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Persuasive Essay Guide

Persuasive Essay About Covid19

How to Write a Persuasive Essay About Covid19 | Examples & Tips

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Steps to Write a Persuasive Essay About Covid-19

Here are the steps to help you write a persuasive essay on this topic, along with an example essay:

Step 1: Choose a Specific Thesis Statement

Your thesis statement should clearly state your position on a specific aspect of COVID-19. It should be debatable and clear. For example:

"COVID-19 vaccination mandates are necessary for public health and safety."

Step 2: Research and Gather Information

Collect reliable and up-to-date information from reputable sources to support your thesis statement. This may include statistics, expert opinions, and scientific studies. For instance:

COVID-19 vaccination effectiveness data
Information on vaccine mandates in different countries
Expert statements from health organizations like the WHO or CDC

Step 3: Outline Your Essay

Create a clear and organized outline to structure your essay. A persuasive essay typically follows this structure:

Introduction
Background Information
Body Paragraphs (with supporting evidence)
Counterarguments (addressing opposing views)

Step 4: Write the Introduction

In the introduction, grab your reader's attention and present your thesis statement. For example:

The COVID-19 pandemic has presented an unprecedented global challenge, and in the face of this crisis, many countries have debated the implementation of vaccination mandates. This essay argues that such mandates are essential for safeguarding public health and preventing further devastation caused by the virus.

Step 5: Provide Background Information

Offer context and background information to help your readers understand the issue better. For instance:

COVID-19, caused by the novel coronavirus SARS-CoV-2, emerged in late 2019 and quickly spread worldwide, leading to millions of infections and deaths. Vaccination has proven to be an effective tool in curbing the virus's spread and severity.

Step 6: Develop Body Paragraphs

Each body paragraph should present a single point or piece of evidence that supports your thesis statement. Use clear topic sentences , evidence, and analysis. Here's an example:

One compelling reason for implementing COVID-19 vaccination mandates is the overwhelming evidence of vaccine effectiveness. According to a study published in the New England Journal of Medicine, the Pfizer-BioNTech and Moderna vaccines demonstrated an efficacy of over 90% in preventing symptomatic COVID-19 cases. This level of protection not only reduces the risk of infection but also minimizes the virus's impact on healthcare systems.

Step 7: Address Counterarguments

Acknowledge opposing viewpoints and refute them with strong counterarguments. This demonstrates that you've considered different perspectives. For example:

Some argue that vaccination mandates infringe on personal freedoms and autonomy. While individual freedom is a crucial aspect of democratic societies, public health measures have long been implemented to protect the collective well-being. Seatbelt laws, for example, are in place to save lives, even though they restrict personal choice.

Step 8: Write the Conclusion

Summarize your main points and restate your thesis statement in the conclusion. End with a strong call to action or thought-provoking statement. For instance:

In conclusion, COVID-19 vaccination mandates are a crucial step toward controlling the pandemic, protecting public health, and preventing further loss of life. The evidence overwhelmingly supports their effectiveness, and while concerns about personal freedoms are valid, they must be weighed against the greater good of society. It is our responsibility to take collective action to combat this global crisis and move toward a safer, healthier future.

Step 9: Revise and Proofread

Edit your essay for clarity, coherence, grammar, and spelling errors. Ensure that your argument flows logically.

Step 10: Cite Your Sources

Include proper citations and a bibliography page to give credit to your sources.

Remember to adjust your approach and arguments based on your target audience and the specific angle you want to take in your persuasive essay about COVID-19.

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Examples of Persuasive Essay About COVID-19

When writing a persuasive essay about the COVID-19 pandemic, it’s important to consider how you want to present your argument. To help you get started, here are some example essays for you to read:

Here is another example explaining How COVID-19 has changed our lives essay:

The COVID-19 pandemic, which began in late 2019, has drastically altered the way we live. From work and education to social interactions and healthcare, every aspect of our daily routines has been impacted. Reflecting on these changes helps us understand their long-term implications.

COVID-19, caused by the novel coronavirus SARS-CoV-2, is an infectious disease first identified in December 2019 in Wuhan, China. It spreads through respiratory droplets and can range from mild symptoms like fever and cough to severe cases causing pneumonia and death. The rapid spread and severe health impacts have led to significant public health measures worldwide.

The pandemic shifted many to remote work and online education. While some enjoy the flexibility, others face challenges like limited access to technology and blurred boundaries between work and home.

Social distancing and lockdowns have led to increased isolation and mental health issues. However, the pandemic has also fostered community resilience, with people finding new ways to connect and support each other virtually.

Healthcare systems have faced significant challenges, leading to innovations in telemedicine and a focus on public health infrastructure. Heightened awareness of hygiene practices, like handwashing and mask-wearing, has helped reduce the spread of infectious diseases.

COVID-19 has caused severe economic repercussions, including business closures and job losses. While governments have implemented relief measures, the long-term effects are still uncertain. The pandemic has also accelerated trends like e-commerce and contactless payments.

The reduction in travel and industrial activities during lockdowns led to a temporary decrease in pollution and greenhouse gas emissions. This has sparked discussions about sustainable practices and the potential for a green recovery.

COVID-19 has reshaped our lives in numerous ways, affecting work, education, social interactions, healthcare, the economy, and the environment. As we adapt to this new normal, it is crucial to learn from these experiences and work towards a more resilient and equitable future.

Let’s look at another sample essay:

The COVID-19 pandemic has been a transformative event, reshaping every aspect of our lives. In my opinion, while the pandemic has brought immense challenges, it has also offered valuable lessons and opportunities for growth.

One of the most striking impacts has been on our healthcare systems. The pandemic exposed weaknesses and gaps, prompting a much-needed emphasis on public health infrastructure and the importance of preparedness. Innovations in telemedicine and vaccine development have been accelerated, showing the incredible potential of scientific collaboration.

Socially, the pandemic has highlighted the importance of community and human connection. While lockdowns and social distancing measures increased feelings of isolation, they also fostered a sense of solidarity. People found creative ways to stay connected and support each other, from virtual gatherings to community aid initiatives.

The shift to remote work and online education has been another significant change. This transition, though challenging, demonstrated the flexibility and adaptability of both individuals and organizations. It also underscored the importance of digital literacy and access to technology.

Economically, the pandemic has caused widespread disruption. Many businesses closed, and millions lost their jobs. However, it also prompted a reevaluation of business models and work practices. The accelerated adoption of e-commerce and remote work could lead to more sustainable and efficient ways of operating in the future.

In conclusion, the COVID-19 pandemic has been a profound and complex event. While it brought about considerable hardship, it also revealed the strength and resilience of individuals and communities. Moving forward, it is crucial to build on the lessons learned to create a more resilient and equitable world.

Check out some more PDF examples below:

Persuasive Essay About Covid-19 Pandemic

Sample Of Persuasive Essay About Covid-19

Persuasive Essay About Covid-19 In The Philippines - Example

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Examples of Persuasive Essay About COVID-19 Vaccine

Covid19 vaccines are one of the ways to prevent the spread of COVID-19, but they have been a source of controversy. Different sides argue about the benefits or dangers of the new vaccines. Whatever your point of view is, writing a persuasive essay about it is a good way of organizing your thoughts and persuading others.

A persuasive essay about the COVID-19 vaccine could consider the benefits of getting vaccinated as well as the potential side effects.

Below are some examples of persuasive essays on getting vaccinated for Covid-19.

Covid19 Vaccine Persuasive Essay

Persuasive Essay on Covid Vaccines

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Examples of Persuasive Essay About COVID-19 Integration

Covid19 has drastically changed the way people interact in schools, markets, and workplaces. In short, it has affected all aspects of life. However, people have started to learn to live with Covid19.

Writing a persuasive essay about it shouldn't be stressful. Read the sample essay below to get an idea for your own essay about Covid19 integration.

Persuasive Essay About Working From Home During Covid19

Searching for the topic of Online Education? Our persuasive essay about online education is a must-read.

Examples of Argumentative Essay About Covid 19

Covid-19 has been an ever-evolving issue, with new developments and discoveries being made on a daily basis.

Writing an argumentative essay about such an issue is both interesting and challenging. It allows you to evaluate different aspects of the pandemic, as well as consider potential solutions.

Here are some examples of argumentative essays on Covid19.

Argumentative Essay About Covid19 Sample

Argumentative Essay About Covid19 With Introduction Body and Conclusion

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Examples of Persuasive Speeches About Covid-19

Do you need to prepare a speech about Covid19 and need examples? We have them for you!

Persuasive speeches about Covid-19 can provide the audience with valuable insights on how to best handle the pandemic. They can be used to advocate for specific changes in policies or simply raise awareness about the virus.

Check out some examples of persuasive speeches on Covid-19:

Persuasive Speech About Covid-19 Example

Persuasive Speech About Vaccine For Covid-19

You can also read persuasive essay examples on other topics to master your persuasive techniques!

Tips to Write a Persuasive Essay About Covid-19

Writing a persuasive essay about COVID-19 requires a thoughtful approach to present your arguments effectively.

Here are some tips to help you craft a compelling persuasive essay on this topic:

Choose a Specific Angle: Narrow your focus to a specific aspect of COVID-19, like vaccination or public health measures.
Provide Credible Sources: Support your arguments with reliable sources like scientific studies and government reports.
Use Persuasive Language: Employ ethos, pathos, and logos , and use vivid examples to make your points relatable.
Organize Your Essay: Create a solid persuasive essay outline and ensure a logical flow, with each paragraph focusing on a single point.
Emphasize Benefits: Highlight how your suggestions can improve public health, safety, or well-being.
Use Visuals: Incorporate graphs, charts, and statistics to reinforce your arguments.
Call to Action: End your essay conclusion with a strong call to action, encouraging readers to take a specific step.
Revise and Edit: Proofread for grammar, spelling, and clarity, ensuring smooth writing flow.
Seek Feedback: Have someone else review your essay for valuable insights and improvements.

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Common Topics for a Persuasive Essay on COVID-19

Here are some persuasive essay topics on COVID-19:

The Importance of Vaccination Mandates for COVID-19 Control
Balancing Public Health and Personal Freedom During a Pandemic
The Economic Impact of Lockdowns vs. Public Health Benefits
The Role of Misinformation in Fueling Vaccine Hesitancy
Remote Learning vs. In-Person Education: What's Best for Students?
The Ethics of Vaccine Distribution: Prioritizing Vulnerable Populations
The Mental Health Crisis Amidst the COVID-19 Pandemic
The Long-Term Effects of COVID-19 on Healthcare Systems
Global Cooperation vs. Vaccine Nationalism in Fighting the Pandemic
The Future of Telemedicine: Expanding Healthcare Access Post-COVID-19

In search of more inspiring topics for your next persuasive essay? Our persuasive essay topics blog has plenty of ideas!

To sum it up,

You have read good sample essays and got some helpful tips. You now have the tools you needed to write a persuasive essay about Covid-19. So don't let the doubts stop you, start writing!

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Frequently Asked Questions

What is a good title for a covid-19 essay.

A good title for a COVID-19 essay should be clear, engaging, and reflective of the essay's content. Examples include:

"The Impact of COVID-19 on Global Health"
"How COVID-19 Has Transformed Our Daily Lives"
"COVID-19: Lessons Learned and Future Implications"

How do I write an informative essay about COVID-19?

To write an informative essay about COVID-19, follow these steps:

Choose a specific focus: Select a particular aspect of COVID-19, such as its transmission, symptoms, or vaccines.
Research thoroughly: Gather information from credible sources like scientific journals and official health organizations.
Organize your content: Structure your essay with an introduction, body paragraphs, and a conclusion.
Present facts clearly: Use clear, concise language to convey information accurately.
Include visuals: Use charts or graphs to illustrate data and make your essay more engaging.

How do I write an expository essay about COVID-19?

To write an expository essay about COVID-19, follow these steps:

Select a clear topic: Focus on a specific question or issue related to COVID-19.
Conduct thorough research: Use reliable sources to gather information.
Create an outline: Organize your essay with an introduction, body paragraphs, and a conclusion.
Explain the topic: Use facts and examples to explain the chosen aspect of COVID-19 in detail.
Maintain objectivity: Present information in a neutral and unbiased manner.
Edit and revise: Proofread your essay for clarity, coherence, and accuracy.

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Lessons learned: What makes vaccine messages persuasive

You’re reading Lessons Learned, which distills practical takeaways from standout campaigns and peer-reviewed research in health and science communication. Want more Lessons Learned? Subscribe to our Call to Action newsletter .

Vaccine hesitancy threatened public health’s response to the COVID-19 pandemic. Scientists at the University of Maryland recently reviewed 47 randomized controlled trials to determine how COVID-19 communications persuaded—or failed to persuade—people to take the vaccine. ( Health Communication , 2023 DOI: 10.1080/10410236.2023.2218145 ).

What they learned: Simply communicating about the vaccine’s safety or efficacy persuaded people to get vaccinated. Urging people to follow the lead of others, by highlighting how many millions were already vaccinated or even trying to induce embarrassment, was also persuasive.

Why it matters: Understanding which message strategies are likely to be persuasive is crucial.

➡️ Idea worth stealing: The authors found that a message’s source didn’t significantly influence its persuasiveness. But messages were more persuasive when source and receivers shared an identity, such as political affiliation.

What to watch: How other formats, such as interactive chatbots and videos, might influence persuasiveness. And whether message tailoring could persuade specific population subgroups.

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How to convince someone to get the vaccine

Illustration shows an "I got my COVID-19 vaccine" sticker with conversation bubbles

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These are frustrating times. In the span of about a month, American society seemingly went from “we must reserve our precious doses of the vaccine for only the most in need” to “everyone go get one right now.” Today, you can walk into pharmacies and vaccination sites around L.A. and get jabbed in a matter of minutes without an appointment.

There’s a shot available for everyone who wants one. But what about the people who don’t?

If your friend, neighbor, coworker or loved one hasn’t gotten their COVID vaccine yet, they probably have a reason. Identifying that reason is key to getting them to get their shot, experts say.

If you want them to change their mind, you cannot approach the conversation as a debate in which, if your case is presented with sufficient evidence, your opponent loses and is sentenced to mandatory vaccination. You are having a discussion and trying to meet the other person where they are, understand their position, and talk with them (not at them!) about their concerns.

It has to come from a place of love, not hostility.

FILE - In this April 10, 2021, file photo, registered nurse Ashleigh Velasco, left, administers the Johnson & Johnson COVID-19 vaccine to Rosemene Lordeus, right, at a clinic held by Healthcare Network in Immokalee, Fla. Fewer Americans are reluctant to get a COVID-19 vaccine than just a few months ago, but questions about side effects and how the shots were tested still hold some back, according to a new poll that highlights the challenges at a pivotal moment in the U.S. vaccination campaign. (AP Photo/Lynne Sladky, File)

World & Nation

Most U.S. residents who remain unvaccinated will need convincing, poll finds

Fewer Americans are reluctant to get a COVID-19 vaccine than a few months ago, but questions about side effects and safety still hold some back.

May 11, 2021

“The first thing I would say is to listen first, not to tell them,” Dr. Chandra Ford, a professor of community health sciences at UCLA Fielding School of Public Health, told my colleague Thuc Nhi Nguyen . “We have to meet people where they are, so we have to actually hear where they are first.”

So Step One is listening. Ask: “Why aren’t you vaccinated?” Hear the person out. It’s fair to have concerns right now. The whole world changed in the last 15 months, then changed some more, then changed again. Saying “you’re being stupid, trust the science, just go get vaccinated already” is unlikely to be persuasive.

Laura Huang is a professor of business administration at Harvard Business School who studied how to change people’s minds while doing research for her book “Edge: Turning Adversity into Advantage.” She said her research showed that people who were most effective in persuading someone to come around to their point of view did so by recognizing the root of the disagreement and trying to overcome it before trying to change the person’s mind. Reservations are probably based in both logic (Is the vaccine really safe? How did they get made so quickly? How do we know what the long-term side effects are if it’s so new?) and emotion ( fear, anxiety , frustration, anger). You need to enter the conversation prepared to address concerns on both fronts.

“The psychology of changing someone’s mind require a high level of emotional intelligence and logical thinking,” Huang said in an email. “When you come out the gate telling people they are incorrect about something they believe, this can come off as insulting and condescending, which often results in the other person losing interest in engaging with you productively.”

You need to determine which sources of information they trust. The global communications firm Edelman does an annual “ trust barometer ” to gauge where people are getting their information and which sources they trust. The places where you get your information are not going to be the same as everyone else’s.

Trust in media sources, the government, and non-governmental organizations fell globally, the report found.

“People have come to know and trust the information that they believe, and they don’t believe the sources that are coming from sort of the ‘other side,’” said Courtney Gray Haupt, who runs the U.S. healthcare team at Edelman.

In other words, if your friend doesn’t trust what he reads in newspapers, sending him an article about how safe and effective vaccines are will not be compelling.

So whom do people trust? Gray Haupt said the research showed a lot of the most trusted voices were local ones. Scientists ranked at the top, then “people in my community,” then “my employer.”

“To address hesitancy,” she said, “people have to hear those local, personal and relatable stories about vaccinations, and how it benefits not just themselves, but how it’s benefiting others around them in their community.”

That’s where you come in.

LOS ANGELES, CA - MARCH 24, 2021: Magic Johnson gives a thumbs up after getting a vaccine from Los Angeles Fire Chief Ralph Terrazas on the rooftop of parking structure at USC as a part of a vaccination awareness event at USC on March 24, 2021 in Los Angeles, California. L.A. Mayor Eric Garcetti is in the background. (Gina Ferazzi / Los Angeles Times)

Science & Medicine

VIDEO: Southern Californians had vaccine questions. We got a virologist and an ob/gyn to answer

We traveled around the L.A. region to ask people whether or not they would take the vaccine, and if not, why. Then we posed their questions to two experts. Here’s what they said.

March 25, 2021

Meet them where they are – and make it easy for them

As a (presumably) vaccinated person yourself, you are a living, breathing example of the benefits of getting the COVID-19 shot. Focus on the big-picture positives:

The vaccine is safe and free.
Your chance of dying from or being hospitalized with COVID-19 drops to nearly zero with the vaccine.
You’re protecting yourself and the people around you.
As more people are vaccinated, schools and businesses can continue to safely reopen.
And fully vaccinated people can stop wearing masks as much , like President Biden:

The first maskless photo of President Biden and Vice President Harris. pic.twitter.com/y846ACA2ll — Christopher Hale (@chrisjollyhale) May 13, 2021

There are levels of concern and hesitancy right now. It’s possible that getting vaccinated just isn’t a priority for your aunt, and she hasn’t made time to do it yet. Or your cousin doesn’t know where to go or how she’ll get there. Your brother might be afraid of needles or of having a reaction and being unable to get home after.

Lower those barriers: Offer to find the nearest place to get an appointment and make it. Also offer to go along or give a ride. Some people just need a helping hand and a friendly face. Around the country, there are regional incentives such as free doughnuts and a $1-million lottery . You might not be able to offer that, but saying you’ll buy lunch after probably wouldn’t hurt.

In addition to finding out whom people trust, assess what they value. When I asked on Twitter how people had persuaded reluctant relatives to get vaccinated, a lot of people said they were able to focus on the potential upsides. Getting vaccinated can mean being able to hug your parents again , or hold a grandchild for the first time. For others, it means freedom to travel to other countries. If someone is worried about getting vaccinated because of the side effects, compare the potential outcomes of vaccination with the effects of getting COVID .

If you’re an employer, you have the potential to play an outsize role in motivating people to get the vaccine. Share your story of getting vaccinated with your employees, and offer time off to get vaccinated and deal with any potential side effects. Offer to talk one on one with employees who still aren’t sure.

President Joe Biden speaks about the economy, in the East Room of the White House, Monday, May 10, 2021, in Washington. (AP Photo/Evan Vucci)

Biden announces Uber, Lyft rides amid July 4 vaccine push

Biden last week set a goal of delivering at least one dose of vaccine to 70% of adult Americans and fully vaccinating at least 160 million by July 1.

If someone has deeper concerns, ask about them. Huang suggested open-ended questions, such as: “Can you help me understand where you stand on vaccines?” or “Help me understand why we disagree on this.” Point to trustworthy sources that answer a person’s questions. For instance, The Times asked a virologist and an ob-gyn for answers to some common vaccine-related questions : “What do we know about long-term effects?” and “Will vaccines affect fertility?”

On Twitter, journalist Amanda Del Cid Lugo sent me the link for a YouTube playlist she’d created of videos about things like side effects, safety, and how mRNA vaccines work from a variety of sources.

It’s fair to have questions right now, UCLA’s Ford said.

“A lot of information about the benefits of getting vaccinated are there, but some questions that might not be addressed in our general discussion about the vaccine and the way we hear people talk about it in the media when we’re really trying to promote vaccination is you don’t really address some of the concerns,” she said. When it comes to questions about safety, “I think these are legitimate questions that a consumer has a right to ask.”

Dr. Rita Burke, an assistant professor of clinical preventive medicine at USC Keck School of Medicine, said the chief concern she heard was about the vaccines’ safety .

“In that case, it’s really important to explain to the person that the technology that’s enabled us to develop a vaccine so quickly has been in place and was in development many, many years ago ,” she said in an interview with The Times. “So the safety of the vaccine was in no way compromised in order to deliver it so quickly.”

With this type of person — someone who would not describe themselves as broadly anti-vaccine but has valid questions about this one specifically — Huang recommends what she calls a “cognitive conversation”: Listen to their issues and reasons for hesitancy, then share information on things like vaccine safety , how mRNA technology works (here’s a cool YouTube video that demonstrates it), and how we were able to develop and test these vaccines in a comparatively short period of time. (I’ve added some links here to get you started, but again, you should be listening to the person you’re trying to persuade and finding sources they trust, not just sending links to the ones you like. This information is in lots of trustworthy places around the internet.) Then help them make an appointment.

This should go without saying, but: Don’t gloat.

Lakewood, CA - March 31: Johnson & Johnson COVID-19 vaccine given to seniors at coronavirus vaccination clinic established by L.A. County Department of Public Health at Whispering Fountains Senior Living Community on Wednesday, March 31, 2021 in Lakewood, CA.(Irfan Khan / Los Angeles Times)

Shorter lines and TikTok ads: California’s push to beat vaccine hesitancy

California is hiring 2,000 canvassers to phone-bank and knock on doors, and is running a flurry of ads and testimonials about COVID-19 vaccines.

May 10, 2021

Changing someone’s mind is really hard . Set your expectations accordingly.

There is no surefire formula for persuading someone to get vaccinated. It’s possible the outcome of your conversation will result in the other person not changing their mind one bit. That doesn’t mean that you failed. You’re serving as a data point in favor of the “get vaccinated” side. Maybe in a month, or six months, or when they’re trying to go on vacation or to a concert or sporting event somewhere that requires a vaccine passport, they’ll be more open to rethinking things.

Again, hesitancy has levels. If you’re talking to someone who is firmly in an alternate-information bubble, you might not be able to overcome beliefs based on conspiracy theories and unfounded rumors.

Lonnie G. Bunch III, the secretary of the Smithsonian, said in a Twitter thread addressing vaccine hesitancy to “keep your expectations modest. Set an achievable goal, such as opening the topic, not changing minds in one chat.”

If they hear from you, and then another person, and then another person, all of whom are enjoying the benefits of vaccination without any of the frightening potential downsides they might have heard about, that can help them realize it might be time to reassess where they’re getting their information from. Some people will just need more time.

Every person who shares a vaccination story, and the benefits of being vaccinated, serves as a positive example and a good steward of public health. That’s right: Posting your smiling vaccine selfie is downright virtuous.

More COVID shots are coming. Will a weary public be more interested this year?

Sept. 13, 2023

LOS ANGELES, CA - MAY 05: Allan Fernandez, 7, middle, reacts after Dr, David Bolour, left, gives him a vaccination as CDC Director Dr. Rochelle Walensky looks on in Ted Watkins Memorial Park on Thursday, May 5, 2022 in Los Angeles, CA. CDC Director Dr. Rochelle Walensky visted a health department vaccination site in the park. Afterwards she walked into the park and watches children and their parents being vaccinated in the park by an outreach team from the near by site. (Francine Orr / Los Angeles Times)

How to get more people vaccinated? ‘You stop talking and you listen,’ Walensky says

May 5, 2022

A resident receives a Covid-19 booster shot at a vaccine clinic inside Trinity Evangelic Lutheran Church in Lansdale, Pennsylvania, U.S, on Tuesday, Apr. 5, 2022. U.S. regulators cleared second booster doses of Covid-19 vaccine from Moderna Inc. and the partnership of Pfizer Inc. and BioNTech SE for adults 50 and older, making millions more people eligible for the shots as concern grows about a potential new wave of infections. Photographer: Hannah Beier/Bloomberg via Getty Images

Editorial: Confused about the second COVID booster? So are some of the experts

April 19, 2022

persuasive speech about covid 19 vaccine brainly

Jessica Roy is a former assistant editor on the West Coast Experiences team at the Los Angeles Times. Previously, Roy was an assistant editor on the Utility Journalism team and an editor on the audience engagement team.

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Presidential Speeches

September 9, 2021: remarks on fighting the covid-⁠19 pandemic, about this speech.

September 09, 2021

As the Delta variant of the Covid-19 virus spreads and cases and deaths increase in the United States, President Joe Biden announces new efforts to fight the pandemic. He outlines six broad areas of action--implementing new vaccination requirements, protecting the vaccinated with booster shots, keeping children safe and schools open, increasing testing and masking, protecting our economic recovery, and improving care of those who do get Covid-19.

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THE PRESIDENT: Good evening, my fellow Americans. I want to talk to you about where we are in the battle against COVID-19, the progress we’ve made, and the work we have left to do.

And it starts with understanding this: Even as the Delta variant 19 [sic] has—COVID-19—has been hitting this country hard, we have the tools to combat the virus, if we can come together as a country and use those tools.

If we raise our vaccination rate, protect ourselves and others with masking and expanded testing, and identify people who are infected, we can and we will turn the tide on COVID-19.

It will take a lot of hard work, and it’s going to take some time. Many of us are frustrated with the nearly 80 million Americans who are still not vaccinated, even though the vaccine is safe, effective, and free.

You might be confused about what is true and what is false about COVID-19. So before I outline the new steps to fight COVID-19 that I’m going to be announcing tonight, let me give you some clear information about where we stand.

First, we have cons—we have made considerable progress

in battling COVID-19. When I became President, about 2 million Americans were fully vaccinated. Today, over 175 million Americans have that protection.

Before I took office, we hadn’t ordered enough vaccine for every American. Just weeks in office, we did. The week before I took office, on January 20th of this year, over 25,000 Americans died that week from COVID-19. Last week, that grim weekly toll was down 70 percent.

And in the three months before I took office, our economy was faltering, creating just 50,000 jobs a month. We’re now averaging 700,000 new jobs a month in the past three months.

This progress is real. But while America is in much better shape than it was seven months ago when I took office, I need to tell you a second fact.

We’re in a tough stretch, and it could last for a while. The highly contagious Delta variant that I began to warn America about back in July spread in late summer like it did in other countries before us.

While the vaccines provide strong protections for the vaccinated, we read about, we hear about, and we see the stories of hospitalized people, people on their death beds, among the unvaccinated over these past few weeks.

This is a pandemic of the unvaccinated. And it’s caused by the fact that despite America having an unprecedented and successful vaccination program, despite the fact that for almost five months free vaccines have been available in 80,000 different locations, we still have nearly 80 million Americans who have failed to get the shot.

And to make matters worse, there are elected officials actively working to undermine the fight against COVID-19. Instead of encouraging people to get vaccinated and mask up, they’re ordering mobile morgues for the unvaccinated dying from COVID in their communities. This is totally unacceptable.

Third, if you wonder how all this adds up, here’s the math: The vast majority of Americans are doing the right thing. Nearly three quarters of the eligible have gotten at least one shot, but one quarter has not gotten any. That’s nearly 80 million Americans not vaccinated. And in a country as large as ours, that’s 25 percent minority. That 25 percent can cause a lot of damage—and they are.

The unvaccinated overcrowd our hospitals, are overrunning the emergency rooms and intensive care units, leaving no room for someone with a heart attack, or pancreitis [pancreatitis], or cancer.

And fourth, I want to emphasize that the vaccines provide very strong protection from severe illness from COVID-19. I know there’s a lot of confusion and misinformation. But the world’s leading scientists confirm that if you are fully vaccinated, your risk of severe illness from COVID-19 is very low.

In fact, based on available data from the summer, only one of out of every 160,000 fully vaccinated Americans was hospitalized for COVID per day.

These are the facts.

So here’s where we stand: The path ahead, even with the Delta variant, is not nearly as bad as last winter. But what makes it incredibly more frustrating is that we have the tools to combat COVID-19, and a distinct minority of Americans –supported by a distinct minority of elected officials—are keeping us from turning the corner. These pandemic politics, as I refer to, are making people sick, causing unvaccinated people to die.

We cannot allow these actions to stand in the way of protecting the large majority of Americans who have done their part and want to get back to life as normal.

As your President, I’m announcing tonight a new plan to require more Americans to be vaccinated, to combat those blocking public health.

My plan also increases testing, protects our economy, and will make our kids safer in schools. It consists of six broad areas of action and many specific measures in each that—and each of those actions that you can read more about at WhiteHouse.gov. WhiteHouse.gov.

The measures—these are going to take time to have full impact. But if we implement them, I believe and the scientists indicate, that in the months ahead we can reduce the number of unvaccinated Americans, decrease hospitalizations and deaths, and allow our children to go to school safely and keep our economy strong by keeping businesses open.

First, we must increase vaccinations among the unvaccinated with new vaccination requirements. Of the nearly 80 million eligible Americans who have not gotten vaccinated, many said they were waiting for approval from the Food and Drug Administration—the FDA. Well, last month, the FDA granted that approval.

So, the time for waiting is over. This summer, we made progress through the combination of vaccine requirements and incentives, as well as the FDA approval. Four million more people got their first shot in August than they did in July.

But we need to do more. This is not about freedom or personal choice. It’s about protecting yourself and those around you—the people you work with, the people you care about, the people you love.

My job as President is to protect all Americans.

So, tonight, I’m announcing that the Department of Labor is developing an emergency rule to require all employers with 100 or more employees, that together employ over 80 million workers, to ensure their workforces are fully vaccinated or show a negative test at least once a week.

Some of the biggest companies are already requiring this: United Airlines, Disney, Tysons Food, and even Fox News.

The bottom line: We’re going to protect vaccinated workers from unvaccinated co-workers. We’re going to reduce the spread of COVID-19 by increasing the share of the workforce that is vaccinated in businesses all across America.

My plan will extend the vaccination requirements that I previously issued in the healthcare field. Already, I’ve announced, we’ll be requiring vaccinations that all nursing home workers who treat patients on Medicare and Medicaid, because I have that federal authority.

Tonight, I’m using that same authority to expand that to cover those who work in hospitals, home healthcare facilities, or other medical facilities–a total of 17 million healthcare workers.

If you’re seeking care at a health facility, you should be able to know that the people treating you are vaccinated. Simple. Straightforward. Period.

Next, I will sign an executive order that will now require all executive branch federal employees to be vaccinated—all. And I’ve signed another executive order that will require federal contractors to do the same.

If you want to work with the federal government and do business with us, get vaccinated. If you want to do business with the federal government, vaccinate your workforce.

And tonight, I’m removing one of the last remaining obstacles that make it difficult for you to get vaccinated.

The Department of Labor will require employers with 100 or more workers to give those workers paid time off to get vaccinated. No one should lose pay in order to get vaccinated or take a loved one to get vaccinated.

Today, in total, the vaccine requirements in my plan will affect about 100 million Americans—two thirds of all workers.

And for other sectors, I issue this appeal: To those of you running large entertainment venues—from sports arenas to concert venues to movie theaters—please require folks to get vaccinated or show a negative test as a condition of entry.

And to the nation’s family physicians, pediatricians, GPs—general practitioners—you’re the most trusted medical voice to your patients. You may be the one person who can get someone to change their mind about being vaccinated.

Tonight, I’m asking each of you to reach out to your unvaccinated patients over the next two weeks and make a personal appeal to them to get the shot. America needs your personal involvement in this critical effort.

And my message to unvaccinated Americans is this: What more is there to wait for? What more do you need to see? We’ve made vaccinations free, safe, and convenient.

The vaccine has FDA approval. Over 200 million Americans have gotten at least one shot.

We’ve been patient, but our patience is wearing thin. And your refusal has cost all of us. So, please, do the right thing. But just don’t take it from me; listen to the voices of unvaccinated Americans who are lying in hospital beds, taking their final breaths, saying, “If only I had gotten vaccinated.” “If only.”

It’s a tragedy. Please don’t let it become yours.

The second piece of my plan is continuing to protect the vaccinated.

For the vast majority of you who have gotten vaccinated, I understand your anger at those who haven’t gotten vaccinated. I understand the anxiety about getting a “breakthrough” case.

But as the science makes clear, if you’re fully vaccinated, you’re highly protected from severe illness, even if you get COVID-19.

In fact, recent data indicates there is only one confirmed positive case per 5,000 fully vaccinated Americans per day.

You’re as safe as possible, and we’re doing everything we can to keep it that way—keep it that way, keep you safe.

That’s where boosters come in—the shots that give you even more protection than after your second shot.

Now, I know there’s been some confusion about boosters. So, let me be clear: Last month, our top government doctors announced an initial plan for booster shots for vaccinated Americans. They believe that a booster is likely to provide the highest level of protection yet.

Of course, the decision of which booster shots to give, when to start them, and who will give them, will be left completely to the scientists at the FDA and the Centers for Disease Control.

But while we wait, we’ve done our part. We’ve bought enough boosters—enough booster shots—and the distribution system is ready to administer them.

As soon as they are authorized, those eligible will be able to get a booster right away in tens of thousands of site across the—sites across the country for most Americans, at your nearby drug store, and for free.

The third piece of my plan is keeping—and maybe the most important—is keeping our children safe and our schools open. For any parent, it doesn’t matter how low the risk of any illness or accident is when it comes to your child or grandchild. Trust me, I know.

So, let me speak to you directly. Let me speak to you directly to help ease some of your worries.

It comes down to two separate categories: children ages 12 and older who are eligible for a vaccine now, and children ages 11 and under who are not are yet eligible.

The safest thing for your child 12 and older is to get them vaccinated. They get vaccinated for a lot of things. That’s it. Get them vaccinated.

As with adults, almost all the serious COVID-19 cases we’re seeing among adolescents are in unvaccinated 12- to 17-year-olds—an age group that lags behind in vaccination rates.

So, parents, please get your teenager vaccinated.

What about children under the age of 12 who can’t get vaccinated yet? Well, the best way for a parent to protect their child under the age of 12 starts at home. Every parent, every teen sibling, every caregiver around them should be vaccinated.

Children have four times higher chance of getting hospitalized if they live in a state with low vaccination rates rather than the states with high vaccination rates.

Now, if you’re a parent of a young child, you’re wondering when will it be—when will it be—the vaccine available for them. I strongly support an independent scientific review for vaccine uses for children under 12. We can’t take shortcuts with that scientific work.

But I’ve made it clear I will do everything within my power to support the FDA with any resource it needs to continue to do this as safely and as quickly as possible, and our nation’s top doctors are committed to keeping the public at large updated on the process so parents can plan.

Now to the schools. We know that if schools follow the science and implement the safety measures—like testing, masking, adequate ventilation systems that we provided the money for, social distancing, and vaccinations—then children can be safe from COVID-19 in schools.

Today, about 90 percent of school staff and teachers are vaccinated. We should get that to 100 percent. My administration has already acquired teachers at the schools run by the Defense Department—because I have the authority as President in the federal system—the Defense Department and the Interior Department—to get vaccinated. That’s authority I possess.

Tonight, I’m announcing that we’ll require all of nearly 300,000 educators in the federal paid program, Head Start program, must be vaccinated as well to protect your youngest—our youngest—most precious Americans and give parents the comfort.

And tonight, I’m calling on all governors to require vaccination for all teachers and staff. Some already have done so, but we need more to step up.

Vaccination requirements in schools are nothing new. They work. They’re overwhelmingly supported by educators and their unions. And to all school officials trying to do the right thing by our children: I’ll always be on your side.

Let me be blunt. My plan also takes on elected officials and states that are undermining you and these lifesaving actions. Right now, local school officials are trying to keep children safe in a pandemic while their governor picks a fight with them and even threatens their salaries or their jobs. Talk about bullying in schools. If they’ll not help—if these governors won’t help us beat the pandemic, I’ll use my power as President to get them out of the way.

The Department of Education has already begun to take legal action against states undermining protection that local school officials have ordered. Any teacher or school official whose pay is withheld for doing the right thing, we will have that pay restored by the federal government 100 percent. I promise you I will have your back.

The fourth piece of my plan is increasing testing and masking. From the start, America has failed to do enough COVID-19 testing. In order to better detect and control the Delta variant, I’m taking steps tonight to make testing more available, more affordable, and more convenient. I’ll use the Defense Production Act to increase production of rapid tests, including those that you can use at home.

While that production is ramping up, my administration has worked with top retailers, like Walmart, Amazon, and Kroger’s, and tonight we’re announcing that, no later than next week, each of these outlets will start to sell at-home rapid test kits at cost for the next three months. This is an immediate price reduction for at-home test kits for up to 35 percent reduction.

We’ll also expand—expand free testing at 10,000 pharmacies around the country. And we’ll commit—we’re committing $2 billion to purchase nearly 300 million rapid tests for distribution to community health centers, food banks, schools, so that every American, no matter their income, can access free and convenient tests. This is important to everyone, particularly for a parent or a child—with a child not old enough to be vaccinated. You’ll be able to test them at home and test those around them.

In addition to testing, we know masking helps stop the spread of COVID-19. That’s why when I came into office, I required masks for all federal buildings and on federal lands, on airlines, and other modes of transportation.

Today—tonight, I’m announcing that the Transportation Safety Administration—the TSA—will double the fines on travelers that refuse to mask. If you break the rules, be prepared to pay.

And, by the way, show some respect. The anger you see on television toward flight attendants and others doing their job is wrong; it’s ugly.

The fifth piece of my plan is protecting our economic recovery. Because of our vaccination program and the American Rescue Plan, which we passed early in my administration, we’ve had record job creation for a new administration, economic growth unmatched in 40 years. We cannot let unvaccinated do this progress—undo it, turn it back.

So tonight, I’m announcing additional steps to strengthen our economic recovery. We’ll be expanding COVID-19 Economic Injury Disaster Loan programs. That’s a program that’s going to allow small businesses to borrow up to $2 million from the current $500,000 to keep going if COVID-19 impacts on their sales.

These low-interest, long-term loans require no repayment for two years and be can used to hire and retain workers, purchase inventory, or even pay down higher cost debt racked up since the pandemic began. I’ll also be taking additional steps to help small businesses stay afloat during the pandemic.

Sixth, we’re going to continue to improve the care of those who do get COVID-19. In early July, I announced the deployment of surge response teams. These are teams comprised of experts from the Department of Health and Human Services, the CDC, the Defense Department, and the Federal Emergency Management Agency—FEMA—to areas in the country that need help to stem the spread of COVID-19.

Since then, the federal government has deployed nearly 1,000 staff, including doctors, nurses, paramedics, into 18 states. Today, I’m announcing that the Defense Department will double the number of military health teams that they’ll deploy to help their fellow Americans in hospitals around the country.

Additionally, we’re increasing the availability of new medicines recommended by real doctors, not conspir-—conspiracy theorists. The monoclonal antibody treatments have been shown to reduce the risk of hospitalization by up to 70 percent for unvaccinated people at risk of developing sefe-—severe disease.

We’ve already distributed 1.4 million courses of these treatments to save lives and reduce the strain on hospitals. Tonight, I’m announcing we will increase the average pace of shipment across the country of free monoclonal antibody treatments by another 50 percent.

Before I close, let me say this: Communities of color are disproportionately impacted by this virus. And as we continue to battle COVID-19, we will ensure that equity continues to be at the center of our response. We’ll ensure that everyone is reached. My first responsibility as President is to protect the American people and make sure we have enough vaccine for every American, including enough boosters for every American who’s approved to get one.

We also know this virus transcends borders. That’s why, even as we execute this plan at home, we need to continue fighting the virus overseas, continue to be the arsenal of vaccines.

We’re proud to have donated nearly 140 million vaccines over 90 countries, more than all other countries combined, including Europe, China, and Russia combined. That’s American leadership on a global stage, and that’s just the beginning.

We’ve also now started to ship another 500 million COVID vaccines—Pfizer vaccines—purchased to donate to 100 lower-income countries in need of vaccines. And I’ll be announcing additional steps to help the rest of the world later this month.

As I recently released the key parts of my pandemic preparedness plan so that America isn’t caught flat-footed when a new pandemic comes again—as it will—next month, I’m also going to release the plan in greater detail.

So let me close with this: We have so-—we’ve made so much progress during the past seven months of this pandemic. The recent increases in vaccinations in August already are having an impact in some states where case counts are dropping in recent days. Even so, we remain at a critical moment, a critical time. We have the tools. Now we just have to finish the job with truth, with science, with confidence, and together as one nation.

Look, we’re the United States of America. There’s nothing—not a single thing—we’re unable to do if we do it together. So let’s stay together.

God bless you all and all those who continue to serve on the frontlines of this pandemic. And may God protect our troops.

Get vaccinated.

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Getting the COVID-19 Vaccine

This article is part of a series of explainers on vaccine development and distribution. Learn more about vaccines – from how they work and how they’re made to ensuring safety and equitable access – in WHO’s Vaccines Explained series.

Vaccines are a critical tool in the battle against COVID-19, and getting vaccinated is one of the best ways to protect yourself and others from COVID-19.

Getting vaccinated is safer than getting infected

Vaccines train our immune system to recognize the targeted virus and create antibodies to fight off the disease without getting the disease itself. After vaccination, the body is ready to fight the virus if it is later exposed to it, thereby preventing illness.

Most people who are infected with SARS-CoV-2, the virus that causes COVID-19, develop an immune response within the first few weeks, but we are still learning how strong and lasting that immune response is, and how it varies between different people.

People who have already been infected with SARS-CoV-2 should still get vaccinated unless told otherwise by their health care provider. Even if you’ve had a previous infection, the vaccine acts as a booster that strengthens the immune response. There have also been some instances of people infected with SARS-CoV-2 a second time, which makes getting vaccinated even more important.

What to expect during vaccination

Medical professionals can best advise individuals on whether or not, and when, they should receive a vaccine. A health worker will administer the vaccine, and the person receiving it will be asked to wait for 15–30 minutes before leaving the vaccination site. This is so that health workers can observe individuals for any unexpected reactions following vaccination.

Like any vaccine, COVID-19 vaccines can cause mild-to-moderate side effects, such as a low-grade fever or pain or redness at the injection site. These should go away on their own within a few days. See WHO’s Safety of COVID-19 Vaccines explainer and Vaccines Safety Q&A to learn more about common side effects and find out who should consult with a doctor before vaccination.

Vaccine doses

For some COVID-19 vaccines, two doses are required . It’s important to get the second dose if the vaccine requires two doses.

For vaccines that require two doses, the first dose presents antigens – proteins that stimulate the production of antibodies – to the immune system for the first time. Scientists call this priming the immune response. The second dose acts as a booster, ensuring the immune system develops a memory response to fight off the virus if it encounters it again.

Because of the urgent need for a COVID-19 vaccine, initial clinical trials of vaccine candidates were performed with the shortest possible duration between doses. Therefore an interval of 21–28 days (3–4 weeks) between doses is recommended by WHO. Depending on the vaccine, the interval may be extended for up to 42 days – or even up to 12 weeks for some vaccines – on the basis of current evidence.

There are many COVID-19 vaccines being developed and produced by different manufacturers around the world. WHO recommends that a vaccine from the same manufacturer be used for both doses if you require two doses. This recommendation may be updated as further information becomes available.

Safety against infection and transmission after vaccination

Available clinical trials have shown COVID-19 vaccines to be safe and highly effective at preventing severe disease. Given how new COVID-19 is, researchers are still looking into how long a vaccinated person is likely to be protected from infection, and whether vaccinated people can still transmit the virus to others. As the vaccine rollout expands, WHO will continue to monitor the data alongside regulatory authorities.

Safe and effective vaccines are making a significant contribution to preventing severe disease and death from COVID-19. As vaccines are rolling out and immunity is building, it is important to continue to follow all of the recommended measures that reduce the spread of SARS-CoV-2. This includes physically distancing yourself from others; wearing a mask, especially in crowded and poorly ventilated settings; cleaning your hands frequently; covering any cough or sneeze in your bent elbow; and opening windows when indoors.

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The Morning Newsletter

Vaccine Persuasion

Many vaccine skeptics have changed their minds.

By David Leonhardt

When the Kaiser Family Foundation conducted a poll at the start of the year and asked American adults whether they planned to get vaccinated, 23 percent said no.

But a significant portion of that group — about one quarter of it — has since decided to receive a shot. The Kaiser pollsters recently followed up and asked these converts what led them to change their minds . The answers are important, because they offer insight into how the millions of still unvaccinated Americans might be persuaded to get shots, too.

First, a little background: A few weeks ago, it seemed plausible that Covid-19 might be in permanent retreat, at least in communities with high vaccination rates. But the Delta variant has changed the situation. The number of cases is rising in all 50 states .

Although vaccinated people remain almost guaranteed to avoid serious symptoms, Delta has put the unvaccinated at greater risk of contracting the virus — and, by extension, of hospitalization and death. The Covid death rate in recent days has been significantly higher in states with low vaccination rates than in those with higher rates:

(For more detailed state-level charts, see this piece by my colleagues Lauren Leatherby and Amy Schoenfeld Walker. The same pattern is evident at the county level, as the health policy expert Charles Gaba has been explaining on Twitter.)

Nationwide, more than 99 percent of recent deaths have occurred among unvaccinated people, and more than 97 percent of recent hospitalizations have occurred among the unvaccinated, according to the C.D.C. “Look,” President Biden said on Friday, “the only pandemic we have is among the unvaccinated.”

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What is Public Health?

A Top Vaccine Expert Answers Important Questions About a COVID-19 Vaccine

The covid-19 vaccine is on track to become the fastest-developed vaccine in history. that doesn’t mean the process is skipping any critical steps..

Understanding what we know—and still don’t—about a vaccine for COVID-19 can help shed light on its safety and efficacy.

Ruth Karron, MD , is one of the top vaccine experts in the world, serving on vaccine committees for the CDC, the WHO, and the FDA. Karron, who leads the Center for Immunization Research at the Johns Hopkins Bloomberg School of Public Health, recently spoke with Josh Sharfstein and answered a list of important questions about the COVID-19 vaccine.

How close are we to a vaccine?

There are some very encouraging developments. We have a few vaccines now that will go into Phase 3 clinical trials, also known as efficacy trials. That means that those vaccines have passed certain goalposts in terms of initial evaluations of safety and immune response such that they can be evaluated in larger trials.

We know that these vaccines are promising, but we don’t yet know if they are going to work. That’s what the purpose of an efficacy trial is—as well as to provide a broader assessment of safety of the vaccine in a large number of people.

Tell me more about these efficacy trials. What do they actually entail?

They involve large numbers of people: In these particular trials for COVID vaccines, there are going to be about 30,000 people enrolled per trial. Individuals are given a vaccine, and then they are followed both to make sure that the side effects from the vaccine are acceptable and to see whether they develop a SARS-CoV-2 infection along with some symptoms.

These are placebo-controlled trials, meaning that some individuals will get a COVID vaccine and some will get a placebo. Then, the rates of disease will be compared in the people who got placebo and the people who got the vaccine to determine the efficacy of the vaccine.

How successful does a vaccine have to be in one of these studies for it to be considered effective?

Recently, the FDA issued guidance about the development of COVID vaccines. The guidance that they issued to vaccine manufacturers— this is a document that is available to the general public —is that a vaccine would need to be at least 50% effective. This means that an individual who was vaccinated would be 50% less likely to get COVID disease—or whatever the particular endpoint is that’s measured in the trial—than individuals that weren’t vaccinated.

This is a reasonable goal for a number of reasons. Typically, the more severe a disease is, the better chance a vaccine has of preventing that disease. So, a vaccine that’s 50% effective against mild COVID disease—which might be the endpoint that’s measured in a clinical trial, or any evidence of COVID infection with any symptom, which is how a lot of trials are designed—might be more effective against severe disease.

When you have a disease that’s as prevalent as COVID—and if we think about what the U.S. has experienced in the past several months in terms of severe disease and death—even if we were only able to cut those numbers in half, that would be a major achievement.

How long would a vaccine be effective for? If you get 50% effectiveness or more, that’s good news. But if it’s only effective for a few months, that’s not such good news.

Time will tell for that. The short answer is that we don’t yet know. Even for the data we have on the vaccine so far in smaller studies, we haven’t yet had the opportunity to follow individuals for very long. The very first people who got the very first vaccine were immunized in March and it’s only July. So, we don’t know very much about the durability of the immune response in people.

Our hope would be [that protection would last] at least a year or more and then people might need boosters.

It’s also possible that a vaccine might not entirely protect against mild disease. So you might actually experience mild disease and then have a boost in your immune response and not suffer severe disease. From a public health perspective, that would be completely acceptable. If we turned a severe disease not into “ no disease ” but into mild disease, that would be a real victory.

Let’s talk about safety. What are they looking for in a 30,000-person study to figure out whether a vaccine is considered safe enough to use?

Every person who is enrolled in the trial will complete information about the kinds of acute symptoms that you might expect following an infection. People will need to provide information about swelling, redness, tenderness around the injection site, fever, and any other symptoms they might experience in the three to seven days following vaccination.

More long term, people will be looking to make sure that when COVID disease is experienced, there’s not any evidence of more severe disease with vaccination [which is known as disease enhancement].

There was a lot of discussion as these vaccines were being developed of a concern about disease enhancement. This is based on some animal models—not with SARS-CoV-2 but with other coronaviruses. We haven’t seen any evidence of enhanced disease thus far and there are a number of scientific reasons why we don’t think it should occur with these vaccines. But, of course, it’s something we would still watch for very carefully just as with any other safety signal.

How should we think about the possibility of adverse effects that might come up after the period of the vaccine trial?

There are a couple of things to mention about that, and one is that individuals with these trials will be followed for a year or longer. It may be that a vaccine is either approved for emergency use or licensed before all of that long-term follow up is completed. Nevertheless, companies will be obligated to complete that follow up and report those results back to the FDA.

It’s important to enroll older adults in these studies. All of these large efficacy trials will be stratified so there will be some younger adults and some older adults enrolled.

In addition, it’s very likely—and this would not just happen with COVID vaccines, but whenever the FDA licenses vaccines—that there is an obligation for post-licensure assessments. If a COVID vaccine is licensed, the companies will work with the FDA to determine exactly what kind of post-licensure safety assessments will need to be done.

COVID affects certain populations more than others—particularly older adults and people with chronic illnesses. What do these studies need [in order] to address the question of whether a vaccine will be protective for them?

I also think it will be important to enroll older adults across an age span. A 65-year-old is not the same as an 85-year-old. Also, a healthy older adult is not the same as a frail older adult who might be living in a care facility.

We’ll need some information about diverse elderly populations in order to think about how to allocate vaccines. There may also be other alternatives for older adults if they don’t respond well to vaccines. There’s a lot of work going on on development of monoclonal antibodies [ learn more about lab-produced antibodies in a recent podcast episode with Arturo Casadevall ] as an alternative for groups that don’t respond well to vaccines such as elderly, frail adults.

Let’s say there are 30,000 patients in the study and only a few hundred who are over 80 years old. What can you learn about a relatively small population of much older adults that would be informative about that group?

We may not have a large enough number of people in that subgroup to directly look at efficacy of a vaccine. But we might have enough to look at the immune response—the antibody response, for example, of a vaccine.

If, in the course of these trials, we can determine a correlative protection—for example, a laboratory measure like a level of a particular kind of antibody that correlates with protection against COVID disease—we can at least look at the immune responses in that subset of very elderly and decide if they are the same or different than the younger groups’. If they are the same, we may be more comfortable making the leap to say that it’s likely those individuals will also be protected by the vaccine.

So, we will learn more from a vaccine trial than just whether or not a vaccine works. We’re going to find out, perhaps, what predicts whether the vaccine works. That information might help us understand—without having to do a whole new trial—who might be protected by a vaccine.

It’s certainly a hope.

The majority of vaccines that we use today don’t have such a marker of protection and they’re very effective. Just because we can’t detect a marker doesn’t mean that a vaccine is not effective. It means that we’re not smart enough to figure out what that marker should be.

We really hope that there will be such a marker of protection because then we can link that—and, in FDA speak, that’s called “bridging”—to another population where we can just look at that marker of immunity rather than doing a whole efficacy trial.

How should we think about the need for racial and ethnic diversity in these clinical trials?

It’s critically important that we have racial and ethnic diversity.

We know that COVID causes increased rates of severe disease in Latinx and Black populations and in Native American populations. We will certainly want to be able to offer these COVID vaccines to these high-risk populations and encourage their use. But we need to know how well these vaccines work in these populations—if different vaccines work differently—so that we can offer the most effective vaccines.

It would not be an understatement to say that there can be a measure of distrust from some communities that have experienced discrimination from the health care system. How does that play into vaccine research?

It’s really important to engage those communities in a number of ways. One way is to engage local leaders early in the process. Lay leaders and leaders of faith communities can have focus groups to find out what their concerns are and how those can be allayed.

I think a very important issue that has been raised by some people who might potentially volunteer for some of these trials has to do with eventual access. People want to have some sense that if they participate in a trial, not only might they have access to the vaccine at the end of that trial, but their families and their communities would, too. Ensuring access among these high risk and vulnerable communities is really critical.

A clear policy decision to make sure that a vaccine is widely available without charge might actually help with the studies to prove whether or not that vaccine is safe and effective?

That’s absolutely the case. It’s great that you brought up the “without charge” piece, too, because a vaccine that’s made available but costs something to the individual may not be used. Particularly for people who don’t have health insurance or people who are undocumented. It has to be broadly and freely available.

Let’s talk about other specific populations. One of those is pregnant women. We know that they can certainly get COVID-19 and that there are some signs that they can have a more severe course. How do you think about the issue of pregnant women in vaccine studies?

I’ve done some work in this area —particularly with Ruth Faden and Carleigh Krubiner in the Berman Institute of Bioethics —specifically related to ensuring that pregnant women are considered and included in vaccine development and implementation for vaccines against epidemic and pandemic diseases.

When thinking about trials, there needs to be a justification for excluding pregnant women from trials rather than a justification for including them. The justification often is—and certainly is the case with these early COVID vaccines—that we don’t know enough yet about the vaccine or the vaccine platform or the safety of the vaccine to do a study in pregnant people.

With the mRNA vaccine, for example, [the type of vaccine being considered for COVID-19] we don’t currently have a licensed mRNA vaccine. It’s a new platform and we’re just learning about the safety of that platform so it wouldn’t have been appropriate to include pregnant women in the early stage trials.

But these 30,000-person studies are going to be really big studies. They will certainly enroll people of child-bearing potential. And even though there’s what we call an exclusion criterion—women are not supposed to be pregnant at the time they are enrolled, and usually women of child-bearing potential will take a pregnancy test prior to enrollment and immunization—we know from previous experience that it’s quite likely that some women will become pregnant in the months immediately following immunization. It happens quite frequently. So, it’s important for companies and the government to anticipate that this will be the case and to think about how they will systematically collect data from women who do become pregnant during these trials.

It’s not that the data needs to be interpreted cautiously—because pregnant women aren’t being formally randomized and we don’t have that kind of trial design—but there are things that could be learned and it’s important to think now about how to collect those data. It’s also important to think about how pregnant women could be directly included in both trials and deployment later down the road.

What about young children who are less likely to get severe disease? Would your approach to clinical trials be different?

Yes. I think we need to learn a bit more about the epidemiology in children. Fortunately, children don’t seem to suffer from acute COVID disease at the rates that adults do. But we need to learn more about that and we also need to learn from our trials in adults before we make decisions about how and whether children will be included in vaccine trials.

Once we have a vaccine that has made it through these various stages and we’re ready to start immunizing people outside of a pure clinical trial, how close are we to really getting the benefit of the vaccine? How does all the work it takes to develop a vaccine compare to what comes next?

The best vaccine in the world won’t work if it isn’t used.

Use has two parts to it: One is availability and access, and the other part is acceptance.

We need to think about what kind of infrastructure we should be planning now for what we’re going to need to deliver this vaccine. We’ll set priorities; certainly not everyone is going to get a vaccine all at once. But certainly, over time we will expect that all adults will receive the vaccine and perhaps children. So we’ll need to have systems in place that can deliver the vaccine. At the same time, we need to make sure that the vaccine is acceptable. We need to communicate the importance of vaccination to the public and address their concerns so that we can not only be able to deliver vaccines, but have those be accepted by the public.

So, there’s a lot of work to be done. But this isn’t science fiction: We are really on a path to a vaccine for a brand new infectious disease.

Yes. If you think back to the fact that in January, we barely knew what this virus was, and here we are, seven months later, embarking on efficacy trials, it’s really a remarkable accomplishment. We have a lot to do yet, but in the time that we’re assessing the efficacy of these vaccines and making sure that they can be delivered to the public, people really need to stay safe and to do all the things we’ve been encouraging them to do all along.

But we are well on our way to developing vaccines not only for people in the U.S., but for people all over the world.

Public Health On Call

This conversation is excerpted from the July 31 episode of Public Health On Call.

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Published: 16 March 2023

COVID-19 vaccine communication and advocacy strategy: a social marketing campaign for increasing COVID-19 vaccine uptake in South Korea

Shin-Ae Hong ORCID: orcid.org/0000-0003-3986-4669 1

Humanities and Social Sciences Communications volume 10 , Article number: 109 ( 2023 ) Cite this article

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Research evidence suggests that communication is a powerful tool for influencing public opinion and attitudes toward various health-related issues, such as vaccine reluctance, provided it is well-designed and thoughtfully conducted. In particular, social marketing techniques that alter the target audience’s behaviors for the public good can substantially improve vaccine uptake if adopted as a communication strategy in immunization programs to counter public hesitancy. This study presents evidence from the Korean government’s current coronavirus disease 2019 (COVID-19) vaccination campaign, which successfully applied a social marketing approach. By the end of August 2022, South Korea had achieved high vaccine coverage, with 94.8% of the population (12+) receiving a second dose, 71.3% a third dose, and a fourth dose drive currently underway. There are five crucial factors to consider when preparing official communication for an immunization program: (i) a high degree of proactiveness, (ii) credibility, (iii) fighting misinformation, (iv) emphasizing social norms and prosocial behavior, and (v) coherence. Although using social marketing strategies may not be successful in all circumstances, the lessons learned and current implementation in Korea suggest their efficacy in fostering vaccine acceptance. This study offers valuable insights for government agencies and global public health practitioners to develop effective targeted campaign strategies that enhance the target population’s vaccination intention.

Assessing COVID-19 vaccine hesitancy and barriers to uptake in Sub-Saharan Africa

Communicating doctors’ consensus persistently increases COVID-19 vaccinations

Dynamic predictors of COVID-19 vaccination uptake and their interconnections over two years in Hong Kong

Introduction.

The unprecedented spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has resulted in the century’s first major public health and economic crisis.

Two years after the pandemic, the world experienced several deadly waves of the coronavirus disease-2019 (COVID-19). Governments worldwide have hurried to implement mass vaccine rollout programs, but public acceptance of the vaccine is crucial for long-term COVID-19 control and prevention. Vaccination is generally regarded as a critical and cost-effective protective intervention for public health (Polack et al., 2020 ; Anderson et al., 2020 ; WHO, 2021a ). While vaccines are the epicenter of the global response to the pandemic, public health officials worldwide are encountering growing vaccine hesitancy, significantly impeding their efforts for reaching herd immunity. Vaccine hesitancy or refusal can be affected by numerous factors such as availability, confidence, cost, anxiety, convenience, and misinformation (Nguyen et al., 2021 ; Loomba et al., 2021 ). Additionally, poor public health communication can cause confusion, skepticism, and resistance in the population, which may negatively impact the implementation of immunization programs (Butler et al., 2015 ).

There is a need for locally contextualized research that closely examines effective immunization campaign practices. It is important to identify useful principles, approaches, and strategies for effective mass vaccination campaigns that increase uptake and address specific aspects influencing vaccine hesitancy. The author reviews a few lessons learned from public vaccination campaigns in South Korea (hereinafter Korea), which earned global acclaim for their effective and successful COVID-19 immunization programs. By August 2022, 94.8% of Korean citizens over 12 years had already received their second dose, 71.3% had received the third (booster) dose, and 16.2% (individuals over 50 years) had received the fourth dose (Korean Ministry of Health and Welfare [KMHW], 2022a ). These exemplary statistics are indicative of Korea’s high vaccination rate compared to the rest of the world. From the time vaccines became available for public use until August 2022, Korea administered 248.88 vaccine doses per 100 people. Meanwhile, China administered 240.75 vaccine doses per 100 people, Italy 236.93, Canada 232.32, Australia 225.29, the United Kingdom 224.60, France 221.56, Germany 221.44, Israel 196.12, and the United States 183.73 (Our World in Data, 2022 ). Before implementing the COVID-19 vaccination campaign, the Korean public largely showed strong hesitancy, having a “wait and see” attitude toward the COVID-19 vaccine; many were concerned about the adverse effects of vaccination (You, 2021 ; Views and News, 2021 ). However, the country overcame widespread vaccine hesitancy by applying social marketing as a behavioral change strategy to public health campaigns. Korea achieved high immunization coverage by addressing the causes of vaccine skepticism and positively appealing to the target audience’s rationale.

Although there is no catholicon communication method for public health communications in times of unparalleled pathogenic crisis, this study highlights the potential value of commercial marketing techniques in immunization promotion campaigns. Such techniques may bolster a campaign’s chances of success by fostering behavioral changes in the target population. This study introduces evidence from South Korea’s successful COVID-19 immunization campaign, incorporating core elements of commercial marketing techniques to influence people’s behavior. It also identifies five key communication attributes that the country’s public health authority considered for an optimum impact while implementing its campaign: (i) a high degree of proactiveness, (ii) credibility, (iii) fighting misinformation, (iv) emphasizing social norms and prosocial behavior, and (v) coherence. This finding offers new insights that can be employed at a national and global scale and is a notable contribution to the literature (Lefebvre, 2013 ; Thorpe et al., 2022 ; Jin et al., 2021 ; Murewanhema et al., 2022 ; Boyd and Buchwald, 2022 ; Hyland-wood et al., 2021 ).

Theoretical perspective: social marketing as a public health intervention strategy

Social marketing has attracted significant attention from health researchers and practitioners as an effective and holistic intervention to increase vaccine uptake and respond to vaccine reluctance (Nowak et al., 2015 ; French and Gordon, 2020 ). The World Health Organization (WHO) has recommended social marketing strategies to build vaccine confidence and address low vaccination rates (WHO, 2020 , 2022a ).

Social marketing programs use commercial marketing-based principles to motivate individuals to adopt the suggested social behaviors to achieve common societal interests. Social marketing is defined by the International Social Marketing Association (iSMA) as an activity that “seeks to develop and integrate marketing concepts with other approaches to influence behaviors that benefit individuals and communities for the greater social good” (iSMA, 2020 ). Social marketing focuses on effecting change at multiple levels of society (person, society, and institution), culminating in transformation (Kemper and Ballantine, 2017 ). These models have been used widely in the public health field to enhance the health and well-being of people by increasing awareness of health issues and altering health behaviors (e.g., limiting cigarette use, advocating a healthy diet, using contraceptives, HIV prevention) (Kemper and Ballantine, 2017 ; Shams, 2018 ). With the release of COVID-19 vaccines, social marketing techniques are adopted in immunization campaigns to educate the general public about the vaccine’s safety and effectiveness, build positive social norms for vaccine uptake, and “nudge” people toward getting vaccines (Rhodes et al., 2021 ; Evans and French, 2021 ).

The core concept of the social marketing program is a willful, voluntary behavioral change for one’s own satisfaction and self-interest (Kotler and Armstrong, 2020 ). Customer buying behaviors are regarded as value exchanges in which both sides mutually benefit. As both players primarily act in their own interests, commercial marketers must first understand their targeted audience’s underlying needs, wants, and interests for their marketing to be successful. Customer orientation is a key theoretical cornerstone of social marketing programs. Following this assessment, a marketer delivers a product that meets customers’ needs and lowers the barriers that might hinder their purchasing behavior. Customers offset the disadvantages of alternatives and decide whether the marketer’s product or service is beneficial and valuable before voluntarily exchanging their resources for the goods offered (French, 2017 ).

The marketing mix: The 4Ps for behavior change

The “4Ps” model—comprising product, price, place, and promotion—is a central element of the social marketing framework. First suggested by Kotler and Zaltman ( 1971 ), the model’s four key categories are beneficial for implementing marketing initiatives. The 4Ps help facilitate the development, communication, and promotion of a product to its target audience. Each dimension consists of a marketing variable that aims to make a product, service, or advocated behavior more appealing.

The premise is that a social marketer must produce the right product at the right price, distribute it to the right market in the right location, and market it to the right group (Lefebvre, 2013 ). The product comprises the offering’s qualities and functions, incorporating the benefits of utilizing the offering or engaging in a suggested set of actions. Critical to its desirability is how it corresponds to the consumer’s aspirations, needs, and interests and offers a solution to a problem. The price refers to the consumer’s cost or sacrifice in exchange for the product. It involves money, time, and physical or psychological effort invested in the exchange. The place is associated with the intermediary physical sales location, facilitating marketer–consumer exchange. The design of the place is crucial, as it provides sufficient incentives for consumers to engage with the product. They may include creating easy, convenient, or accessible outlets for people to engage in exchange. Promotion encompasses the marketer’s persuasive communication activities that emphasize product features/benefits, associated prices, and places to buy the offering. A promotional strategy usually comprises promotional activities via public relations, media and advertising, message delivery channels, and special events that influence change (MacDonald et al., 2013 ).

The marketing mix for COVID-19 vaccine communication

The social marketing approach offers consumer behavioral insights into vaccines and immunizations. The approach helps develop programs and acquire knowledge about the wants, values, and needs of target individuals whose health behavior changes we aim to influence. Immunization program planning decisions can be made when policymakers understand the benefits and barriers of the inoculation program from the targeted audience’s perspective. This enables them to create a demand for vaccination services in the local community. Well-designed immunization campaigns can certainly boost vaccination coverage by enhancing public trust, alleviating anxiety and fear, and enabling people to connect better with the community and its goals (Lee et al., 2022 ; Shekhar, 2022 ).

As the Korean public health authority began the campaign, it projected “herd immunity” as the best way to end the pandemic and recommended that everyone be immunized against SARS-CoV-2 (KDCA, 2021a ). This policy encouraged the public to embrace new behaviors (vaccine uptake) and avoid antisocial ones (vaccine delay or not getting vaccinated); however, this policy was not mandatory. It relied on voluntary cooperation because it was presumed that the general population would adopt a behavioral change if its benefits/rewards/social consequences suited their needs. Public health officials have applied the social marketing approach to health communication to positively stimulate vaccine-acceptance behavior in the population. They also tailored their communication strategies and distributed accurate vaccine information via diverse media channels. The 4Ps model is used to explain vaccine communication as follows.

Product communication

“Product” refers to what is being sold—in this instance, the vaccine’s benefits. Vaccine intention can be predicted by the perceived benefits of vaccines (Lee et al., 2022 ). Recommended behaviors include adherence to the vaccination schedule or taking the vaccine; engaging in this behavior facilitates health benefits (Nowak et al., 2015 ; Wassler et al., 2022 ). Product communication is applied to vaccines by identifying the behavioral mechanisms that benefit people. These behavioral proposals aim to enhance individual and community health by stimulating the human immune system to produce antibodies and fight against COVID-19 infection. This reduces the incidence of contracting or transmitting the infection, lowers the mortality rate, and decreases the chance of developing severe COVID-19 symptoms among fully vaccinated populations (Dye, 2022 ; Sadarangani et al., 2021 ; Kerr et al., 2022 ).

Price communication

“Price” refers to the target group barriers to procuring the vaccine, such as financial cost, inaccessibility, inconvenience, and perceived low vaccine efficacy or safety. Immunization planners must consider interventions to reduce these hurdles, alter public perception, and increase the perceived value of vaccination (WHO, 2021b ). For strategic communication, public health officials must highlight the drivers of vaccination (e.g., safety, efficacy, health, and social rewards) that outweigh the perceived risk or cost (unexpected side effects, undesirable social consequences, etc.). The Korean government encouraged the public to be immunized to achieve herd immunity, and the communicated goal was to protect the community from virus infection and return to pre-COVID-19 normalcy. Furthermore, it emphasized that adverse side effects are extremely infrequent and assured the public that they would be compensated in the event of an adverse reaction to the vaccine (KDCA, n.d.-a ).

Place communication

“Place” denotes where and when people can access the vaccination service (e.g., hospitals, clinics, mass vaccination centers, etc.). Given that herd immunity can only be achieved by substantial public buy-in, the majority of the community must embrace product communication (getting a vaccine). Hence, multiple communication tools have been employed via numerous media channels to communicate with the public, effectively manage information flow, and enhance risk communication.

Promotion communication

“Promotion” refers to communication strategies for clear, accurate, and coherent information on immunization plans (CDC, n.d. ). This involves providing updated vaccine information and suggested actions through trusted media outlets. This communication strategy leveraged public service advertisements, spokespersons, media outreach, and communication materials to promote vaccinations.

Integrating behavioral intervention into the marketing mix: value creation and exchange

When changing attitudes and behaviors is insufficient, behavioral science proposes the use of other behavioral intervention tools, such as “nudging” or the default option, in combination with persuasive communication to overcome barriers and influence behavior (Evans and French, 2021 ; French and Gordon, 2020 ; Dai et al., 2021 ). Within the proposed approach, Evans and French ( 2021 ) recommend using both incentivizing and disincentivizing elements in social marketing strategies to elicit a behavioral response and maintain behavior change. They suggest four types of behavioral interventions: Hug, Smack, Shove , and Nudge , to increase the target audience’s vaccine uptake against COVID-19. Hug is an active cognitive engagement and positive incentive for adaptation (e.g., offering rewards with financial incentives, vaccine badges, vaccine holidays, and access permits for facilities when you have a “vaccine passport”). Nudge is a passive cognitive engagement and positive incentive for adaptation (e.g., setting up default options for the entire populace, using small financial rewards, gift cards, or sending reminder text messages or emails for vaccination). Smack is an active cognitive engagement and punishment for non-adaptation (e.g., no access to shopping malls, penalty fines, or dismissal from work in high-risk industries without a vaccine certificate). Shove is passive cognitive engagement and punishment for non-adaptation (e.g., multiple polymerase chain reaction (PCR) test requirements before using public facilities if not vaccinated). Together with persuasive communication, Korea employed these schemes in its COVID-19 vaccination policy to encourage vaccine uptake.

This study reviewed the relevant literature from immunization inception in January 2021 to August 2022. Four major databases were searched: Web of Science, PubMed, ScienceDirect, and Factiva, using the following keywords: COVID-19 vaccination and recommendation OR public health communication/campaign. The study also searched three major governmental agencies—the Korean Presidential Office Broadcast (KTV), Korea Disease Control and Prevention Agency (KDCA), and KMHW—following both website and non-website communications regarding COVID-19 vaccination recommendations. Any communication material used to inform people—official documents, daily briefings, news reports, and website information and announcements—was collected as primary source data for the study. Additionally, a review of local media reports on COVID-19 vaccination was conducted using the online database Bigkind through keyword search.

The present study found that the social marketing public health campaign targeting COVID-19 vaccination behavior effectively increased voluntary uptake of the COVID-19 vaccine in Korea. The intended behavioral outcomes were observed when social marketing techniques were adopted in the immunization campaign. In August 2022, Korea achieved high COVID-19 immunization coverage. About 94.8% of Korean citizens over the age of 12 years had completed their second dose; 71.3% had received the third (booster) dose; and 16.2% (over the age of 50) had completed the fourth dose (KMHW, 2022a ). The pre-campaign survey revealed that 67.7% of Koreans had concerns about vaccine safety and side effects and preferred to wait and see how others responded to it (Dailymedi News, 2021 ). However, a high prevalence of vaccine hesitancy, delay, or refusal was significantly decreased and behavior adaptation rates increased when people were exposed to social marketing immunization campaign messages. This change indicates that social marketing communication techniques effectively responded to concerns in the public sector, successfully engaged with the target audience’s perceptions, and changed their attitude, leading to action.

Korea’s COVID-19 vaccine communication strategy

Korea was among the first countries to be severely affected by COVID-19 due to its proximity to China. The first confirmed case was reported on January 20, 2020, followed by three waves of infection. The first peak was reached between February and March 2020, the second between August and September 2020, and the third between November 2020 and February 2021 (KMHW, 2020a ). In February 2021, Korea announced a COVID-19 vaccination program, aiming to immunize 70% of the adult population by September 2021 (KDCA, 2021a , 2021b ). However, most Koreans were reluctant to take the vaccine because of uncertainties about adverse long- or short-term side effects, and lack of awareness. Understanding the public’s concern and general attitude toward COVID-19 vaccines, the Korean public health authority started a social marketing campaign to educate the public regarding vaccine safety and efficacy. The program gradually increased vaccine confidence among the general public and engagement behaviors were manifested. The country’s slow initial vaccination uptake progressively improved as the promotion campaign continued, and a high uptake rate was eventually achieved. By August 2022, 94.8% of Korean citizens over the age of 12 had completed the second dose, 71.3% had received the third (booster) dose, and 16.2% (those aged over 50) had received the fourth dose (KMHW, 2020a ).

Whenever faced with hesitancy or resistance, the Korean public health authority provided detailed information to build public trust in vaccines (products) (KDCA, n.d.-a ). Specifically, they explicitly stated the need for vaccination uptake (behavior change), stressing its worth and the multifold benefits of COVID-19 immunization. Great values of COVID-19 vaccines include high efficacy; protection from developing severe symptoms, hospitalization, and death; prosocial behavior for the community; and reconnecting with social networks without concern of infection (KDCA, n.d.-a ; KMHW, n.d. ). Such a goal is attainable if each individual adopts protective behaviors and takes the COVID-19 vaccine (Statistic Korea, n.d.-b ).

The KDCA presented scientific evidence-based communication about the benefits of vaccination during its daily public briefings, informing the public about clinical trial results that suggest high vaccine efficacy rates (Polack et al., 2020 ; Voysey et al., 2021 ). The KDCA addressed the benefits of booster shots to stay protected against subvariants by showing how people who had taken the third booster had reduced the risk of infection and hospitalizations compared with those who received only two doses (KMHW, 2022b ). Communicating proven scientific data to the public helped individuals better understand the vaccine’s benefits and perceive immunization as a self-protective behavior.

Extending the values of immunization beyond individual health benefits, the Korean government has publicized the significant social benefits of vaccination to appeal to the public; as herd immunity is achieved, population immunity against pathogens can be attained. In this way, countries can protect the lives of their citizens and the most vulnerable groups and escape the tremendous social and economic burden of COVID-19. Thus, failing to curtail virus transmission greatly risks national security. Owing to the collectivistic nature of Korean society, where people tend to value the community and their common interests over individual needs, this was a convincing strategy (KDCA, 2021c ; Hong, 2022 ). Consequently, the public made informed decisions. In October 2021, the nation’s herd immunity threshold was surpassed; 41.31 million Korean adults (79.7% of the total population) had completed their COVID-19 immunization (Our World in Data, 2022 ). A post-vaccination survey revealed that the public’s primary reasons for COVID-19 immunization were to protect their family members (76.4%) and to help the nation achieve herd immunity (63.9%) (Yonhap News, 2021 ).

During the rollout, the Korean government introduced incentives to support the behavior change ( Hug ). Benefits such as exemptions from quarantine rules, paid-vaccine holidays, free access to parks, free lodging in private resort facilities, and free meals in certain restaurants across the country were provided to vaccinated individuals (Korean Ministry of Culture, Sports, and Tourism [KMCST], 2021 ).

Barriers can be linked to various factors, such as values, knowledge, abilities, and economic standing. However, the most common and significant obstacle to vaccination is associated with risk perception, such as side effects. Although the COVID-19 vaccine was acknowledged as the most effective public health intervention for virus control, its adverse effects have been regarded as a major barrier to vaccine intention (Nguyen et al., 2021 ). As stated previously, safety and potential adverse events were the primary barriers among the Korean public regarding the COVID-19 vaccination. To reduce the psychological price/cost of vaccination, the KDCA provided advocative proof of the safety and adequacy of COVID-19 immunization. In their briefings, the KDCA shared their recommendation of the importance of undertaking the COVID-19 vaccine and offered evidence from trial data, suggesting vaccine-attributable severe side effects were extremely rare, mostly short-term injection site pain, tiredness, and mild headaches (KDCA, 2021c ).

The KDCA’s public message also focused on fostering vaccine literacy (e.g., how mRNA/protein subunit vaccines work to produce viral proteins and develop immunity in the body, active ingredients, effectiveness against variant strains of COVID-19, up-to-date clinical trial outcomes, and side effects of vaccines (KDCA, n.d.-a ). To tackle misinformation that creates negative public opinion, the Korean government widely employed fact-checking and debunking strategies against anti-vaccination propaganda on various social media. If invalidated misinformation is circulated and receives public attention, the public health authority promptly refutes the rumors via fact-checking and debunking.

The government aimed to reduce the target behavior’s costs/prices/barriers; it also increased the costs of the competing behavior by employing disincentive measures. They announced compulsory quarantine regulation for the contact between confirmed COVID-19 cases and inbound travelers, and a 14-day mandatory quarantine was applied for unvaccinated individuals (The Korea Herald, 2021 ). People had to prove their negative status with a negative PCR test before being released from isolation ( Shove ). On December 13, 2021, the Korean government introduced the “vaccine passport” to further increase barriers against non-compliant behavior (KDCA, n.d.-a ). During this period, adults had to present a vaccine certificate or a negative PCR test to access public venues such as gyms, concert halls, cinemas, and hospitals ( Smack ). This regulation was abolished on March 1, 2022, because of strong public opposition. Nevertheless, the COVID-19 certificates helped the country control the COVID-19 pandemic and maintain behavior adoption after reaching herd immunity.

Throughout the immunization process, the Korean government provided open and honest communication to the public and widely disseminated information regarding COVID-19 vaccination via diverse media channels. Such information included how to make reservations, where to get vaccinations, and access to separate queues for older adults during vaccination registration (KDCA, n.d.-b , n.d.-d ). Regarding the booking process, the KDCA made multiple formats available to ensure quick and easy public access. The KDCA’s website was the primary booking method; it provided a clear, easy-to-understand format for people to follow.

In addition, telephone options and in-person reservations were made available for older adults who were not familiar with the internet. The campaign message also informed the public about the accessibility of the vaccine and vaccination locations in real-time. In May 2021, the KDCA announced the availability of mobile app services on Naver and KaKao Talk messenger. These services enabled the public to search for nearby vaccination centers and provided up-to-date information on vaccine data. The government carefully selected the physical sites to ensure easy and convenient venues. Large sports arenas, cinemas, conference halls, hospitals, and clinics were available, along with free vehicle pick-up and drop-off services for individuals in remote areas (KMHW, 2020b ). The government used clear, multiple, easy-to-read signs to direct people to vaccination centers (especially older adults). In the centers, trained staff guided them through the vaccination services and addressed their concerns. They also provided special care and friendly guidance for older adults.

There were three key messages in the Korean government’s COVID-19 vaccination promotion campaign: vaccine services were free, vaccines were safe and effective, and vaccines provided the best protection against the virus for individuals, their families, and the community (Statistic Korea, n.d.-a ). The goal of the promotional message was to persuade the public that they would benefit more if vaccinated. In January, a month before the rollout, the KDCA stated that vaccines would be free for all Korean citizens and foreign residents. This promotion strategy removed financial barriers and facilitated uptake behavior.

For successful immunization against COVID-19, the Korean public health authority conducted an extensive public education campaign concerning the safety and efficacy of vaccines with rational arguments. In this process, they recruited credible healthcare professionals, religious and community leaders, and local celebrities who had established trusting relationships with the community. Their advocacy message about vaccine safety and efficacy could support the message of public health communication (Catholic Bishop’s Conference of Korea, 2021 ).

Finally, the government’s promotional message advertised the benefits of behavior change (vaccination) as the best protection for oneself, others, and the whole nation (Statistic Korea, n.d.-b ). In collectivistic cultures such as Korea, prosocial messages appeal to the sense of social responsibility and are more effective in engaging the public emotionally to work toward a common goal.

To reach the entire nation, the government communicated through the media. They used numerous conventional and emerging social media outlets, including official media and YouTube, Facebook, Twitter, Naver, and Kakao. The following information channels play an important role in increasing public trust in the safety and effectiveness of vaccines by disseminating current vaccine research development throughout immunization campaigns: mass media (TV, radio, Internet, metro/bus posters, street banners and signs, electronic documents, etc.), public videos (hospital waiting areas, public facilities, local city offices, community service centers, etc.), service-based communication (doctors, nurses, and healthcare workers), special events, and advocacy via influencers (political leaders, public health officials, local community and religious leaders, local celebrities, etc.) (KDCA, 2018 ). To further increase the urgency of vaccine uptake, the Korean government sent reminders via text messages, pamphlets, and other informational materials to capture public attention ( nudge ). Sending repeated messages, notifying people of the vaccination schedule, and prompting implementation reminded the public to get vaccinated.

Campaign effect: increasing the COVID-19 vaccine acceptance

Social marketing is a proven behavioral change technique, widely adopted in public health campaigns for promoting changes in knowledge, norms, belief, attitude, and behavior of the general population (Lee et al., 2022 ; Melovic et al., 2020 ; Coffie et al., 2022 ; Evans and French, 2021 ; Osborne et al., 2021 ). In the context of COVID-19 vaccination, the current study found that the social marketing vaccination campaign was effective in increasing individuals’ intention to adopt immunization behaviors as it could significantly improve the targets’ knowledge, belief, attitude, and barriers to COVID-19 vaccination (Adane et al., 2022 ; Salali et al., 2022 ; Evans and French, 2021 ).

Knowledge, belief, and attitude toward COVID-19 vaccines

The level of vaccine hesitancy significantly decreased in Korea due to the ongoing efforts of Korean public health officials to convince and educate the public about the safety and efficacy of COVID-19 vaccines. In the pre-vaccination period, a significant portion of the Korean population was hesitant to vaccinate (Dailymedi News, 2021 ; Views and News, 2021 ). Only a small portion of people indicated a positive intention to vaccinate (Heo, 2021 ; You, 2021 ; Lee and Yang, 2021 ). Importantly, these studies reveal that high rates of vaccine hesitancy and skepticism are associated with safety concerns, insufficient vaccine literacy (e.g., poor perception or low belief in the efficacy of vaccines), and lack of awareness about the threat of COVID-19.

To our knowledge, the Korean population’s overall perception, knowledge, and attitude toward COVID-19 vaccination have become significantly favorable as the vaccination campaign progressed. A previous study also suggested that there were substantial improvements in overall knowledge, perceptions, and attitudes toward COVID-19 vaccination among the Korean public during the vaccine rollout, indicated by a steady increase in vaccine acceptance (Choi et al., 2022 ). A survey by Choi et al. ( 2022 ) conducted during the first rollout in March 2022 indicates an improved perception toward vaccines. After months of public campaigns on COVID-19 vaccination, the majority of the Korean public (75.5%) felt that the decision to vaccinate was important and worth it. Moreover, 74.3% of people said they believed in the vaccine’s efficacy, indicating high vaccine intention (You, 2021 ). This increased vaccine confidence and their positive attitudes could lead them to have voluntary behavioral engagement toward vaccination.

Perceived barriers toward COVID-19 vaccines

The study observed that the social marketing immunization campaign effectively reduced perceived barriers to vaccination. As noted, the Korean public was skeptical regarding vaccine safety and its side effects (You, 2021 ; Lee and Yang, 2021 ). However, the public’s perception of barriers was significantly reduced, and their risk perception toward vaccination diminished during the COVID-19 immunization campaign. On social media platforms, keywords such as “side effects” and “safety” (the most frequent terms on the top four platforms, Naver, Daum, Google, and Twitter, during pre-vaccination in Korea) received less attention after the public immunization campaign began. Negative keywords related to the side effects associated with COVID-19 vaccines (e.g., blood clots, severe allergic reactions, or death) did not appear either (Choi et al., 2022 ). This observation was supported by a national survey conducted in April 2021, suggesting that the Korean public’s perceived benefit of vaccines surpassed the perceived barriers in all age groups. This tendency was reported to be even greater among older adults (60+ years) (You, 2021 ).

Five effective public health messages to boost vaccine intention

Overcoming the COVID-19 pandemic necessitates adequate behavioral changes. Communicating effectively and persuasively with the public is critical to elicit a behavioral response (Betsch, 2020 ). This section discusses how the Korean government framed campaign messages to maximize their message effectiveness, persuading the general population to adopt vaccination behavior and identifying the main characteristics of the campaign, such as high proactiveness, credibility, fighting misinformation, emphasizing social norms, and coherence of official communication.

(i) Proactiveness : Delivering critical vaccine information to the public during a pandemic could create confusion and concern (Lyu et al., 2022 ). Hence, public health communication must anticipate problems and share necessary information. If the target audience’s attention is not captured from inception, misinformation and fake news by anti-vaccine propagandists will impact the process (Loomba et al., 2021 ; Roetzel, 2019 ; Zheng, 2022 ). Given the enormous amount of negative information about vaccines on social media, a negative attitude toward vaccination is likely to develop, resulting in low immunization uptake rates (Olson, 2020 ; Kim et al., 2021 ). Thus, proactive communication interventions have been emphasized and implemented as effective communication strategies throughout Europe (Butler et al., 2015 ). Korea also adopted the “Be First” messaging principle, emphasizing proactive communication in responding to public health emergencies (KDCA, 2018 ). Striving to be the louder voice in the country as the official information channel regarding COVID-19 vaccines, the country could successfully overcome vaccine hesitancy. Consequently, by proactively hushing the misinformation and anti-scientific attitudes, the Korean public health authority decreased anxieties and skepticism about vaccine safety and efficacy (Choi et al., 2022 ), and effectively increased vaccination uptake (KDCA, n.d.-c ).

(ii) Credibility : Research has shown that higher credibility will likely generate greater message compliance (De Meulenaer et al., 2018 ). Credibility is a central feature of effective and persuasive health communication. Perceiving a source as trustworthy and valid can significantly affect the beliefs and intentions of the target population to adopt the suggested behaviors. Vaccine hesitancy can considerably decrease when the public perceives the public health authority as trustworthy (Trent et al., 2022 ). Korea’s public healthcare system is well equipped to provide quality healthcare services; therefore, public trust in the system is already high. During the COVID-19 pandemic, the Korean public showed a significantly high level of trust in the KDCA, which led to the pandemic mitigation plans and national inoculation policies (78% in the first week of June 2021) (Korea Research, 2021 ). Vaccine hesitancy or refusal can increase when the public loses faith in the governmental authority. A higher degree of confidence in public health authorities rendered the Korean public less prone to fake news or conspiracy theories. People were more willing to listen to the immunization messages delivered by Chong En-Kyong, the KDCA’s key commissioner, and other well-known public health scholars and expert groups (Hong, 2022 ; Abu-Akel et al., 2021 ). We may infer that a high level of public confidence in government organizations increases the likelihood of message acceptance toward COVID-19 vaccines and decreases the perceived validity of fake news. Therefore, conspiracy theories may not significantly affect Koreans’ views and attitudes toward vaccination.

(iii) Fighting misinformation : Misinformation about COVID-19 vaccines can cause public vaccine hesitancy or refusal by arousing doubt, anxiety, and concerns about vaccines (Nguyen et al., 2021 ; Loomba et al., 2021 ; Springer and Özdemir, 2022 ). The Korean government used fact-checking and debunking strategies to tackle mis/disinformation and vaccine hesitancy, and discredit commonly held myths; they exposed logical flaws in the misinformation to correct any misconceptions (e.g., COVID-19 vaccines cause infertility and other diseases, they have a microchip, they cause death, they alter one’s DNA, etc.) (KDCA, 2021d ). Concurrently, the KDCA and Korea Communication Commission (KCC) introduced a reporting system on the website www.KCC.go.kr/vaccinejebo to prevent the spread of misinformation on vaccine efficacy and safety. All anti-vaccine messages were monitored using artificial intelligence (AI), and messages spreading misinformation, fear, and negative opinions regarding government intervention were reported on the website and deleted from the media platform (KCC, n.d. ). To further reduce the effect of fake news on immunization, Twitter, Korea, and YouTube removed over 43,000 tweets and 1,000,000 erroneous COVID-19-related messages and videos that disseminate false claims about vaccines (WHO, 2022b ). This strategy significantly reduced public exposure to misinformation, which could impact vaccine intention.

(iv) Emphasizing social norms and prosocial behavior : Perceived social norms and beliefs about how others conduct themselves impact a person’s behavior and intent (Schultz et al., 2007 ). In the context of COVID-19 vaccination, individuals are more inclined to follow the COVID-19 protocol and get vaccinated if they believe that more people are participating in these preventive actions (Rabb et al., 2022 ). Notably, a study on the Korean public’s awareness and attitude toward COVID-19 immunization corroborates this result, showing a shift in perception from negative to positive as more people get the inoculation (Choi et al., 2022 ). We can infer that people’s beliefs and intentions toward COVID-19 vaccines are affected by the higher vaccination intentions and behaviors of others.

In particular, people belonging to collectivistic cultures prioritize the interests of society over the individuals’ interests. Preferences are more likely to be affected by beliefs about other people’s intentions—social norms—within the community and their close social networks, such as family, friends, and neighbors (Salali et al., 2022 ; Cammett and Lieberman, 2020 ). During the vaccine rollout, the Korean public health authority effectively influenced people’s vaccination behavior and intention. They used messages such as “everyone gets vaccinated,” “taking the vaccine is the right thing to do,” “get vaccinated to return to normal life,” “achieve herd immunity with the vaccination,” and “protect your family elders with the COVID-19 vaccine,” to assert social norms and prosocial behavior (KDCA, 2021c ; KDCA, n.d.-c ). The Korean government appealed to its people’s collective responsibility and intrinsic motivation to avoid harm to their social ties, thereby aligning its population with the public health goal of achieving herd immunity within a year. These messages from public health authorities about the country’s new immunization goal gave the public the collective task of vaccination against COVID-19 as early as possible. This message significantly affected vaccine intention and uptake behavior among the Korean public (Hong, 2022 ).

(v) Coherence : Previous studies suggest that clear, coherent, and consistent public health messages about the safety and efficacy of vaccines can effectively decrease public confusion and anxiety about vaccination, and increase vaccination intention (Jin et al., 2021 ; Murewanhema et al., 2022 ; Hyland-Wood et al., 2021 ). In the context of COVID-19 immunization communication, Korean public authorities sought to increase message receptivity and public support for immunization, reducing belief in the infodemic about COVID-19 vaccines (KDCA, 2018 ).

Since the rollout began, the KDCA provided clear and specific instructions to the public, calling for action (e.g., “To register for the vaccine, visit the KDCA website”; or “call the 1339 help desk directly”) and particular events (e.g., “From February 6 to April 2021, healthcare professionals, older adults over 75 years of age, and people with chronic conditions have to be vaccinated”) (KDCA, 2021a ). Communicating coherent and consistent pro-vaccine messages was used to prompt people to adopt healthy attitudes and vaccination behaviors (e.g., “COVID-19 vaccines provide the best protection against novel coronavirus,” “The benefits of getting a COVID-19 vaccine outweigh the risks”) (KDCA, 2021c ). All public health figures and organizations in Korea (e.g., the Central Disaster and Safety Countermeasure Headquarters, KMHW, KDCA, and local governments) applied this coherent and consistent message strategy to their vaccination messages (KMHW, 2019 ). Korea was able to communicate more effectively with the public and boost their vaccination intentions by presenting a uniform and united front among all government agencies throughout the vaccination campaign.

Conclusions and outlook

Government communication could play a substantial role in influencing public attitudes toward immunization. The public’s understanding of the pandemic, immunization, and vaccine intentions can be shaped by public health messages. This study analyzed the Korean government’s COVID-19 mass vaccination campaign strategies and interventions and offered insights contributing to global discussions on health communication strategies and approaches. The results indicate that a robust social marketing campaign can effectively customize messages according to the target population’s interests and values, persuade the public about the product (the need for vaccination), and overcome barriers to immunization acceptance. It enhances general confidence in the COVID-19 vaccine and, at least partly, overcomes hesitancy by increasing and reinforcing vaccine literacy, providing balanced information about the benefits and risks, and dispelling rumors and misconceptions. Furthermore, the study identified five key communication attributes—proactiveness, credibility, fighting misinformation, emphasizing social norms and prosocial behavior, and coherence—for official communication to improve communication interventions for maximum effect. These attributes can be applied in other countries’ vaccine messaging campaigns and national immunization programs. Although the study has explored the link between government communication and individuals’ intention to vaccinate through a social marketing perspective, it has limitations. This study relied on a document analysis design. Future studies must employ a quantitative design, such as a cross-sectional survey or regression analysis, to further examine the causal effects between variables. In addition, this study was conducted in Korea, and the results should not be generalized to other cultural settings. Consequently, future research must examine communication and messaging strategies from other geographic locations with more diverse population groups and sociocultural contexts. Repeated local studies using other approaches that facilitate vaccination will be essential for vaccine promotion. This is essential for public health policymakers to devise suitable communication intervention strategies to improve vaccination, booster uptake, and future immunization.

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Acknowledgements

This research was supported by the National Research Foundation of Korea (NRF) grant funded by the Korean government (MSIT) (No. 2021R1A2C1095688) and in part by the Ministry of the Interior and Safety (MOIS, Korea)’s ‘Policy-linked Technology Development Program on Natural Disaster Prevention and Mitigation’ under Grant No. 2021-MOIS35-003.

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Hong, SA. COVID-19 vaccine communication and advocacy strategy: a social marketing campaign for increasing COVID-19 vaccine uptake in South Korea. Humanit Soc Sci Commun 10 , 109 (2023). https://doi.org/10.1057/s41599-023-01593-2

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Motivating COVID-19 Vaccination through Persuasive Communication: A Systematic Review of Randomized Controlled Trials

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1 Department of Communication, University of Maryland.
PMID: 37254940
DOI: 10.1080/10410236.2023.2218145

Vaccination is a vital defense against COVID-19 infections and outbreaks, yet vaccine hesitancy poses a significant threat to pandemic response and recovery. We conducted a systematic review of published randomized controlled trials ( N = 47) assessing the persuasive effects of COVID-19 communication on COVID-19 vaccine acceptance. Individual vs. collective appeals and gain vs. loss frames are among the most frequently assessed message features, but they generally do not make a difference in persuasion. Normative messages that highlight higher (vs. lower) prevalence of vaccine acceptance are more persuasive. Message sources overall have limited impact on COVID-19 vaccine acceptance, but sources that have a shared identity with the message receivers tend to be persuasive. More engaging message channels such as interactive chatbots and videos are promising communication tools but are generally under-utilized and under-studied. Compared to no communication or irrelevant communication, COVID-19 vaccine messages generally have a small advantage in increasing COVID-19 vaccine acceptance. Messages that include 1) vaccine safety and/or efficacy information; 2) collective appeals combined with embarrassment appeals; and 3) political leaders' vaccine endorsement are among the most effective messaging strategies. There is no evidence of any backfire effects of COVID-19 vaccine messages. We discuss the implications of our findings for persuasive message design in pandemic vaccine communication.

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Elsevier - PMC COVID-19 Collection

Examining persuasive message type to encourage staying at home during the COVID-19 pandemic and social lockdown: A randomized controlled study in Japan

• We examined persuasive message types in terms of a narrator encouraging self-restraint.
• Messages from a governor, an expert, a physician, a patient, and a resident were compared.
• The message from a physician increased intention to stay at home the most.
• The physician’s message conveyed the crisis of collapse of the medical system.

Behavioral change is the only prevention against the COVID-19 pandemic until vaccines become available. This is the first study to examine the most persuasive message type in terms of narrator difference in encouraging people to stay at home during the COVID-19 pandemic and social lockdown.

Participants (n = 1,980) were randomly assigned to five intervention messages (from a governor, a public health expert, a physician, a patient, and a resident of an outbreak area) and a control message. Intention to stay at home before and after reading messages was assessed. A one-way ANOVA with Tukey’s or Games–Howell test was conducted.

Compared with other messages, the message from a physician significantly increased participants’ intention to stay at home in areas with high numbers of people infected (versus a governor, p = .002; an expert, p = .023; a resident, p = .004).

The message from a physician―which conveyed the crisis of overwhelmed hospitals and consequent risk of people being unable to receive treatment―increased the intent to stay at home the most.

Practice implications

Health professionals and media operatives may be able to encourage people to stay at home by disseminating the physicians’ messages through media and the internet.

1. Introduction

The outbreak of the coronavirus disease 2019 (COVID-19) has emerged as the largest global pandemic ever experienced [ 1 ]. Experts have proposed that social lockdown will lead to improvements such as controlling the increase in the number of infected individuals and preventing a huge burden on the healthcare system [ [2] , [3] , [4] ]. Governments of many countries across the world have declared local and national social lockdown [ 4 , 5 ]. In April 2020, the Japanese government declared a state of emergency, which allows prefectural governors to request residents to refrain from unnecessary and nonurgent outings from home [ 6 ]. However, despite such governor declarations, people in various countries have resisted and disregarded calls to stay at home [ [7] , [8] , [9] ]. Because social lockdown is the only existing weapon for prevention of the pandemic until vaccines becomes available to treat COVID-19, behavioral change in individuals regarding staying at home is crucial [ 3 , 4 ]. Many news articles about COVID-19 are published daily by the mass media and over the internet. Such articles convey messages from governors, public health experts, physicians, COVID-19 patients, and residents of outbreak areas, encouraging people to stay at home. This is the first study to examine which narrator’s message is most persuasive in encouraging people to do so during the COVID-19 pandemic and social lockdown.

2.1. Participants and design

Participants were recruited from people registered in a survey company database in Japan. The eligibility criterion was men and women aged 18–69 years. Exclusion criteria were individuals who answered screening questions by stating: that they cannot go out because of illness or disability; that they have been diagnosed with a mental illness; or/and that they or their family members have been infected with COVID-19. A total of 1,980 participants completed the survey from May 9–11, 2020, when the state of emergency covered all prefectures in Japan. Participants were included according to the population composition ratio in Japan nationwide by gender, age, and residential area. Participants were randomly assigned either to a group that received an intervention message (i.e., from a governor, a public health expert, a physician, a patient, and a resident of the outbreak area) or to one that received a control message. The study was registered as a University Hospital Medical Information Network Clinical Trials Registry (number: UMIN000040286) on May 1, 2020. The methods of the present study adhered to CONSORT guidelines. The protocol was approved by the ethical review committee at the Graduate School of Medicine, University of Tokyo (number: 2020032NI). All participants gave written informed consent in accordance with the Declaration of Helsinki.

2.2. Intervention and control messages

We searched news articles about COVID-19 using Yahoo! JAPAN News ( https://news.yahoo.co.jp ), the largest Japanese news portal site. We also searched videos posted by residents of outbreak areas such as New York using YouTube ( https://www.youtube.com/user/YouTubeJapan ). By referring to these articles and videos, we created five intervention messages from a governor, a public health expert, a physician, a patient, and a resident of an outbreak area. The content of each message encouraged readers to stay at home. We included threat and coping messages in each intervention message based on protection motivation theory (PMT) [ 10 , 11 ]. Appendix A shows the five intervention messages used in this study, translated into English for this report. For a control message we obtained textual information about bruxism from the website of the Ministry of Health, Labour and Welfare ( https://www.e-healthnet.mhlw.go.jp/ ).

2.3. Measures

The primary outcome was intention to stay at home. The secondary outcomes were PMT constructs (i.e., perceived severity, vulnerability, response efficacy, and self-efficacy). Participants responded to two or three questions for each measure (see Appendix B ). These measures were adapted and modified from previous studies [ [12] , [13] , [14] , [15] ]. All primary and secondary outcomes were measured before and after the participants read intervention or control messages, and mean scores were calculated. Higher scores indicated greater intention and perception. All participants were asked for their sociodemographic information before they read intervention or control messages.

2.4. Sample size

Based on the effect size in a previous randomized controlled study [ 16 ], we estimated a small effect size (Cohen’s d = .20) in the current study. We conducted a power analysis at an alpha error rate of .05 (two-tailed) and a beta error rate of .20. The power analysis indicated that 330 participants were required in each of the intervention and control groups.

2.5. Statistical analysis

A one-way analysis of variance (ANOVA) was conducted with the absolute change in mean values for each measure before and after intervention as the dependent variable and the group assignment as the independent variable. For multiple comparisons, Tukey’s test was conducted on significant main effects where appropriate. The Games–Howell test was performed when the assumption of homogeneity of variances was not satisfied. Additionally, we conducted subgroup analyses including only participants who lived in 13 “specified warning prefectures,” where the number of infected individuals showed a marked increase [ 17 ]. A p value of <.05 was considered significant in all statistical tests. All statistical analyses were performed using IBM SPSS Statistics for Windows, Version 21.0 (IBM, Armonk, NY, USA).

Table 1 shows the participants’ characteristics. Table 2 , Table 3 present a comparison among the five intervention groups using one-way ANOVA and multiple comparisons when including all prefectures and only participants who lived in the specified warning prefectures, respectively. More significant differences between intervention messages were found in the specified warning prefectures compared with all prefectures. In Table 3 , the Games–Howell test indicates that the message from a physician increased participants’ intention to stay at home significantly more than other narrators’ messages (versus a governor, p = .002; an expert, p = .023; a resident, p = .004). Multiple comparisons demonstrated that the message from a physician increased participants’ perceived severity (versus a governor, p = .015), response efficacy (versus a resident, p = .014), and self-efficacy (versus a governor, p = .022; a patient, p = .009) significantly more than other narrators’ messages.

Participants’ sociodemographic information.

	Governor (n = 330)	Expert (n = 330)	Physician (n = 330)	Patient (n = 330)	Resident (n = 330)	Control (n = 330)	Total (N = 1,980)
	49.7	49.7	49.7	49.7	49.7	49.7	49.7

18–29	16.1	16.1	16.1	16.1	16.1	16.1	16.1
30–39	18.5	18.5	18.5	18.5	18.5	18.5	18.5
40–49	23.6	23.6	23.6	23.6	23.6	23.6	23.6
50–59	20.6	20.6	20.6	20.6	20.6	20.6	20.6
60–69	21.2	21.2	21.2	21.2	21.2	21.2	21.2

Hokkaido	4.8	4.8	4.8	4.8	4.8	4.8	4.8
Tohoku	7.9	7.9	7.9	7.9	7.9	7.9	7.9
Kanto	32.4	32.4	32.4	32.4	32.4	32.4	32.4
Hokuriku and Chubu	17.9	17.9	17.9	17.9	17.9	17.9	17.9
Kinki	16.7	16.7	16.7	16.7	16.7	16.7	16.7
Chugoku and Shikoku	8.8	8.8	8.8	8.8	8.8	8.8	8.8
Kyushu and Okinawa	11.5	11.5	11.5	11.5	11.5	11.5	11.5
	16.8	17.3	16.2	16.3	17.8	15.5	64.3

Less than high school	1.5	1.8	1.2	3.0	1.8	0.6	1.7
High school graduate	29.1	25.2	24.2	23.0	27.0	27.6	26.0
Some college	21.5	24.5	28.2	22.7	26.4	21.5	24.1
College graduate	43.6	39.1	38.2	42.1	36.7	44.5	40.7
Graduate school	4.2	9.4	8.2	9.1	8.2	5.8	7.5

Less than 2 million yen	7.9	9.7	8.8	9.4	8.2	11.5	9.2
2–6 million yen	42.7	43.3	40.0	46.1	45.5	46.1	43.9
More than 6 million yen	41.8	34.5	42.1	35.2	36.1	33.6	37.2
Unknown	7.6	12.4	9.1	9.4	10.3	8.8	9.6

Comparison of amount of change before and after intervention among groups when including all prefectures (N = 1,980).

	Governor (n = 330)			Expert (n = 330)			Physician (n = 330)			Patient (n = 330)			Resident (n = 330)				Control (n = 330)
	Before	After	Change	Before	After	Change	Before	After	Change	Before	After	Change	Before	After	Change		Before	After	Change
Intention	4.72 (0.73)	4.89 (0.74)	0.17 (0.13–0.22)	4.81 (0.75)	5.00 (0.74)	0.19 (0.14–0.24)	4.74 (0.71)	5.01 (0.76)	0.27 (0.21–0.32)	4.69 (0.79)	4.91 (0.82)	0.22 (0.16–0.27)	4.78 (0.74)	4.96 (0.74)	0.18 (0.14–0.23)	.098	4.71 (0.74)	4.77 (0.75)	0.06 (0.01–0.09)
Severity	4.42 (0.79)	4.48 (0.84)	0.06 (0.01–0.12)	4.34 (0.84)	4.51 (0.85)	0.17 (0.10–0.24)	4.25 (0.86)	4.42 (0.87)	0.17 (0.10–0.24)	4.24 (0.93)	4.57 (0.90)		4.37 (0.88)	4.51 (0.88)	0.14 (0.09–0.21)	<.001	4.34 (0.84)	4.27 (0.86)	−0.07 (−.14 to −0.00)
Vulnerability	3.04 (0.88)	3.19 (0.86)	0.15 (0.07–0.22)	3.10 (0.97)	3.24 (1.00)	0.14 (0.06–0.23)	3.09 (0.89)	3.21 (0.97)	0.12 (0.04–0.20)	3.05 (0.96)	3.46 (1.00)		3.16 (0.90)	3.58 (0.92)		<.001	3.10 (0.86)	3.13 (0.82)	0.029 (−0.04–0.10)
Response efficacy	4.42 (0.85)	4.67 (0.75)	0.25 (0.18–0.31)	4.47 (0.84)	4.79 (0.82)	0.33 (0.26–0.39)	4.40 (0.80)	4.76 (0.82)	0.36 (0.29–0.43)	4.42 (0.86)	4.71 (0.88)	0.29 (0.22–0.37)	4.50 (0.83)	4.74 (0.83)	0.24 (0.18–0.30)	.065	4.43 (0.76)	4.52 (0.81)	.09 (0.04–0.15)
Self-efficacy	4.67 (0.73)	4.85 (0.75)	0.18 (0.12–0.23)	4.72 (0.78)	4.94 (0.75)	0.22 (0.15–0.28)	4.67 (0.73)	4.95 (0.75)	0.28 (0.22–0.34)	4.67 (0.77)	4.85 (0.81)	0.17 (0.12–0.23)	4.72 (0.78)	4.92 (0.75)	0.20 (0.15–0.26)	.089	4.65 (0.71)	4.73 (0.75)	.08 (0.03–0.12)

Comparison of amount of change before and after intervention among groups when including only the “specified warning prefectures” (N = 1,274).

	Governor (n = 214)			Expert (n = 220)			Physician (n = 207)			Patient (n = 208)			Resident (n = 227)				Control (n = 198)
	Before	After	Change	Before	After	Change	Before	After	Change	Before	After	Change	Before	After	Change		Before	After	Change
Intention	4.72 (0.72)	4.89 (0.75)	0.17 (0.11.22)	4.88 (0.72)	5.07 (0.69)	0.19 (0.13–0.25)	4.75 (0.71)	5.08 (0.70)		4.72 (0.79)	4.92 (0.84)	0.21 (0.14–0.27)	4.81 (0.76)	4.99 (0.74)	0.17 (0.12–0.23)	.003	4.68 (0.76)	4.79 (0.73)	0.11 (0.05–0.16)
Severity	4.40 (0.79)	4.46 (0.82)	0.06 (−0.00–0.12)	4.29 (0.84)	4.51 (0.84)		4.21 (0.86)	4.45 (0.85)		4.26 (0.90)	4.56 (0.91)		4.35 (0.90)	4.45 (0.90)	0.10 (0.03–0.18)	<.001	4.37 (0.81)	4.30 (0.82)	–0.08 (−0.16–0.00)
Vulnerability	3.07 (0.84)	3.23 (0.86)	0.16 (0.07–0.25)	3.12 (0.98)	3.24 (1.04)	0.12 (0.02–0.22)	3.14 (0.88)	3.24 (0.99)	0.10 (0.00–0.19)	3.11 (0.94)	3.49 (0.95)		3.14 (0.90)	3.56 (0.92)		<.001	3.09 (0.88)	3.17 (0.87)	.09 (−0.01–0.19)
Response efficacy	4.46 (0.80)	4.69 (0.74)	0.23 (0.16–0.30)	4.49 (0.84)	4.85 (0.81)		4.41 (0.78)	4.78 (0.80)		4.41 (0.86)	4.69 (0.91)	0.28 (0.19–0.37)	4.54 (0.88)	4.73 (0.88)	0.19 (0.12–0.26)	.005	4.42 (0.77)	4.52 (0.81)	.10 (0.04–0.17)
Self-efficacy	4.68 (0.75)	4.85 (0.75)	0.17 (0.11–0.23)	4.81 (0.77)	5.00 (0.74)	0.19 (0.11–0.28)	4.68 (0.68)	5.01 (0.71)		4.70 (0.76)	4.86 (0.85)	0.16 (0.09–0.23)	4.74 (0.81)	4.94 (0.76)	0.21 (0.14–0.27)	.008	4.65 (0.70)	4.73 (0.75)	.08 (0.03–0.14)

4. Discussion and conclusion

4.1. discussion.

As Appendix A shows, the message from a physician specifically communicated the critical situation of hospitals being overwhelmed and the consequent risk of people being unable to receive treatment. Depiction of the crisis of overwhelmed hospitals may have evoked heightened sensation that elicited sensory, affective, and arousal responses in recipients. Social lockdown presumably evoked psychological reactance in many individuals [ 18 ]. Psychological reactance is considered one of the factors that impedes individuals’ staying at home during a pandemic [ 18 ]. Studies of psychological reactance have indicated that heightened sensation is the feature of a message that reduces psychological reactance [ 19 , 20 ]. Additionally, in Japan recommendations by physicians have a strong influence on individuals’ decision making owing to the remnants of paternalism in the patient–physician relationship [ 21 ]. These may constitute the reasons for the message from a physician generating the greatest impact on recipients’ protection motivation.

Public health professionals, governors, media professionals, and other influencers should use messages from physicians and disseminate relevant articles through the media and social networking services to encourage people to stay at home. It is important that health professionals and media have a network and collaborate with one another [ 22 ]. To build relationships and provide reliable resources, health professionals are expected to hold press conferences and study meetings with journalists. Through such networking, journalists can acquire accurate information in dealing with the pandemic, such as using messages from physicians to encourage people to stay at home. Consequently, journalists should disseminate such messages. It is also important that governments, municipalities, medical associations, and other public institutions convey messages from physicians and that the media effectively spread those messages. Owing to the advances of Web 2.0 [ 23 ], health professionals’ grassroots communication with journalists and citizens via social media may provide opportunities for many people to access persuasive messages from physicians.

4.1.1. Limitations

First, the content of the intervention messages in this study may not represent voices of all governors, public health experts, physicians, patients, and residents of outbreak areas. Second, it is not clear from this study which sentences in the intervention message made the most impact on recipients and why. Third, this study assessed intention rather than actual behavior. Finally, it is unclear as to what extent the present findings are generalizable to populations other than the Japanese participants in this study.

4.2. Conclusion

In areas with high numbers of infected people, the message from a physician, which conveyed the crisis of hospitals being overwhelmed and the consequent risk of people being unable to receive treatment, increased the intention to stay at home to a greater extent than other messages from a governor, a public health expert, a patient with COVID-19, and a resident of an outbreak area.

4.3. Practice implications

Governors, health professionals, and media professionals may be able to encourage people to stay at home by disseminating the physicians’ messages through media such as television and newspapers as well as social networking services on the internet.

This work was supported by the Japan Society for the Promotion of Science KAKENHI (grant number 19K10615).

CRediT authorship contribution statement

Tsuyoshi Okuhara: Conceptualization, Methodology, Formal analysis, Investigation, Writing - original draft, Funding acquisition. Hiroko Okada: Methodology, Investigation, Writing - review & editing. Takahiro Kiuchi: Supervision, Writing - review & editing.

Declaration of Competing Interest

The authors declare that there is no conflict of interest.

Acknowledgement

We thank Hugh McGonigle, from Edanz Group ( https://en-author-services.edanzgroup.com/ac ), for editing a draft of the manuscript.

Appendix A.

Intervention: the message from a governor.

The following is a message from the governor of your local area.

“As the novel coronavirus spreads, now is a crucial time in deciding whether we will see an explosive growth in the number of cases. The same epidemic and overwhelmed hospitals that have occurred in cities abroad can occur here. Unless absolutely essential, please refrain from going out unnecessarily and stay at home.
Please do not go to these three high-density places: closed spaces with poor ventilation, crowded places where many people gather together, and intimate spaces where you would have conversations in close proximity. As for commuting, please work from home or stagger commuting times where possible to reduce contact with other people.
The action taken by all of us will be the most effective remedy in overcoming this disease and ending the coronavirus epidemic quickly. We will do our utmost to improve our healthcare provision system, prevent the spread of infection, and mitigate the impacts on the local economy.
Let us all work together to overcome this difficult situation.”

Please avoid leaving your house as much as possible.

Staying at home can save lives and prevent the spread of infection.

Intervention: The message from an expert

The following is a message from an infectious disease control expert.

“One characteristic of the novel coronavirus is that it is difficult to notice that you are infected. As a result, it is possible that you could feel healthy but pass the virus on to 2–3 people within a week.
Those individuals could then each pass the virus on to a further 2–3 people, and those in turn could then pass the virus on to another 2–3 people. Two will become 4, 4 will become 8, 8 will become 16, 16 will become 32, and so on, and the number of infected people will keep doubling.
Unless contact between people decreases, it is estimated that about 850,000 people will become seriously ill in Japan and about 420,000 people will die.
However, if everybody stops going out and stays at home, and if we are able to reduce our contact with people by 80 %, we will be able to prevent the spread of infection. For example, stop meeting with your friends, stop going shopping, and work from home. If we can reduce the number of people infected, we can reduce the burden on doctors and nurses and prevent hospitals being overwhelmed.”

Intervention: The message from a physician

The following is a message from an emergency medical care doctor.

“The beds and intensive care units at my hospital have all been filled by patients who have the novel coronavirus, and we can no longer accept new patients. The overwhelming of hospitals and collapse of the healthcare system that happened in Italy and New York is already under way in Japan.
Doctors and nurses are being fully mobilized for treatment, but they lack masks and protective clothing. We have cut plastic folders with scissors to make face shields to cover our faces. We use the same mask for 3 days. With the high risk of infection, we are being pushed to the limit.
It is not uncommon for infection to occur within the hospital. Even if only one of the doctors or nurses gets infected, many co-workers have to isolate themselves at home and are unable to continue providing treatment. This means that, if any one of you becomes infected and their condition becomes critical, there may be no treatment available.
We are staying in the hospitals and continuing to provide treatment. So please, stay at home. If you do your part, we will be able to do ours.”

Intervention: The message from a patient

The following is a message from a patient who is infected with the novel coronavirus.

“I had a 40-degree fever and a headache that felt like someone was stomping on my head. I could not stop coughing, and the pain felt as though I was inhaling broken glass. I really thought that I was going to die.
I have no pre-existing conditions, do not smoke, and was perfectly healthy, but now I cannot breathe without a breathing tube. I have a drip and a catheter stuck into both of my hands. Right now, I feel ten times better than I did when I was at my worst, and I am able to talk about my condition. But my fever refused to go down even after I had taken medication, and I do not know how many days have passed since I was hospitalized.
I do not know where I was infected. I do not know the route of infection, whether it was my workplace, somewhere I had visited for work, or when I was out shopping. Afterward, the rest of my family also tested positive. I had passed it to them.
You do not know where you can be infected. Do not assume that you will be okay because you are young or healthy. The virus does not pick and choose. Please stop going out. Stay at home.”

Intervention: The message from a resident

The following is a message from an individual who lives in an area where an outbreak of novel coronavirus has occurred.

“In the beginning, I did not really feel a sense of crisis. Of course I thought ‘Coronavirus is scary; better be careful,’ but nothing more. However, in the area where I live, the number of those infected has increased tenfold from 1500 to 15,000 in just one week. It is a real outbreak.
The number of infected people increased all at once and overwhelmed the hospitals. They are lacking beds and ventilators. Some doctors and nurses are infected, and there are not enough hospital staff. Because of the healthcare system collapse, even if you are infected with coronavirus you will be unable to receive a test or treatment. If I or my family are infected and our condition becomes critical, we will likely die.
I am scared to go grocery shopping. I always disinfect my purchases with alcohol, but soon my alcohol will run out.
If you continue to go out, the number of those infected could jump to the tens of thousands, and the situation in your area will be the same as it is here. Please stop going out. Stay at home.”

A control message

According to the traditional definition, grinding one’s teeth is when somebody makes a sound by strongly grinding the teeth together, usually unconsciously or while asleep. Nowadays, it is often referred to as ‘teeth grinding,’ a term which also covers various actions that we do while awake.

Whether you are sleeping or awake, the non-functional biting habit of grinding one’s teeth dynamically or statically, or clenching one’s teeth, can also be referred to as bruxism (sleep bruxism if it occurs at night). Bruxism can be categorized into the movements of: sliding the upper and lower teeth together like mortar and pestle (grinding); firmly and statically engaging the upper and lower teeth (clenching); and dynamically bringing the upper and lower teeth together with a tap (tapping).

Bruxism is difficult to diagnose, as it often has no noticeable symptoms. Stress and dentition are thought to be causes of bruxism, but it is currently unclear and future research is anticipated.

Splint therapy, which involves the use of a mouthpiece as an artificial plastic covering on one’s teeth, and cognitive behavioral therapy are being researched as treatments for bruxism.

Appendix B.

(Cronbach’s α 0.863)

(1) Would you like to cancel or postpone plans such as “meeting people,” “eating out,” and “attending events” because of the new coronavirus infection?

(2) Would you like to reduce the time you spend shopping in stores outside your home because of the new coronavirus infection?

(3) Would you like to avoid crowded spaces because of the new coronavirus infection?

(Cronbach’s α 0.480)

(1) How serious do you think your health will be if you are infected with the new coronavirus?

(2) How serious do you think the social situation will be if the new coronavirus spreads?

(Cronbach’s α 0.875)

(1) How likely are you to be infected with the new coronavirus?

(2) How likely are you to be infected with the new coronavirus when compared with someone of the same sex and age as you?

(Cronbach’s α 0.921)

(1) Do you think that you can save your life from the new coronavirus infection and prevent the spread of infection …by canceling or postponing your appointments such as “meeting people,” “eating out,” and “attending events”?

(2) …by reducing the time you spend shopping at stores outside your home?

(3) …by avoiding crowded spaces?

(Cronbach’s α 0.853)

(1) Do you think that you can cancel or postpone your appointments such as “meeting people,” “eating out,” and “attending events” because of the new coronavirus infection?

(2) Do you think you can reduce the time you spend shopping in stores outside your home because of the new coronavirus infection?

(3) Do you think you can avoid the crowded spaces because of the new coronavirus infection?

All questions above were on a scale of 1–6, ranging from “extremely unlikely” to “unlikely,” “a little unlikely,” “a little likely,” “likely,” and “extremely likely.”

Does Free Speech Protect COVID-19 Vaccine Misinformation?

April 22, 2022
Sharon Beckstrand
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We all know, or have heard about, someone who’s refused to get a COVID-19 vaccine. While some individuals have medical or religious reasons for avoiding vaccination, for some, other factors influence their decision. Despite the importance of vaccines for public health — and the serious risk associated with being unvaccinated — getting the shot may feel like a betrayal of certain political beliefs.

But where does this feeling come from? Throughout the pandemic, some politicians and other influencers have promoted advice that’s not based on scientific data — sometimes it’s with good intentions, other times it’s intentionally misleading. But the outcome is the same: misinformation.

This led Michelle Mello , JD, PhD, a Stanford Medicine professor of health policy and Stanford Law professor, to dig into questions that surround this issue.

While some might say making or spreading known false statements related to the vaccine should be criminalized, the First Amendment, which guarantees free speech, continues to provide protection for people who promulgate such faulty information. So, how can the spread of misinformation be stopped without quashing free speech?

I spoke with Mello and asked her to address the Supreme Court’s view on vaccine misinformation — an issue she addressed in a recent Viewpoint piece in JAMA Health Forum . The following Q&A has been edited and condensed.

Several countries have criminalized vaccine misinformation, but the United States has not. Has the Supreme Court’s interpretation of the First Amendment allowed the continued spread of false claims?

The Supreme Court has held that many kinds of false statements are protected speech under the First Amendment. In a 2012 case called United States v. Alvarez , the Supreme Court struck down a law that made it a criminal offense to lie about having received military medals. It refused to hold that a statement’s falsity put it outside the realm of First Amendment protection.

But there are some kinds of false speech that can be penalized by the government, including lying in court, making false statements to the government, impersonating a government official, defaming someone and committing commercial fraud. But it’s a pretty limited list. The Supreme Court’s general finding is that false statements can often be valuable in terms of allowing people to challenge widely held beliefs without fear of repercussions, and that things could go pretty wrong if the government had a wider berth to regulate them.

What risks would be involved in allowing the government to police false claims?

One problem is that we may not all agree on how demonstrably false something has to be in order for it to be restricted. For vaccine risks, for example, some claims about health harms have been persuasively disproven, while others have simply not been studied. So, if I claim that a vaccine was the reason my hair fell out, is that false or just not demonstrably true? Should the difference matter?

A related problem is that for some claims, especially scientific ones, the knowledge base that makes a statement true or false evolves over time. To complicate things further, some people who disseminate false statements know they are lies, while others believe they’re true. Finally, many people just don’t trust the government to not abuse the power to declare something false speech.

All of these challenges make the Supreme Court wary of restricting speech that might ultimately prove to be truthful, or at least contribute to public debate that aids in discovering the truth. The Supreme Court would prefer to let the decision about what’s true be hashed out by “the marketplace of ideas.”

But the interesting thing is, these problems also apply to areas where courts do allow regulation of false statements. Lawmakers have found ways of addressing them, such as requiring the government to prove certain things about the statement or the speaker’s state of mind. It’s not clear, therefore, why the Supreme Court draws the lines it does.

How does our reverence for freedom of speech in the United States intensify our vulnerability to public health threats?

It limits our policy toolkit. Rather than curbing misinformation about health issues, the government is relegated to trying to fight it with counter-speech. Although the idea that clashing ideas will surface the best ideas is appealing to judges, it doesn’t always work out in practice. People’s false beliefs arising from vaccine misinformation, in particular, are extremely difficult to change.

First Amendment protections also make it hard for the government to do things like require warnings about health risks. For example, the Food and Drug Administration fought legal battles for years over its initiative to require cigarette makers to put pictorial warning labels on cigarette packs, with the industry arguing that the requirement constituted compelled speech in violation of free speech rights. The City of San Francisco had similar problems when it tried to require beverage companies to put warnings on their billboard advertisements about the link between consumption of sugary drinks and obesity.

What is the broader impact of taking medical advice from non-medical professionals who may have an agenda not grounded in science or medicine?

Many people — including some medical practitioners — have made it harder for Americans to understand how to protect themselves during the pandemic by crowding the information space with claims that aren’t evidence-based.

It can be hard for people to distinguish between reliable and unreliable sources of information, especially about a new health threat and especially when unreliable information is disseminated by individuals who seem trustworthy by dint of their professional role.

In the case of COVID-19 vaccines, misinformation has led as many as 12 million Americans to forgo vaccination, resulting in an estimated 1,200 excess hospitalizations and 300 deaths per day, according to Johns Hopkins’ Center for Health Security.

What are the ramifications of the continued politicization of the COVID-19 pandemic on our ability to make public health decisions?

Often, when an issue becomes politicized, people view messages from the group they don’t identify with as suspicious, and messages from the group they do identify with as trustworthy — regardless of how well the messages align with the evidence. If we can’t make sound decisions about how we interact with information, we can’t make sound decisions about health.

(Originally published by Stanford Medicine’s Scope Blog on April 21, 2022)

Here Are Arguments That Can Help Overcome COVID-19 Vaccine Hesitancy

August 2024

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The White House 1600 Pennsylvania Ave NW Washington, DC 20500

Remarks by President Biden on Fighting the COVID- ⁠ 19 Pandemic

5:02 P.M. EDT THE PRESIDENT: Good evening, my fellow Americans. I want to talk to you about where we are in the battle against COVID-19, the progress we’ve made, and the work we have left to do. And it starts with understanding this: Even as the Delta variant 19 [sic] has — COVID-19 — has been hitting this country hard, we have the tools to combat the virus, if we can come together as a country and use those tools. If we raise our vaccination rate, protect ourselves and others with masking and expanded testing, and identify people who are infected, we can and we will turn the tide on COVID-19. It will take a lot of hard work, and it’s going to take some time. Many of us are frustrated with the nearly 80 million Americans who are still not vaccinated, even though the vaccine is safe, effective, and free. You might be confused about what is true and what is false about COVID-19. So before I outline the new steps to fight COVID-19 that I’m going to be announcing tonight, let me give you some clear information about where we stand. First, we have cons- — we have made considerable progress in battling COVID-19. When I became President, about 2 million Americans were fully vaccinated. Today, over 175 million Americans have that protection. Before I took office, we hadn’t ordered enough vaccine for every American. Just weeks in office, we did. The week before I took office, on January 20th of this year, over 25,000 Americans died that week from COVID-19. Last week, that grim weekly toll was down 70 percent. And in the three months before I took office, our economy was faltering, creating just 50,000 jobs a month. We’re now averaging 700,000 new jobs a month in the past three months. This progress is real. But while America is in much better shape than it was seven months ago when I took office, I need to tell you a second fact. We’re in a tough stretch, and it could last for a while. The highly contagious Delta variant that I began to warn America about back in July spread in late summer like it did in other countries before us. While the vaccines provide strong protections for the vaccinated, we read about, we hear about, and we see the stories of hospitalized people, people on their death beds, among the unvaccinated over these past few weeks. This is a pandemic of the unvaccinated. And it’s caused by the fact that despite America having an unprecedented and successful vaccination program, despite the fact that for almost five months free vaccines have been available in 80,000 different locations, we still have nearly 80 million Americans who have failed to get the shot. And to make matters worse, there are elected officials actively working to undermine the fight against COVID-19. Instead of encouraging people to get vaccinated and mask up, they’re ordering mobile morgues for the unvaccinated dying from COVID in their communities. This is totally unacceptable. Third, if you wonder how all this adds up, here’s the math: The vast majority of Americans are doing the right thing. Nearly three quarters of the eligible have gotten at least one shot, but one quarter has not gotten any. That’s nearly 80 million Americans not vaccinated. And in a country as large as ours, that’s 25 percent minority. That 25 percent can cause a lot of damage — and they are. The unvaccinated overcrowd our hospitals, are overrunning the emergency rooms and intensive care units, leaving no room for someone with a heart attack, or pancreitis [pancreatitis], or cancer. And fourth, I want to emphasize that the vaccines provide very strong protection from severe illness from COVID-19. I know there’s a lot of confusion and misinformation. But the world’s leading scientists confirm that if you are fully vaccinated, your risk of severe illness from COVID-19 is very low. In fact, based on available data from the summer, only one of out of every 160,000 fully vaccinated Americans was hospitalized for COVID per day. These are the facts. So here’s where we stand: The path ahead, even with the Delta variant, is not nearly as bad as last winter. But what makes it incredibly more frustrating is that we have the tools to combat COVID-19, and a distinct minority of Americans –supported by a distinct minority of elected officials — are keeping us from turning the corner. These pandemic politics, as I refer to, are making people sick, causing unvaccinated people to die. We cannot allow these actions to stand in the way of protecting the large majority of Americans who have done their part and want to get back to life as normal. As your President, I’m announcing tonight a new plan to require more Americans to be vaccinated, to combat those blocking public health. My plan also increases testing, protects our economy, and will make our kids safer in schools. It consists of six broad areas of action and many specific measures in each that — and each of those actions that you can read more about at WhiteHouse.gov. WhiteHouse.gov. The measures — these are going to take time to have full impact. But if we implement them, I believe and the scientists indicate, that in the months ahead we can reduce the number of unvaccinated Americans, decrease hospitalizations and deaths, and allow our children to go to school safely and keep our economy strong by keeping businesses open. First, we must increase vaccinations among the unvaccinated with new vaccination requirements. Of the nearly 80 million eligible Americans who have not gotten vaccinated, many said they were waiting for approval from the Food and Drug Administration — the FDA. Well, last month, the FDA granted that approval. So, the time for waiting is over. This summer, we made progress through the combination of vaccine requirements and incentives, as well as the FDA approval. Four million more people got their first shot in August than they did in July. But we need to do more. This is not about freedom or personal choice. It’s about protecting yourself and those around you — the people you work with, the people you care about, the people you love. My job as President is to protect all Americans. So, tonight, I’m announcing that the Department of Labor is developing an emergency rule to require all employers with 100 or more employees, that together employ over 80 million workers, to ensure their workforces are fully vaccinated or show a negative test at least once a week. Some of the biggest companies are already requiring this: United Airlines, Disney, Tysons Food, and even Fox News. The bottom line: We’re going to protect vaccinated workers from unvaccinated co-workers. We’re going to reduce the spread of COVID-19 by increasing the share of the workforce that is vaccinated in businesses all across America. My plan will extend the vaccination requirements that I previously issued in the healthcare field. Already, I’ve announced, we’ll be requiring vaccinations that all nursing home workers who treat patients on Medicare and Medicaid, because I have that federal authority. Tonight, I’m using that same authority to expand that to cover those who work in hospitals, home healthcare facilities, or other medical facilities –- a total of 17 million healthcare workers. If you’re seeking care at a health facility, you should be able to know that the people treating you are vaccinated. Simple. Straightforward. Period. Next, I will sign an executive order that will now require all executive branch federal employees to be vaccinated — all. And I’ve signed another executive order that will require federal contractors to do the same. If you want to work with the federal government and do business with us, get vaccinated. If you want to do business with the federal government, vaccinate your workforce. And tonight, I’m removing one of the last remaining obstacles that make it difficult for you to get vaccinated. The Department of Labor will require employers with 100 or more workers to give those workers paid time off to get vaccinated. No one should lose pay in order to get vaccinated or take a loved one to get vaccinated. Today, in total, the vaccine requirements in my plan will affect about 100 million Americans –- two thirds of all workers. And for other sectors, I issue this appeal: To those of you running large entertainment venues — from sports arenas to concert venues to movie theaters — please require folks to get vaccinated or show a negative test as a condition of entry. And to the nation’s family physicians, pediatricians, GPs — general practitioners –- you’re the most trusted medical voice to your patients. You may be the one person who can get someone to change their mind about being vaccinated. Tonight, I’m asking each of you to reach out to your unvaccinated patients over the next two weeks and make a personal appeal to them to get the shot. America needs your personal involvement in this critical effort. And my message to unvaccinated Americans is this: What more is there to wait for? What more do you need to see? We’ve made vaccinations free, safe, and convenient. The vaccine has FDA approval. Over 200 million Americans have gotten at least one shot. We’ve been patient, but our patience is wearing thin. And your refusal has cost all of us. So, please, do the right thing. But just don’t take it from me; listen to the voices of unvaccinated Americans who are lying in hospital beds, taking their final breaths, saying, “If only I had gotten vaccinated.” “If only.” It’s a tragedy. Please don’t let it become yours. The second piece of my plan is continuing to protect the vaccinated. For the vast majority of you who have gotten vaccinated, I understand your anger at those who haven’t gotten vaccinated. I understand the anxiety about getting a “breakthrough” case. But as the science makes clear, if you’re fully vaccinated, you’re highly protected from severe illness, even if you get COVID-19. In fact, recent data indicates there is only one confirmed positive case per 5,000 fully vaccinated Americans per day. You’re as safe as possible, and we’re doing everything we can to keep it that way — keep it that way, keep you safe. That’s where boosters come in — the shots that give you even more protection than after your second shot. Now, I know there’s been some confusion about boosters. So, let me be clear: Last month, our top government doctors announced an initial plan for booster shots for vaccinated Americans. They believe that a booster is likely to provide the highest level of protection yet. Of course, the decision of which booster shots to give, when to start them, and who will give them, will be left completely to the scientists at the FDA and the Centers for Disease Control. But while we wait, we’ve done our part. We’ve bought enough boosters — enough booster shots — and the distribution system is ready to administer them. As soon as they are authorized, those eligible will be able to get a booster right away in tens of thousands of site across the — sites across the country for most Americans, at your nearby drug store, and for free. The third piece of my plan is keeping — and maybe the most important — is keeping our children safe and our schools open. For any parent, it doesn’t matter how low the risk of any illness or accident is when it comes to your child or grandchild. Trust me, I know. So, let me speak to you directly. Let me speak to you directly to help ease some of your worries. It comes down to two separate categories: children ages 12 and older who are eligible for a vaccine now, and children ages 11 and under who are not are yet eligible. The safest thing for your child 12 and older is to get them vaccinated. They get vaccinated for a lot of things. That’s it. Get them vaccinated. As with adults, almost all the serious COVID-19 cases we’re seeing among adolescents are in unvaccinated 12- to 17-year-olds — an age group that lags behind in vaccination rates. So, parents, please get your teenager vaccinated. What about children under the age of 12 who can’t get vaccinated yet? Well, the best way for a parent to protect their child under the age of 12 starts at home. Every parent, every teen sibling, every caregiver around them should be vaccinated. Children have four times higher chance of getting hospitalized if they live in a state with low vaccination rates rather than the states with high vaccination rates. Now, if you’re a parent of a young child, you’re wondering when will it be — when will it be — the vaccine available for them. I strongly support an independent scientific review for vaccine uses for children under 12. We can’t take shortcuts with that scientific work. But I’ve made it clear I will do everything within my power to support the FDA with any resource it needs to continue to do this as safely and as quickly as possible, and our nation’s top doctors are committed to keeping the public at large updated on the process so parents can plan. Now to the schools. We know that if schools follow the science and implement the safety measures — like testing, masking, adequate ventilation systems that we provided the money for, social distancing, and vaccinations — then children can be safe from COVID-19 in schools. Today, about 90 percent of school staff and teachers are vaccinated. We should get that to 100 percent. My administration has already acquired teachers at the schools run by the Defense Department — because I have the authority as President in the federal system — the Defense Department and the Interior Department — to get vaccinated. That’s authority I possess. Tonight, I’m announcing that we’ll require all of nearly 300,000 educators in the federal paid program, Head Start program, must be vaccinated as well to protect your youngest — our youngest — most precious Americans and give parents the comfort. And tonight, I’m calling on all governors to require vaccination for all teachers and staff. Some already have done so, but we need more to step up. Vaccination requirements in schools are nothing new. They work. They’re overwhelmingly supported by educators and their unions. And to all school officials trying to do the right thing by our children: I’ll always be on your side. Let me be blunt. My plan also takes on elected officials and states that are undermining you and these lifesaving actions. Right now, local school officials are trying to keep children safe in a pandemic while their governor picks a fight with them and even threatens their salaries or their jobs. Talk about bullying in schools. If they’ll not help — if these governors won’t help us beat the pandemic, I’ll use my power as President to get them out of the way. The Department of Education has already begun to take legal action against states undermining protection that local school officials have ordered. Any teacher or school official whose pay is withheld for doing the right thing, we will have that pay restored by the federal government 100 percent. I promise you I will have your back. The fourth piece of my plan is increasing testing and masking. From the start, America has failed to do enough COVID-19 testing. In order to better detect and control the Delta variant, I’m taking steps tonight to make testing more available, more affordable, and more convenient. I’ll use the Defense Production Act to increase production of rapid tests, including those that you can use at home. While that production is ramping up, my administration has worked with top retailers, like Walmart, Amazon, and Kroger’s, and tonight we’re announcing that, no later than next week, each of these outlets will start to sell at-home rapid test kits at cost for the next three months. This is an immediate price reduction for at-home test kits for up to 35 percent reduction. We’ll also expand — expand free testing at 10,000 pharmacies around the country. And we’ll commit — we’re committing $2 billion to purchase nearly 300 million rapid tests for distribution to community health centers, food banks, schools, so that every American, no matter their income, can access free and convenient tests. This is important to everyone, particularly for a parent or a child — with a child not old enough to be vaccinated. You’ll be able to test them at home and test those around them. In addition to testing, we know masking helps stop the spread of COVID-19. That’s why when I came into office, I required masks for all federal buildings and on federal lands, on airlines, and other modes of transportation. Today — tonight, I’m announcing that the Transportation Safety Administration — the TSA — will double the fines on travelers that refuse to mask. If you break the rules, be prepared to pay. And, by the way, show some respect. The anger you see on television toward flight attendants and others doing their job is wrong; it’s ugly. The fifth piece of my plan is protecting our economic recovery. Because of our vaccination program and the American Rescue Plan, which we passed early in my administration, we’ve had record job creation for a new administration, economic growth unmatched in 40 years. We cannot let unvaccinated do this progress — undo it, turn it back. So tonight, I’m announcing additional steps to strengthen our economic recovery. We’ll be expanding COVID-19 Economic Injury Disaster Loan programs. That’s a program that’s going to allow small businesses to borrow up to $2 million from the current $500,000 to keep going if COVID-19 impacts on their sales. These low-interest, long-term loans require no repayment for two years and be can used to hire and retain workers, purchase inventory, or even pay down higher cost debt racked up since the pandemic began. I’ll also be taking additional steps to help small businesses stay afloat during the pandemic. Sixth, we’re going to continue to improve the care of those who do get COVID-19. In early July, I announced the deployment of surge response teams. These are teams comprised of experts from the Department of Health and Human Services, the CDC, the Defense Department, and the Federal Emergency Management Agency — FEMA — to areas in the country that need help to stem the spread of COVID-19. Since then, the federal government has deployed nearly 1,000 staff, including doctors, nurses, paramedics, into 18 states. Today, I’m announcing that the Defense Department will double the number of military health teams that they’ll deploy to help their fellow Americans in hospitals around the country. Additionally, we’re increasing the availability of new medicines recommended by real doctors, not conspir- — conspiracy theorists. The monoclonal antibody treatments have been shown to reduce the risk of hospitalization by up to 70 percent for unvaccinated people at risk of developing sefe- — severe disease. We’ve already distributed 1.4 million courses of these treatments to save lives and reduce the strain on hospitals. Tonight, I’m announcing we will increase the average pace of shipment across the country of free monoclonal antibody treatments by another 50 percent. Before I close, let me say this: Communities of color are disproportionately impacted by this virus. And as we continue to battle COVID-19, we will ensure that equity continues to be at the center of our response. We’ll ensure that everyone is reached. My first responsibility as President is to protect the American people and make sure we have enough vaccine for every American, including enough boosters for every American who’s approved to get one. We also know this virus transcends borders. That’s why, even as we execute this plan at home, we need to continue fighting the virus overseas, continue to be the arsenal of vaccines. We’re proud to have donated nearly 140 million vaccines over 90 countries, more than all other countries combined, including Europe, China, and Russia combined. That’s American leadership on a global stage, and that’s just the beginning. We’ve also now started to ship another 500 million COVID vaccines — Pfizer vaccines — purchased to donate to 100 lower-income countries in need of vaccines. And I’ll be announcing additional steps to help the rest of the world later this month. As I recently released the key parts of my pandemic preparedness plan so that America isn’t caught flat-footed when a new pandemic comes again — as it will — next month, I’m also going to release the plan in greater detail. So let me close with this: We have so- — we’ve made so much progress during the past seven months of this pandemic. The recent increases in vaccinations in August already are having an impact in some states where case counts are dropping in recent days. Even so, we remain at a critical moment, a critical time. We have the tools. Now we just have to finish the job with truth, with science, with confidence, and together as one nation. Look, we’re the United States of America. There’s nothing — not a single thing — we’re unable to do if we do it together. So let’s stay together. God bless you all and all those who continue to serve on the frontlines of this pandemic. And may God protect our troops. Get vaccinated. 5:28 P.M. EDT

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Persuasive Essay About Covid19
A persuasive essay about the COVID-19 vaccine could consider the benefits of getting vaccinated as well as the potential side effects. ... Persuasive speeches about Covid-19 can provide the audience with valuable insights on how to best handle the pandemic. They can be used to advocate for specific changes in policies or simply raise awareness ...
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With the release of COVID-19 vaccines, social marketing techniques are adopted in immunization campaigns to educate the general public about the vaccine's safety and effectiveness, build ...
Persuasive messaging to increase COVID-19 vaccine uptake ...
Without high rates of uptake, however, the pandemic is likely to be prolonged. Here we use two survey experiments to study how persuasive messaging affects COVID-19 vaccine uptake intentions. In the first experiment, we test a large number of treatment messages. One subgroup of messages draws on the idea that mass vaccination is a collective ...
Motivating COVID-19 Vaccination through Persuasive ...
Vaccination is a vital defense against COVID-19 infections and outbreaks, yet vaccine hesitancy poses a significant threat to pandemic response and recovery. We conducted a systematic review of published randomized controlled trials (N = 47) assessing the persuasive effects of COVID-19 communication on COVID-19 vaccine acceptance. Individual vs ...
Examining persuasive message type to encourage staying at home during
Such articles convey messages from governors, public health experts, physicians, COVID-19 patients, and residents of outbreak areas, encouraging people to stay at home. This is the first study to examine which narrator's message is most persuasive in encouraging people to do so during the COVID-19 pandemic and social lockdown.
Does Free Speech Protect COVID-19 Vaccine Misinformation?
In the case of COVID-19 vaccines, misinformation has led as many as 12 million Americans to forgo vaccination, resulting in an estimated 1,200 excess hospitalizations and 300 deaths per day, according to Johns Hopkins' Center for Health Security.
Make a persuasive essay about the covid 19 vaccine
NicoleOfficial. report flag outlined. Answer: The COVID-19 vaccines produce protection against the disease, as a result of developing an immune response to the SARS-Cov-2 virus. Developing immunity through vaccination means there is a reduced risk of developing the illness and its consequences. This immunity helps you fight the virus if exposed.
Here Are Arguments That Can Help Overcome COVID-19 Vaccine Hesitancy
Here are statements found to be most convincing for vaccination acceptance, according to the poll: • "At 95 percent efficacy, this vaccine is extraordinarily effective at protecting you from the virus". • "Vaccines will help bring this pandemic to an end". • "Getting vaccinated will help keep you, your family, your community, and ...
Remarks by President Biden on Fighting the COVID-19 Pandemic
19. Pandemic. Briefing Room. Speeches and Remarks. 5:02 P.M. EDT. THE PRESIDENT: Good evening, my fellow Americans. I want to talk to you about where we are in the battle against COVID-19, the ...