchoolisrenownedforitsresearch,postgraduatestudies,andcontinuingeducationinpublicandglobalhealth.TheSchoolhasaninternationalpresenceandcollaborativeethos,andisuniquelyplacedtohelpshapehealthpolicyandtranslateresearchfindingsintotangibleimpact.
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whyvaccineconfidencematterstonationalsecurity
AbouttheHigh-LevelPanelonVaccineConfidenceandMisinformation
InJuly2020,theCenterforStrategicandInternationalStudies’(CSIS)GlobalHealthPolicyCenterandtheLondonSchoolofHygiene&TropicalMedicine’s(LSHTM)VaccineConfidenceProject?convenedahigh-levelpanelofexpertstoconsidertheurgentchallengesofvaccinehesitancy,misinformation,andU.S.nationalsecurity.InOctober2020,thepanelissuedacalltoactiontoaddresstheseissuesinthecontextoftheCovid-19crisis.
Thepanelisco-chairedbyJ.StephenMorrison,seniorvicepresidentanddirectoroftheCSISGlobalHealthPolicyCenter,andHeidiJ.Larson,professorofanthropology,risk,anddecisionscienceanddirectoroftheVaccineConfidenceProject?attheLondonSchoolofHygiene&TropicalMedicine.Thepanel’ssecretariatisbasedattheCSISGlobalHealthPolicyCenterandisheadedbyKatherineE.Bliss,projectdirectorandseniorfellow,andsupportedbyMichaelaSimoneau,programmanager.
Acknowledgments
ThepanelisgratefultoMichaelaSimoneau,forcoordinatingtheworkofthehigh-levelpanel’ssecretariatandforheranalyticalcontributionstothegraphicelementsinthereport;SamanthaChivers,forsupportingcommunicationsassociatedwiththepanel’seventsandpublications;MotiHeda,MaggieHicks,NoelleHuhn,LaurenMann,andMichaelRendelmanforresearchassistance;andtheCSISGlobalHealthPolicyCenterstafffortheirsupportofthisproject.SpecialthanksalsototheentireteamfromtheCSISDracopoulosiDeasLabfortheirprodigiouseffortsproducingthisreportandtheassociatedmultimediaproducts.
Thepanel’sworkissupportedbyagrantfromtheRobertWoodJohnsonFoundation.
Theviewsexpressedheredonotnecessarilyreflecttheviewsofthefoundation.
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whyvaccineconfidencematterstonationalsecurity
LetterfromtheCo-Chairs
AsthesecondyearoftheCovid-19pandemicunfolds,theUnitedStateshasenteredanewphaseofheightenedhopeintheracetocontrolthepandemicandgetaheadofevolvingvariants,withanimperativetomovewithacceleratedspeedtovaccinateatscaleandtoaddressdisparitiesathomeandabroad.
WheredoestheUnitedStatesremainmostvulnerable?Publictrustandconfidenceinvaccines,inscience,andinpublichealthauthoritiesremainfragilebutabsolutelypivotaldimensionsofvaccineacceptance.Awearyandoftenskepticalpublicsearchesforanswersinaconfusinginformationenvironment,besetbymisinformation,falsehoods,andconspiracies.HistoricallegaciesandpartisandivisionsintheUnitedStatesshapeattitudesinprofoundways.Solutionsarenotimmediatelyevident,simple,oreasytoimplement.IntheUnitedStatesandelsewhere,widespreadvaccinehesitancyandrefusal,ifnotaddressedstrategicallyandsensitively,canbesignificantbarrierstoachievingherdimmunity,reopeningeconomiesandsociety,andeasingracialandsocialstrife.Thesearematters,atbase,ofU.S.nationalsecurity.
LaunchedinJuly2020,theHigh-LevelPanelonVaccineConfidenceandMisinformation,jointlyorganizedbytheCSISGlobalHealthPolicyCenterandtheLondonSchoolofHygiene&TropicalMedicine’sVaccineConfidenceProject?,hasbroughttogetherexpertsinpublichealth,cybersecurity,nationalsecurity,andthesocialsciences.Itsmandateistounravelthetangledweboffactorsshapingvaccinebehaviorsandchoicesandtoidentifyconcretemeasuresthatwillstrengthentrustandconfidence.Muchcanbegained,inourview,throughenhancedandinnovativeengagementandpartnershipsthatimprovecommunityperceptionandunderstandingofpublichealthpoliciesandthescienceandvaluesthatinformthem.Ifsuccessful,theseactionscanbetterprotectAmericans’health,promoteU.S.nationalsecurity,andinformU.S.internationalengagementtosupportsimilargainsglobally.
Weinviteyoutoreadthepanel’sreportandrecommendations,hopeyoufindthemtimelyanduseful,andwelcomeyourthoughts.
HEIDIJ.LARSON J.STEPHENMORRISON
ProfessorofAnthropology,Risk,andDecisionScience SeniorVicePresident
Director,VaccineConfidenceProject? Director,GlobalHealthPolicyCenter
LondonSchoolofHygiene&TropicalMedicine CenterforStrategicandInternationalStudies
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whyvaccineconfidencematterstonationalsecurity
MembersoftheCSIS-LSHTMHigh-LevelPanelonVaccineConfidenceandMisinformation
VI
whyvaccineconfidencematters
CONGRESSMANAMIBERA(D-CA-07)
U.S.HouseofRepresentatives
MOLLYANNBRODIE
ExecutiveVicePresident,COO,andExecutiveDirector,
PublicOpinionandSurveyResearch
KaiserFamilyFoundation
DAVIDA.BRONIATOWSKI
AssociateProfessorofEngineeringManagementandSystemsEngineeringandAssociateDirector,InstituteforData,Democracy,andPoliticsTheGeorgeWashingtonUniversity
SUSANW.BROOKS
FormerCongresswoman(R-IN-05)
U.S.HouseofRepresentatives
FREDERICKR.CHANG
Chair,ComputerScienceDepartment,
LyleSchoolofEngineering
SouthernMethodistUniversity
RENéEDIRESTA
TechnicalResearchManager,
StanfordInternetObservatory
StanfordUniversity
CARYFUNK
Director,ScienceandSocietyResearch
PewResearchCenter
BRUCEGELLIN
President,GlobalImmunization
SabinVaccineInstitute
DENISEA.GRAY-FELDER
FoundingPresidentandCEO
CommunicationforSocialChangeConsortium
MARGARET“PEGGY”HAMBURG
InterimVicePresident,GlobalBiologicalPolicy
andPrograms,NuclearThreatInitiative
andFormerCommissioner
U.S.FoodandDrugAdministration
JOHNNYHEALD
ChiefExecutiveOfficer
ORBInternational
REBECCAHERSMAN
SeniorAdvisorandDirector,ProjectonNuclearIssuesCSISInternationalSecurityProgram
KATEJOHNSON
FormerProgramDirector,CenterforBestPractices,NationalGovernorsAssociation
DeputyDirector,MedicaidPolicy&ProgramsAurreraHealthGroup
JULIETTEKAYYEM
SeniorBelferLecturerinInternationalSecurityHarvardKennedySchool
JAMESA.LEWIS
SeniorVicePresidentandDirector
CSISStrategicTechnologiesProgram
LAQUANDRAS.NESBITT
Director
DistrictofColumbiaDepartmentofHealth
JOEROSPARS
Founder&CEO
BlueState
UMAIRA.SHAH
SecretaryofHealth
WashingtonStateDepartmentofHealth
tonationalsecurity
SARAHSHIRAZYAN
LecturerinLaw,StanfordLawSchool
andContentPolicyManager
Facebook,Inc.
JULIASPENCER
AssociateVicePresident,GlobalVaccinesPublicPolicy,
Partnerships,andGovernmentAffairs
Merck&Co.,Inc.
CLAIREWARDLE
Co-FounderandU.S.Director
FirstDraft
ELIZABETHWEHR
StrategyandPolicyAdvisor
ParsonsCorporation
JUANZARATE
GlobalCo-ManagingPartner&ChiefStrategyOfficerK2Integrity
Disclaimer
Thepanelistsparticipatedintheirindividualcapacities,notasrepresentativesoftheirrespectiveorganizations.Thisreportrepresentsamajorityconsensus;nopanelistisexpectedtoendorseeverysinglepointcontainedinthedocument.Inbecomingasignatorytothereport,panelistsaffirmtheirbroadagreementwithitsfindingsandrecommendations.Languageincludedinthisreportdoesnotimplyinstitutionalendorsementbytheorganizationsthatpanelistsrepresent,andtheopinionsexpressedherein,includinganyimplicationsforpolicy,shouldnotbeattributedtothoseorganizations.
VII
whyvaccineconfidencematterstonationalsecurity
Contents
LetterfromtheCo-Chairs
V
MembersoftheCSIS-LSHTMHigh-LevelPanelonVaccineConfidenceandMisinformation
VI
Introduction
1
ACrisisDecadesintheMaking:VaccineHesitancyfromSmallpoxtoCovid-19
6
HealthandCommunitywithintheInformationRevolution
12
VaccinesforHealthandNationalSecurity
17
Recommendations:BolsteringConfidenceNowandPreparingfortheFuture
21
Endnotes
27
VIII
whyvaccineconfidencematterstonationalsecurity
CHAPTER01
Introduction
photosource:patrickt.fallon/afp/gettyimages
SINCEJANUARY2020,THEOUTBREAKOFNOVELCORONAVIRUSINTHEUNITEDSTATESHASLEDTOMORETHAN32MILLIONCONFIRMEDCASES,ANDMORETHAN577,000DEATHS,WITHSEVERALSTATESREPORTINGHOSPITALSYSTEMSANDINTENSIVECAREUNITSAT,OROVER,CAPACITY.
TheUnitedStatesleadstheworldwithmorethanone-fifthofthemorethan153millionreportedcasesandnearly20percentofallreporteddeaths.1
ConfirmedCovid-19casesintheUnitedStateshavevariedbystateandcounty,withminoritygroupsbeinghitespeciallyhard.2Ofthe15.9millioncasesforwhichraceorethnicitydatawasavailableonMay3,2021,29.1percentwereHispanic/Latino,yetHispanicsaccountforanestimated18.5percentofthepopulation.3AndBlacks,anestimated12.5percentoftheU.S.population,accountfornearly14percentofdeaths.
UndertheadministrationofDonaldJ.Trump,thefederalgovernmentinvestedbillionsoftaxpayerdollarsintoOperationWarpSpeed(OWS),apublic-privatepartnershipledbytheDepartmentsofDefenseandHealthandHumanServicesandinvolvingmultiplefederalagenciesandpharmaceuticalcompanies,withtheintentofdeliveringmorethan300millionvaccinestopeoplelivingintheUnitedStatesbytheendof2021.
InDecemberof2020,theFoodandDrugAdministration(FDA)grantedemergencyuseauthorizationfortwovaccines,andonFebruary26itsVaccinesandRelatedBiological
ProductsAdvisoryCommittee(VRBPAC)approvedtheapplicationofJanssenBiotechInc.(Johnson&Johnson)foremergencyuseauthorizationforitsonedosevaccine.4FollowingthecompletionofitsownphaseIIIclinicaltrials,AstraZenecaalsoindicatedonMarch22thatitwillpreparetoseekFDAemergencyuseauthorizationintheUnitedStates.5TheDepartmentofHealthandHumanServices(HHS)hasallocatedshipmentsofvaccinestostates,territories,tribalareas,andmajorurbancenters,leavingdistributionplanninglargelyuptolocalgoverningbodiesinthoseentities.6
Incommunitiesacrossthecountry,thepercentageofpositivetestsinminoritycommunitieshasbeenroutinelyhigherthanmajoritywhiteneighborhoodsinthesameareas,andyetearlyvaccinedistributiondatashowsthatwhiteswithineligiblerecipientgroupshavesecuredadisproportionatelyhighpercentageofavailablevaccines.7
“TherehavebeenalotofopportunitiestotalkaboutthereasonswhywehavedisparitiesinCovid-relatedoutcomesintheUnitedStates.Thesedisparitiesarenotduetotheacutenatureoftheemerginginfectiousdisease,butarerootedinthesystemicnatureofwhatcausesdisparitiesinhealthoutcomesandhealthcaredisparitiesoverall.InordertoeliminatethesedisparitiesinCovid-19-relatedoutcomes,whetheritbetreatmentdisparitiesorthevaccinedisparitiesthatwehavethepotentialtosee,weneedtoengagemultiplesectorsofgovernmentbeyondgovernmentalpublichealthintheCovid-19response.”
LaQuandraS.Nesbitt,
DistrictofColumbiaDepartmentofHealth
DifferentialaccesstoonlineregistrationservicesoravailabilitytowaitatmassvaccinationsitesduringworkdayhoursmayaccountforsomeoftheracialdisparitiesinaccesstotheCovid-19vaccines.Atthesametime,historicexperienceofdiscriminationwithinthehealthsystemiscontributingtovaccinehesitancyonthepartofmanyBlackandLatinopopulations.8
InsufficientattentionhasbeenpaidtohesitancyandvaccinerefusalamongRepublicans,includingruralRepublicanvoters.RecentsurveysshowthatalmosthalfofRepublicanmendonotintendtogetaCovid-19vaccine.9And44percentofRepublicansindicatetheywillprobablynot,ordefinitelynot,bevaccinated.10AmongDemocrats,thenumberismuch
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whyvaccineconfidencematterstonationalsecurity
lower,at18percent.Asvaccinesupplyshiftsfromrelativescarcitytoabundance,therehavebeenincreasedcallsforformerpresidentTrumpandothertrustedRepublicanleaderstobecomemoreactiveincommunicatingthesafetyandvalueofvaccinestotheirsupporters.InhisFebruary28addresstotheConservativePoliticalActionConference(CPAC),formerpresidentTrumpstated,“Everybody,gogetyourshot.”11OnMarch16hefurtherurgedhisfollowerstobevaccinated,sayingherecommendstheshots“toalotofpeoplewhodon’twanttogetit,andalotofthosepeoplevotedforme.”12
“Thispandemichasprovidedthedeeplyunfortunateanswertothequestion:‘Willsomeleadersreallyseekadvantageforthemselvesbydeliberatelypoliticizingotherwiseuncontroversialpublichealthstepsthatpreventmassdeath?’Inacrisislikethis,responsibleleadershaveadutyofpeerpressure:topersuadecolleagueswhopossessinfluentialplatformstobevocalvaccineproponents,andtoconfrontandholdaccountabledisingenuouscolleagueswhoseektoprofitpoliticallybyperpetuatingdangertousall.”
JoeRospars,BlueState
Thespreadofmisinformationthroughface-to-faceconversationsaswellasthroughmainstreamanddigitalmediaisalsounderminingconfidenceinvaccines.Extremistgroups,includinganti-vaccinationgroups,haveusedsocialmediatospreadmisinformationandtoorganizeprotestsorotherwisedisruptvaccinationprograms.13Andforeignactors,notablyRussiaandChina,usemisinformationaboutCovid-19vaccinestoraisequestionsaboutthemotivesoftheU.S.governmentindistributingthemtounderminetheinfluenceoftheUnitedStatesabroad.
Withvaccinesofferinghopeofslowingtheoutbreak,reachingCovid-19herdimmunity,restoringeconomicgrowth,andavertingmajornationalsecuritychallenges,itisimportanttounderstandbothwhatmakespeopleconfidentorhesitantaboutvaccineswithintheCovid-19contextandtheextenttowhichmisinformationisunderminingvaccineconfidence,aswellaspoliticalstability.
InJuly2020,theCSISGlobalHealthPolicyCenterjoinedwiththeLondonSchoolofHygiene&TropicalMedicine’sVaccineConfidenceProject?toconveneabipartisanandinternationalgroupofexpertsfrompublichealth,cybersecurity,publicopinionresearch,andcommunications,
withthegoalofassessingtheimplicationsofmisinformationandvaccineconfidenceforU.S.nationalsecuritywithintheCovid-19context.Theexpertsfocusedontwokeyquestions:Inwhatwaysdovaccinehesitancyandmisinformationimpactnationalsecurity?Andwhataretheconcrete,feasiblestepsthattheU.S.government,Congress,socialmedia,industry,advocates,andcommunityleadersshouldstandbehindtoimproveAmericans’healthandsecurity?
TheHigh-LevelPanelonVaccineConfidenceandMisinformationisco-chairedbyJ.StephenMorrison,seniorvicepresidentatCSISanddirectoroftheGlobalHealthPolicyCenter,andHeidiJ.Larson,professorofanthropology,risk,anddecisionscienceattheLondonSchoolandfoundingdirectorofitsVaccineConfidenceProject?.KatherineE.Bliss,seniorfellowwiththeCSISGlobalHealthPolicyCenter,istheprojectdirector.
Asthepanelmet(virtually)overthesummerandfall,memberswereemphaticaboutthreethings:
ThedangerouslylowlevelsofpublicconfidenceinCovid-19vaccinesbeingreportedrepresentaclearthreattothepotentialoftheUnitedStatestoeffectivelycontrolandrecoverfromthepandemic.
Makingsafeandhighlyeffectivevaccinesaccessiblequicklyandequitablyiskeytoescapingtheburdenofanuncontrolledpandemicandreopeningtheeconomyandsociety.Atthesametime,thevaccinesmustbedeliveredtothepublicinacoordinatedandequitableprocessbuiltonreliabledata,activeoutreach,andsensitivitytohistorytoensurepublicconfidenceinthem.
AddressingthechallengesofmisinformationanddisinformationaboutCovid-19vaccinesrequiresamultidisciplinary,multiprongedapproach.
InOctober,thepanelissuedacalltoaction,definingthechallengeofwaningvaccineconfidenceandmisinformationaboutvaccinesasanationalsecuritythreat.14
ThisreportbuildsonthatcalltoactionandrecommendsfivestepstoaddressthechallengesofvaccineconfidenceandmisinformationwithintheCovid-19context:
Innovationsinreachingdiverseandunderservedpopulationswithvaccinesdeliveredinthecontextofhealthandsocialservices.
Pledgesandactionsbymainstreamanddigitalmediaplatformstostopthespreadofmisinformationandtocollaboratewithhealthprovidersandthe
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whyvaccineconfidencematterstonationalsecurity
scientificcommunitytoincreasetheavailabilityofaccuratecontent.
IncreasedengagementbykeysocialandeconomicsectorstoempowerpeopletomakeinformedchoicesaboutCovid-19vaccines.
Greaterexecutivebranchcoordinationandactionbeyondtheemergency.
IncreasedU.S.supportforglobalimmunizationpartners.
SinceOctober,thepanelhashostedaseriesofpublicdiscussionstofacilitateinteractionwithabroadsetofactorsonwaystobolstervaccineconfidencewithintheU.S.pandemiccontext.TheseonlineconversationshaveofferedanopportunitytorefinetheoriginalrecommendationsandreflectontheimplicationsofthepoliticaltransitionandneweffortsonthepartoftheBidenadministrationtostrengthenpublicconfidenceinCovid-19vaccines.
Anumberofeducationalprogramshavebegunreachingouttokeypopulationstohelpthosewhoarehesitant
makeinformeddecisionsaboutCovid-19vaccines.TheAdCouncilandCOVIDCollaborativehavelauncheda$50millioncampaign—theCOVID-19VaccineEducationInitiative—toreachthecommunitieshardesthitbythepandemicwiththemessagethat“It’sUptoYou.”15Itisalsoencouragingsocialmedia“influencers”tosharephotographsandmessagespromotingthevaccines.16
“Weneedtolookfortrustedleadersincommunities,trainthemup,andallowthemtodeliverthemessage.Thatreallyhasbeenshown,inmanysettings,tobeaneffectivewaytogetapublichealthmessageout.Itisnotanexternalpersoncomingintoacommunitytotellyouwhatyouneedtodo.Itissomeonewhoalreadyhasaleveloftrust,armingthemwiththeinformationanddataandlettingthemdeliverthatinformationanddatainthelanguageandthemethodsthatworkwithinthosecommunities.”
CongressmanAmiBera(D-CA-07)
4
whyvaccineconfidencematterstonationalsecurity
PeoplelineupearlyattheJacobJavitsConventionCenterCovid-19vaccinationhubonMarch4,2021,inNewYorkCity.
timothya.clary/afp/gettyimages
TheBlackCoalitionAgainstCOVID-19hasmobilizedhealthcarepersonnelandotherfrontlineworkerstoaddressthe“reluctanceonthepartofmanyAmericans,butparticularlyAmericansofcolor,tofollowtheguidancethathasbeenofferedand,also,averygreatreluctancetobewillingtoparticipateintheclinicaltrialsforthevaccineandforacceptingavaccineoncesafeandproven.”17AndtheCONVINCEprojectisa“globalinitiativetopromotevaccineliteracygenerallyandconfidenceinCOVID-19vaccinesinparticular.”18
“Thereisalotmoreawarenesstodayofthewaysinwhichhealthmisinformationcanbedeeplysociallyharmful:theorganizationsthathavetocounterthesenarrativesaretakingsocialmediacontentmoreseriously,andtheplatformsarefinallythinkingaboutimprovingcurationinwhattheysurface.Counteringhealthmisinformationreallyrequiresawholeofsocietyapproach.Myhopeisthat,particularlygiventheimpactfulexperienceofthepandemic,wewillseesustainedfocusondevelopingsolutionsthatwillallowustodevelopabetterinformationecosystemoverall.”
RenéeDiResta,StanfordInternetObservatory
Socialmediacompanieshavetakendeliberatestepstocollaboratewithpublichealthauthorities,includingsteppingupfact-checkingefforts,banningadsthatmakefalseclaimsaboutCovid-19vaccines,directingreadersawayfromwhatisdeterminedtobemisinformationandtowardpublichealthsites,andalteringalgorithmicmethodstoreducetheamplificationoffalseorinaccurateinformationaboutvaccines.19Facebookhasannouncedtheformationofanindependentoversightboardtoadviseonthecorrectbalancebetweenfreedomofexpressionandfreedomfromdangerousmisinformation,andthecompanyhastakenmeasurestoconnectuserswithonlinetoolsthatcanhelpthemlearnwhenandwheretheycangetaCovid-19vaccine.20
SincethepresidentialtransitioninJanuary,theBidenadministrationhasmadebolsteringvaccineconfidenceapriority,issuinganexecutiveordercreatingaCovid-19EquityTaskForceandsituatingfederalvaccinationcentersinminoritycommunitieshardesthitbythepandemic.21Withambitiousgoalstoacceleratethedistributionofvaccines,
theadministrationannouncedanagreementonFebruary11withPfizer/BioNTechandModernaforthepurchaseofanadditional200milliondoses,ensuringenoughsupplytovaccinateeveryadultintheUnitedStatesbyJuly2021.22InearlyMarch,theBidenadministrationannouncedaplantopurchaseadditionaldosesoftherecentlyauthorizedJohnson
Johnsonvaccine,madepossiblethroughaWhiteHouse-brokeredproductionarrangementwithMerck&Co.23Andduringhistelevisedspeechontheone-yearanniversaryoftheWorldHealthOrganization’s(WHO)declarationthatCovid-19wasapandemic,PresidentBidendirectedallstatesandterritoriestomakeallpeopleage18andoldereligibleforvaccinesbyMay1,2020.24
TherecentpassageoftheAmericanRescuePlanActof2021,a$1.9trillionbill,isavitallyimportantstepandincludesupto$1billiontosupporttheU.S.CentersforDiseaseControlandPrevention(CDC)inconductingeducationdedicatedtobuildingconfidenceinvaccines,includingCovid-19vaccines.25AndaWhiteHouseannouncementonMarch25promisestocommitadditionalresourcestobringfederalinvestmentsforvaccineconfidence-boostingactivitiesupto$3billion,witha“focusonreachingcommunitieshardesthitbythepandemic.”26
“Restoringvaccineconfidenceiscriticaltorestoringthepublichealth,economy,andsocialcohesionofourcountry—aswellasstrengtheningournationalsecurityandpreparedness.Unfortunately,vaccinationshavealsobecomeadomainofcompetitionanddisinformationstokedbythosesee
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