persuasive essay about covid 19 vaccination

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:

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:

Step 5: Provide Background Information

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

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:

Step 7: Address Counterarguments

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

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:

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 Covid19

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:

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

If you're in search of a compelling persuasive essay on business, don't miss out on our “ persuasive essay about business ” blog!

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

Interested in thought-provoking discussions on abortion? Read our persuasive essay about abortion blog to eplore arguments!

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 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

Looking for a persuasive take on the topic of smoking? You'll find it all related arguments in out Persuasive Essay About Smoking blog!

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

Start by narrowing down your focus. COVID-19 is a broad topic, so selecting a specific aspect or issue related to it will make your essay more persuasive and manageable. For example, you could focus on vaccination, public health measures, the economic impact, or misinformation.

Provide Credible Sources

Support your arguments with credible sources such as scientific studies, government reports, and reputable news outlets. Reliable sources enhance the credibility of your essay.

Use Persuasive Language

Employ persuasive techniques, such as ethos (establishing credibility), pathos (appealing to emotions), and logos (using logic and evidence). Use vivid examples and anecdotes to make your points relatable.

Organize Your Essay

Structure your essay involves creating a persuasive essay outline and establishing a logical flow from one point to the next. Each paragraph should focus on a single point, and transitions between paragraphs should be smooth and logical.

Emphasize Benefits

Highlight the benefits of your proposed actions or viewpoints. Explain how your suggestions can improve public health, safety, or well-being. Make it clear why your audience should support your position.

Use Visuals -H3

Incorporate graphs, charts, and statistics when applicable. Visual aids can reinforce your arguments and make complex data more accessible to your readers.

Call to Action

End your essay with a strong call to action. Encourage your readers to take a specific step or consider your viewpoint. Make it clear what you want them to do or think after reading your essay.

Revise and Edit

Proofread your essay for grammar, spelling, and clarity. Make sure your arguments are well-structured and that your writing flows smoothly.

Seek Feedback

Have someone else read your essay to get feedback. They may offer valuable insights and help you identify areas where your persuasive techniques can be improved.

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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

Are there any ethical considerations when writing a persuasive essay about covid-19.

Yes, there are ethical considerations when writing a persuasive essay about COVID-19. It's essential to ensure the information is accurate, not contribute to misinformation, and be sensitive to the pandemic's impact on individuals and communities. Additionally, respecting diverse viewpoints and emphasizing public health benefits can promote ethical communication.

What impact does COVID-19 have on society?

The impact of COVID-19 on society is far-reaching. It has led to job and economic losses, an increase in stress and mental health disorders, and changes in education systems. It has also had a negative effect on social interactions, as people have been asked to limit their contact with others.

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Persuasive Essay Writing

Persuasive Essay About Covid 19

Top Examples of Persuasive Essay about Covid-19

Published on: Jan 10, 2023

Last updated on: Jan 29, 2024

Examples of Persuasive Essay About Covid-19

The coronavirus pandemic has everyone on edge. You can expect your teachers to give you an essay about covid-19. You might be overwhelmed about what to write in an essay.

Worry no more!

Here are a few examples to help get you started.

Persuasive Essay About Covid-19 Pandemic

Sample Of Persuasive Essay About Covid-19

Persuasive Essay About Covid-19 In The Philippines - Example

Check out some more persuasive essay examples to get more inspiration and guidance.

Examples of Persuasive Essay About the Covid-19 Vaccine

With so much uncertainty surrounding the Covid-19 vaccine, it can be challenging for students to write a persuasive essay about getting vaccinated.

Here are a few examples of persuasive essays about vaccination against covid-19.

Check these out to learn more.

Persuasive essay on the covid-19 vaccine

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Examples of Persuasive Essay About Covid-19 Integration

Writing a persuasive essay on Covid-19 integration doesn't have to be stressful or overwhelming.

With the right approach and preparation, you can write an essay that will get them top marks!

Here are a few samples of compelling persuasive essays. Give them a look and get inspiration for your next essay.

Integration of Covid-19 Persuasive essay

Integration of Covid-19 Persuasive essay sample

Examples of Argumentative Essay About Covid-19

Writing an argumentative essay can be a daunting task, especially when the topic is as broad as the novel coronavirus pandemic.

Read the following examples of how to make a compelling argument on covid-19.

Argumentative essay on Covid-19

Argumentative Essay On Covid-19

Examples of Persuasive Speeches About Covid-19

Writing a persuasive speech about anything can seem daunting. However, writing a persuasive speech about something as important as the Covid-19 pandemic doesnât have to be difficult.

So let's explore some examples of perfectly written persuasive essays.

Persuasive Speech About Covid-19 Example

Tips to Write a Persuasive Essay

Here are seven tips that can help you create a strong argument on the topic of covid-19.

Check out this informative video to learn more about effective tips and tricks for writing persuasive essays.

1. Start with an attention-grabbing hook:

Use a quote, statistic, or interesting fact related to your argument at the beginning of your essay to draw the reader in.

2. Make sure you have a clear thesis statement:

A thesis statement is one sentence that expresses the main idea of your essay. It should clearly state your stance on the topic and provide a strong foundation for the rest of your content.

3. Support each point with evidence:

To make an effective argument, you must back up each point with credible evidence from reputable sources. This will help build credibility and validate your claims throughout your paper.

4. Use emotional language and tone:

Emotional appeals are powerful tools to help make your argument more convincing. Use appropriate language for the audience and evokes emotion to draw them in and get them on board with your claims.

5. Anticipate counterarguments:

Use proper counterarguments to effectively address all point of views.

Acknowledge opposing viewpoints and address them directly by providing evidence or reasoning why they are wrong.

6. Stay focused:

Keep your main idea in mind throughout the essay, making sure all of your arguments support it. Donât stray off-topic or introduce unnecessary information that will distract from the purpose of your paper.

7. Conclude strongly:

Make sure you end on a strong note. Reemphasize your main points, restate your thesis statement, and challenge the reader to respond or take action in some way. This will leave a lasting impression in their minds and make them more likely to agree with you.

Writing an effective persuasive essay is a piece of cake with our guide and examples. Check them out to learn more!

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Frequently Asked Questions

How do you begin a persuasive essay.

To begin a persuasive essay, you must choose a topic you feel strongly about and formulate an argument or position. Start by researching your topic thoroughly and then formulating your thesis statement.

What are good topics for persuasive essays?

Good topics for persuasive essays include healthcare reform, gender issues, racial inequalities, animal rights, environmental protection, and political change. Other popular topics are social media addiction, internet censorship, gun control legislation, and education reform.

What impact does COVID-19 have on society?

The COVID-19 pandemic has had a major impact on society worldwide. It has changed the way we interact with one another. The pandemic has also caused economic disruption, forcing many businesses to close or downsize their operations.

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Should COVID-19 vaccines be mandatory? Two experts discuss

persuasive essay about covid 19 vaccination

Senior Research Fellow, Oxford Uehiro Centre for Practical Ethics, University of Oxford

NIHR Academic Clinical Fellow in Public Health Medicine, UCL

Disclosure statement

Alberto Giubilini receives funding from the Arts and Humanities Research Council/UK Research and Innovation (AHRC/UKRI) and has previously received funding from the Wellcome Trust.

Vageesh Jain is affiliated with Public Health England under an honorary contract as a speciality registrar.

University College London provides funding as a founding partner of The Conversation UK.

University of Oxford provides funding as a member of The Conversation UK.

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To be properly protective, COVID-19 vaccines need to be given to most people worldwide. Only through widespread vaccination will we reach herd immunity – where enough people are immune to stop the disease from spreading freely. To achieve this, some have suggested vaccines should be made compulsory , though the UK government has ruled this out . But with high rates of COVID-19 vaccine hesitancy in the UK and elsewhere , is this the right call? Here, two experts to make the case for and against mandatory COVID-19 vaccines.

Alberto Giubilini, Senior Research Fellow, Oxford Uehiro Centre for Practical Ethics, University of Oxford

COVID-19 vaccination should be mandatory – at least for certain groups. This means there would be penalties for failure to vaccinate, such as fines or limitations on freedom of movement.

The less burdensome it is for an individual to do something that prevents harm to others, and the greater the harm prevented, the stronger the ethical reason for mandating it.

Being vaccinated dramatically reduces the risk of seriously harming or killing others. Vaccines such as the Pfizer , AstraZeneca or Moderna ones with 90-95% efficacy at preventing people from getting sick are also likely to be effective at stopping the virus from spreading, though possibly to a lower degree. Such benefits would come at a very minimal cost to individuals.

Lockdown is mandatory. Exactly like mandatory vaccination, it protects vulnerable people from COVID-19. But, as I have argued in detail elsewhere, unlike mandatory vaccination, lockdown entails very large individual and societal costs. It is inconsistent to accept mandatory lockdown but reject mandatory vaccination. The latter can achieve a much greater good at a much smaller cost.

Also, mandatory vaccination ensures that the risks and burdens of reaching herd immunity are distributed evenly across the population. Because herd immunity benefits society collectively, it’s only fair that the responsibility of reaching it is shared evenly among society’s individual members.

Of course, we might achieve herd immunity through less restrictive alternatives than making vaccination mandatory – such as information campaigns to encourage people to be vaccinated. But even if we reach herd immunity, the higher the uptake of vaccines, the lower the risk of falling below the herd immunity threshold at a later time. We should do everything we can to prevent that emergency from happening – especially when the cost of doing so is low.

Fostering trust and driving uptake by making people more informed is a nice narrative, but it’s risky. Merely giving people information on vaccines does not always result in increased willingness to vaccinate and might actually lower confidence in vaccines. On the other hand, we’ve seen mandatory vaccination policies in Italy recently successfully boost vaccine uptake for other diseases.

Mandatory seatbelt policies have proven very successful in reducing deaths from car accidents, and are now widely endorsed despite the (very small) risks that seatbelts entail. We should see vaccines as seatbelts against COVID-19. In fact, as very special seatbelts, which protect ourselves and protect others.

A protestor holding a sign that says: 'No to mandatory vaccines'

Vageesh Jain, NIHR Academic Clinical Fellow in Public Health Medicine, UCL

Mandatory vaccination does not automatically increase vaccine uptake. An EU-funded project on epidemics and pandemics, which took place several years before COVID-19, found no evidence to support this notion. Looking at Baltic and Scandinavian countries, the project’s report noted that countries “where a vaccination is mandatory do not usually reach better coverage than neighbour or similar countries where there is no legal obligation”.

According to the Nuffield Council of Bioethics, mandatory vaccination may be justified for highly contagious and serious diseases. But although contagious, Public Health England does not classify COVID-19 as a high-consequence infectious disease due to its relatively low case fatality rate.

COVID-19 severity is strongly linked with age, dividing individual perceptions of vulnerability within populations. The death rate is estimated at 7.8% in people aged over 80, but at just 0.0016% in children aged nine and under. In a liberal democracy, forcing the vaccination of millions of young and healthy citizens who perceive themselves to be at an acceptably low risk from COVID-19 will be ethically disputed and is politically risky.

Public apprehensions for a novel vaccine produced at breakneck speed are wholly legitimate. A UK survey of 70,000 people found 49% were “very likely” to get a COVID-19 vaccine once available. US surveys are similar . This is not because the majority are anti-vaxxers.

Despite promising headlines, the trials and pharmaceutical processes surrounding them have not yet been scrutinised. With the first trials only beginning in April , there is limited data on long-term safety and efficacy. We don’t know how long immunity lasts for. None of the trials were designed to tell us if the vaccine prevents serious disease or virus transmission.

To disregard these ubiquitous concerns would be counterproductive. As a tool for combating anti-vaxxers – estimated at around 58 million globally and making up a small minority of those not getting vaccinated – mandatory vaccines are also problematic. The forces driving scientific and political populism are the same . Anti-vaxxers do not trust experts, industry and especially not the government. A government mandate will not just be met with unshakeable defiance, but will also be weaponised to recruit others to the anti-vaxxer cause.

In the early 1990s, polio was endemic in India , with between 500 and 1,000 children getting paralysed daily. By 2011, the virus was eliminated. This was not achieved through legislation. It was down to a consolidated effort to involve communities, target high-need groups, understand concerns, inform, educate, remove barriers, invest in local delivery systems and link with political and religious leaders.

Mandatory vaccination is rarely justified. The successful roll-out of novel COVID-19 vaccines will require time, communication and trust. We have come too far, too fast, to lose our nerve now.

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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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Open access
Published: 14 May 2021

Public attitudes toward COVID-19 vaccination: The role of vaccine attributes, incentives, and misinformation

Sarah Kreps 1 ,
Nabarun Dasgupta 2 ,
John S. Brownstein 3 , 4 ,
Yulin Hswen 5 &
Douglas L. Kriner ORCID: orcid.org/0000-0002-9353-2334 1

npj Vaccines volume 6 , Article number: 73 ( 2021 ) Cite this article

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While efficacious vaccines have been developed to inoculate against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2; also known as COVID-19), public vaccine hesitancy could still undermine efforts to combat the pandemic. Employing a survey of 1096 adult Americans recruited via the Lucid platform, we examined the relationships between vaccine attributes, proposed policy interventions such as financial incentives, and misinformation on public vaccination preferences. Higher degrees of vaccine efficacy significantly increased individuals’ willingness to receive a COVID-19 vaccine, while a high incidence of minor side effects, a co-pay, and Emergency Use Authorization to fast-track the vaccine decreased willingness. The vaccine manufacturer had no influence on public willingness to vaccinate. We also found no evidence that belief in misinformation about COVID-19 treatments was positively associated with vaccine hesitancy. The findings have implications for public health strategies intending to increase levels of community vaccination.

Determinants of behaviour and their efficacy as targets of behavioural change interventions

Long COVID: major findings, mechanisms and recommendations

Exploring the reported adverse effects of COVID-19 vaccines among vaccinated Arab populations: a multi-national survey study

Introduction.

In less than a year, an array of vaccines was developed to bring an end to the SARS-CoV-2 pandemic. As impressive as the speed of development was the efficacy of vaccines such as Moderna and Pfizer, which are over 90%. Despite the growing availability and efficacy, however, vaccine hesitancy remains a potential impediment to widespread community uptake. While previous surveys indicate that overall levels of vaccine acceptance may be around 70% in the United States 1 , the case of Israel may offer a cautionary tale about self-reported preferences and vaccination in practice. Prospective studies 2 of vaccine acceptance in Israel showed that about 75% of the Israeli population would vaccinate, but Israel’s initial vaccination surge stalled around 42%. The government, which then augmented its vaccination efforts with incentive programs, attributed unexpected resistance to online misinformation 3 .

Research on vaccine hesitancy in the context of viruses such as influenza and measles, mumps, and rubella, suggests that misinformation surrounding vaccines is prevalent 4 , 5 . Emerging research on COVID-19 vaccine preferences, however, points to vaccine attributes as dominant determinants of attitudes toward vaccination. Higher efficacy is associated with greater likelihood of vaccinating 6 , 7 , whereas an FDA Emergency Use Authorization 6 or politicized approval timing 8 is associated with more hesitancy. Whether COVID-19 misinformation contributes to vaccine preferences or whether these attributes or policy interventions such as incentives play a larger role has not been studied. Further, while previous research has focused on a set of attributes that was relevant at one particular point in time, the evidence and context about the available vaccines has continued to shift in ways that could shape public willingness to accept the vaccine. For example, governments, employers, and economists have begun to think about or even devise ways to incentivize monetarily COVID-19 vaccine uptake, but researchers have not yet studied whether paying people to receive the COVID-19 vaccine would actually affect likely behavior. As supply problems wane and hesitancy becomes a limiting factor, understanding whether financial incentives can overcome hesitancy becomes a crucial question for public health. Further, as new vaccines such as Johnson and Johnson are authorized, knowing whether the vaccine manufacturer name elicits or deters interest in individuals is also important, as are the corresponding efficacy rates of different vaccines and the extent to which those affect vaccine preferences. The purpose of this study is to examine how information about vaccine attributes such as efficacy rates, the incidence of side effects, the nature of the governmental approval process, identity of the manufacturers, and policy interventions, including economic incentives, affect intention to vaccinate, and to examine the association between belief in an important category of misinformation—false claims concerning COVID-19 treatments—and willingness to vaccinate.

General characteristics of study population

Table 1 presents sample demographics, which largely reflect those of the US population as a whole. Of the 1335 US adults recruited for the study, a convenience sample of 1100 participants consented to begin the survey, and 1096 completed the full questionnaire. The sample was 51% female; 75% white; and had a median age of 43 with an interquartile range of 31–58. Comparisons of the sample demographics to those of other prominent social science surveys and U.S. Census figures are shown in Supplementary Table 1 .

Vaccination preferences

Each subject was asked to evaluate a series of seven hypothetical vaccines. For each hypothetical vaccine, our conjoint experiment randomly assigned values of five different vaccine attributes—efficacy, the incidence of minor side effects, government approval process, manufacturer, and cost/financial inducement. Descriptions of each attribute and the specific levels used in the experiment are summarized in Table 2 . After seeing the profile of each vaccine, the subject was asked whether she would choose to receive the vaccine described, or whether she would choose not to be vaccinated. Finally, subjects were asked to indicate how likely they would be to take the vaccine on a seven-point likert scale.

Across all choice sets, in 4419 cases (58%) subjects said they would choose the vaccine described in the profile rather than not being vaccinated. As shown in Fig. 1 , several characteristics of the vaccine significantly influenced willingness to vaccinate.

Circles present the estimated effect of each attribute level on the probability of a subject accepting vaccination from the attribute’s baseline level. Horizontal lines through points indicate 95% confidence intervals. Points without error bars denote the baseline value for each attribute. The average marginal component effects (AMCEs) are the regression coefficients reported in model 1 of Table 3 .

Efficacy had the largest effect on individual vaccine preferences. An efficacy rate of 90% increased uptake by about 20% relative to the baseline at 50% efficacy. Even a high incidence of minor side effects (1 in 2) had only a modest negative effect (about 5%) on willingness to vaccinate. Whether the vaccine went through full FDA approval or received an Emergency Use Authorization (EUA), an authority that allows the Food and Drug Administration mechanisms to accelerate the availability and use of treatments or medicines during medical emergencies 9 , significantly influenced willingness to vaccinate. An EUA decreased the likelihood of vaccination by 7% compared to a full FDA authorization; such a decline would translate into about 23 million Americans. While a $20 co-pay reduced the likelihood of vaccination relative to a no-cost baseline, financial incentives did not increase willingness to vaccinate. Lastly, the manufacturer had no effect on vaccination attitudes, despite the public pause of the AstraZeneca trial and prominence of Johnson & Johnson as a household name (our experiment was fielded before the pause in the administration of the Johnson & Johnson shot in the United States).

Model 2 of Table 3 presents an expanded model specification to investigate the association between misinformation and willingness to vaccinate. The primary additional independent variable of interest is a misinformation index that captures the extent to which each subject believes or rejects eight claims (five false; three true) about COVID-19 treatments. Additional analyses using alternate operationalizations of the misinformation index yield substantively similar results (Supplementary Table 4 ). This model also includes a number of demographic control variables, including indicators for political partisanship, gender, educational attainment, age, and race/ethnicity, all of which are also associated with belief in misinformation about the vaccine (Supplementary Table 2 ). Finally, the model also controls for subjects’ health insurance status, past experience vaccinating against seasonal influenza, attitudes toward the pharmaceutical industry, and beliefs about vaccine safety generally.

Greater levels of belief in misinformation about COVID-19 treatments were not associated with greater vaccine hesitancy. Instead, the relevant coefficient is positive and statistically significant, indicating that, all else being equal, individuals who scored higher on our index of misinformation about COVID-19 treatments were more willing to vaccinate than those who were less susceptible to believing false claims.

Strong beliefs that vaccines are safe generally was positively associated with willingness to accept a COVID-19 vaccine, as were past histories of frequent influenza vaccination and favorable attitudes toward the pharmaceutical industry. Women and older subjects were significantly less likely to report willingness to vaccinate than men and younger subjects, all else equal. Education was positively associated with willingness to vaccinate.

This research offers a comprehensive examination of attitudes toward COVID-19 vaccination, particularly the role of vaccine attributes, potential policy interventions, and misinformation. Several previous studies have analyzed the effects of vaccine characteristics on willingness to vaccinate, but the modal approach is to gauge willingness to accept a generic COVID-19 vaccine 10 , 11 . Large volumes of research show, however, that vaccine preferences hinge on specific vaccine attributes. Recent research considering the influence of attributes such as efficacy, side effects, and country of origin take a step toward understanding how properties affect individuals’ intentions to vaccinate 6 , 7 , 8 , 12 , 13 , but evidence about the attributes of actual vaccines, debates about how to promote vaccination within the population, and questions about the influence of misinformation have moved quickly 14 .

Our conjoint experiment therefore examined the influence of five vaccine attributes on vaccination willingness. The first category of attributes involved aspects of the vaccine itself. Since efficacy is one of the most common determinants of vaccine acceptance, we considered different levels of efficacy, 50%, 70%, and 90%, levels that are common in the literature 7 , 15 . Evidence from Phase III trials suggests that even the 90% efficacy level in our design, which is well above the 50% threshold from the FDA Guidance for minimal effectiveness for Emergency Use Authorization 16 , has been exceeded by both Pfizer’s and Moderna’s vaccines 17 , 18 . The 70% efficacy threshold is closer to the initial reports of the efficacy of the Johnson & Johnson vaccine, whose efficacy varied across regions 19 . Our analysis suggests that efficacy levels associated with recent mRNA vaccine trials increases public vaccine uptake by 20% over a baseline of a vaccine with 50% efficacy. A 70% efficacy rate increases public willingness to vaccinate by 13% over a baseline vaccine with 50% efficacy.

An additional set of epidemiological attributes consisted of the frequency of minor side effects. While severe side effects were plausible going into early clinical trials, evidence clearly suggests that minor side effects are more common, ranging from 10% to 100% of people vaccinated depending on the number of doses and the dose group (25–250 mcg) 20 . Since the 100 mcg dose was supported in Phase III trials 21 , we include the highest adverse event probability—approximating 60% as 1 in 2—and 1 in 10 as the lowest likelihood, approximating the number of people who experienced mild arthralgia 20 . Our findings suggest that a the prevalence of minor side effects associated with recent trials (i.e. a 1 in 2 chance), intention to vaccinate decreased by about 5% versus a 1 in 10 chance of minor side effects baseline. However, at a 25% rate of minor side effects, respondents did not indicate any lower likelihood of vaccination compared to the 10% baseline. Public communications about how to reduce well-known side effects, such as pain at the injection site, could contribute to improved acceptance of the vaccine, as it is unlikely that development of vaccine-related minor side effects will change.

We then considered the effect of EUA versus full FDA approval. The influenza H1N1 virus brought the process of EUA into public discourse 22 , and the COVID-19 virus has again raised the debate about whether and how to use EUA. Compared to recent studies also employing conjoint experimental designs that showed just a 3% decline in support conditional on EUA 6 , we found decreases in support of more than twice that with an EUA compared to full FDA approval. Statements made by the Trump administration promising an intensely rapid roll-out or isolated adverse events from vaccination in the UK may have exacerbated concerns about EUA versus full approval 8 , 23 , 24 , 25 . This negative effect is even greater among some subsets of the population. As shown in additional analyses reported in the Supplementary Information (Supplementary Fig. 5 ), the negative effects are greatest among those who believe vaccines are generally safe. Among those who believe vaccines generally are extremely safe, the EUA decreased willingness to vaccinate by 11%, all else equal. This suggests that outreach campaigns seeking to assure those troubled by the authorization process used for currently available vaccines should target their efforts on those who are generally predisposed to believe vaccines are safe.

Next, we compared receptiveness as a function of the manufacturer: Moderna, Pfizer, Johnson and Johnson, and AstraZeneca, all firms at advanced stages of vaccine development. Vaccine manufacturers in the US have not yet attempted to use trade names to differentiate their vaccines, instead relying on the association with manufacturer reputation. In other countries, vaccine brand names have been more intentionally publicized, such as Bharat Biotech’s Covaxin in India and Gamaleya Research Institute of Epidemiology and Microbiology Sputnik V in Russia. We found that manufacturer names had no impact on willingness to vaccinate. As with hepatitis and H. influenzae vaccines 26 , 27 , interchangeability has been an active topic of debate with coronavirus mRNA vaccines which require a second shot for full immunity. Our research suggests that at least as far as public receptiveness goes, interchangeability would not introduce concerns. We found no significant differences in vaccination uptake across any of the manufacturer treatments. Future research should investigate if a manufacturer preference develops as new evidence about efficacy and side effects becomes available, particularly depending on whether future booster shots, if needed, are deemed interchangeable with the initial vaccination.

Taking up the question of how cost and financial incentives shape behavior, we looked at paying and being paid to vaccinate. While existing research suggests that individuals are often willing to pay for vaccines 28 , 29 , some economists have proposed that the government pay individuals up to $1,000 to take the COVID-19 vaccine 30 . However, because a cost of $300 billion to vaccinate the population may be prohibitive, we posed a more modest $100 incentive. We also compared this with a $10 incentive, which previous studies suggest is sufficient for actions that do not require individuals to change behavior on a sustained basis 31 . While having to pay a $20 co-pay for the vaccine did deter individuals, the additional economic incentives had no positive effect although they did not discourage vaccination 32 . Consistent with past research 31 , 33 , further analysis shows that the negative effect of the $20 co-pay was concentrated among low-income earners (Supplementary Fig. 7 ). Financial incentives failed to increase vaccination willingness across income levels.

Our study also yields important insights into the relationship between one prominent category of COVID-19 misinformation and vaccination preferences. We find that susceptibility to misinformation about COVID-19 treatments—based on whether individuals can distinguish between factual and false information about efforts to combat COVID-19—is considerable. A quarter of subjects scored no higher on our misinformation index than random guessing or uniform abstention/unsure responses (for the full distribution, see Supplementary Fig. 2 ). However, subjects who scored higher on our misinformation index did not exhibit greater vaccination hesitancy. These subjects actually were more likely to believe in vaccine safety more generally and to accept a COVID-19 vaccine, all else being equal. These results run counter to recent findings of public opinion in France where greater conspiracy beliefs were negatively correlated with willingness to vaccinate against COVID-19 34 and in Korea where greater misinformation exposure and belief were negatively correlated with taking preventative actions 35 . Nevertheless, the results are robust to alternate operationalizations of belief in misinformation (i.e., constructing the index only using false claims, or measuring misinformation beliefs as the number of false claims believed: see Supplementary Table 4 ).

We recommend further study to understand the observed positive relationship between beliefs in COVID-19 misinformation about fake treatments and willingness to receive the COVID-19 vaccine. To be clear, we do not posit a causal relationship between the two. Rather, we suspect that belief in misinformation may be correlated with an omitted factor related to concerns about contracting COVID-19. For example, those who believe COVID-19 misinformation may have a higher perception of risk of COVID-19, and therefore be more willing to take a vaccine, all else equal 36 . Additional analyses reported in the Supplementary Information (Supplementary Fig. 6 ) show that the negative effect of an EUA on willingness to vaccinate was concentrated among those who scored low on the misinformation index. An EUA had little effect on the vaccination preferences of subjects most susceptible to misinformation. This pattern is consistent with the possibility that these subjects were more concerned with the disease and therefore more likely to vaccinate, regardless of the process through which the vaccine was brought to market.

We also observe that skepticism toward vaccines in general does not correlate perfectly with skepticism toward the COVID-19 vaccine. Therefore, it is important not to conflate people who are wary of the COVID-19 vaccine and those who are anti-vaccination, as even medically informed individuals may be hesitant because of the speed at which the COVID-19 vaccine was developed. For example, older people are more likely to believe vaccines are safe but less willing to receive the COVID-19 vaccine in our survey, perhaps following the high rates of vaccine skepticism among medical staff expressing concerns regarding the safety of a rapidly-developed vaccine 2 . This inverse relationship between age and willingness to vaccinate is also surprising. Most opinion surveys find older adults are more likely to vaccinate than younger adults 37 . However, most of these survey questions ask about willingness to take a generic vaccine. Two prior studies, both recruiting subjects from the Lucid platform and employing conjoint experiments to examine the effects of vaccine attributes on public willingness to vaccinate, also find greater vaccine hesitancy among older Americans 6 , 7 . Future research could explore whether these divergent results are a product of the characteristics of the sample or of the methodological design in which subjects have much more information about the vaccines when indicating their vaccination preferences.

An important limitation of our study is that it necessarily offers a snapshot in time, specifically prior to both the election and vaccine roll-out. We recommend further study to understand more how vaccine perceptions evolve both in terms of the perceived political ownership of the vaccine—now that President Biden is in office—and as evidence has emerged from the millions of people who have been vaccinated. Similarly, researchers should consider analyzing vaccine preferences in the context of online vaccine controversies that have been framed in terms of patient autonomy and right to refuse 38 , 39 . Vaccination mandates may evoke feelings of powerlessness, which may be exacerbated by misinformation about the vaccines themselves. Further, researchers should more fully consider how individual attributes such as political ideology and race intersect with vaccine preferences. Our study registered increased vaccine hesitancy among Blacks, but did not find that skepticism was directly related to misinformation. Perceptions and realities of race-based maltreatment could also be moderating factors worth exploring in future analyses 40 , 41 .

Overall, we found that the most important factor influencing vaccine preferences is vaccine efficacy, consistent with a number of previous studies about attitudes toward a range of vaccines 6 , 42 , 43 . Other attributes offer potential cautionary flags and opportunities for public outreach. The prospect of a 50% likelihood of mild side effects, consistent with the evidence about current COVID-19 vaccines being employed, dampens likelihood of uptake. Public health officials should reinforce the relatively mild nature of the side effects—pain at the injection site and fatigue being the most common 44 —and especially the temporary nature of these effects to assuage public concerns. Additionally, in considering policy interventions, public health authorities should recognize that a $20 co-pay will likely discourage uptake while financial incentives are unlikely to have a significant positive effect. Lastly, belief in misinformation about COVID-19 does not appear to be a strong predictor of vaccine hesitancy; belief in misinformation and willingness to vaccinate were positively correlated in our data. Future research should explore the possibility that exposure to and belief in misinformation is correlated with other factors associated with vaccine preferences.

Survey sample and procedures

This study was approved by the Cornell Institutional Review Board for Human Participant Research (protocol ID 2004009569). We conducted the study on October 29–30, 2020, prior to vaccine approval, which means we captured sentiments prospectively rather than based on information emerging from an ongoing vaccination campaign. We recruited a sample of 1096 adult Americans via the Lucid platform, which uses quota sampling to produce samples matched to the demographics of the U.S. population on age, gender, ethnicity, and geographic region. Research has shown that experimental effects observed in Lucid samples largely mirror those found using probability-based samples 45 . Supplementary Table 1 presents the demographics of our sample and comparisons to both the U.S. Census American Community Survey and the demographics of prominent social science surveys.

After providing informed consent on the first screen of the online survey, participants turned to a choice-based conjoint experiment that varied five attributes of the COVID-19 vaccine. Conjoint analyses are often used in marketing to research how different aspects of a product or service affect consumer choice. We build on public health studies that have analyzed the influence of vaccine characteristics on uptake within the population 42 , 46 .

Conjoint experiment

We first designed a choice-based conjoint experiment that allowed us to evaluate the relative influence of a range of vaccine attributes on respondents’ vaccine preferences. We examined five attributes summarized in Table 2 . Past research has shown that the first two attributes, efficacy and the incidence of side effects, are significant drivers of public preferences on a range of vaccines 47 , 48 , 49 , including COVID-19 6 , 7 , 13 , 50 . In this study, we increased the expected incidence of minor side effects from previous research 6 to reflect emerging evidence from Phase III trials. The third attribute, whether the vaccine received full FDA approval or an EUA, examines whether the speed of the approval process affects public vaccination preferences 6 . The fourth attribute, the manufacturer of the vaccine, allows us to examine whether the highly public pause in the AstraZeneca trial following an adverse event, and the significant differences in brand familiarity between smaller and less broadly known companies like Moderna and household name Johnson & Johnson affects public willingness to vaccinate. The fifth attribute examines the influence of a policy tool—offsetting the costs of vaccination or even incentivizing it financially—on public willingness to vaccinate.

Attribute levels and attribute order were randomly assigned across participants. A sample choice set is presented in Supplementary Fig. 1 . After viewing each profile individually, subjects were asked: “If you had to choose, would you choose to get this vaccine, or would you choose not to be vaccinated?” Subjects then made a binary choice, responding either that they “would choose to get this vaccine” or that they “would choose not to be vaccinated.” This is the dependent variable for the regression analyses in Table 3 . After making a binary choice to take the vaccine or not be vaccinated, we also asked subjects “how likely or unlikely would you be to get the vaccine described above?” Subjects indicated their vaccination preference on a seven-point scale ranging from “extremely likely” to “extremely unlikely.” Additional analyses using this ordinal dependent variable reported in Supplementary Table 3 yield substantively similar results to those presented in Table 3 .

To determine the effect of each attribute-level on willingness to vaccinate, we followed Hainmueller, Hopkins, and Yamamoto and employed an ordinary least squares (OLS) regression with standard errors clustered on respondent to estimate the average marginal component effects (AMCEs) for each attribute 51 . The AMCE represents the average difference in a subject choosing a vaccine when comparing two different attribute values—for example, 50% efficacy vs. 90% efficacy—averaged across all possible combinations of the other vaccine attribute values. The AMCEs are nonparametrically identified under a modest set of assumptions, many of which (such as randomization of attribute levels) are guaranteed by design. Model 1 in Table 3 estimates the AMCEs for each attribute. These AMCEs are illustrated in Fig. 1 .

Analyzing additional correlates of vaccine acceptance

To explore the association between respondents’ embrace of misinformation about COVID-19 treatments and vaccination willingness, the survey included an additional question battery. To measure the extent of belief in COVID-19 misinformation, we constructed a list of both accurate and inaccurate headlines about the coronavirus. We focused on treatments, relying on the World Health Organization’s list of myths, such as “Hand dryers are effective in killing the new coronavirus” and true headlines such as “Avoiding shaking hands can help limit the spread of the new coronavirus 52 .” Complete wording for each claim is provided in Supplementary Appendix 1 . Individuals read three true headlines and five myths, and then responded whether they believed each headline was true or false, or whether they were unsure. We coded responses to each headline so that an incorrect accuracy assessment yielded a 1; a correct accuracy assessment a -1; and a response of unsure was coded as 0. From this, we created an additive index of belief in misinformation that ranged from -8 to 8. The distribution of the misinformation index is presented in Supplementary Fig. 2 . A possible limitation of this measure is that because the survey was conducted online, some individuals could have searched for the answers to the questions before responding. However, the median misinformation index score for subjects in the top quartile in terms of time spent taking the survey was identical to the median for all other respondents. This may suggest that systematic searching for correct answers is unlikely.

To ensure that any association observed between belief in misinformation and willingness to vaccinate is not an artifact of how we operationalized susceptibility to misinformation, we also constructed two alternate measures of belief in misinformation. These measures are described in detail in the Supplementary Information (see Supplementary Figs. 3 and 4 ). Additional regression analyses using these alternate measures of misinformation beliefs yield substantively similar results (see Supplementary Table 4 ). Additional analyses examining whether belief in misinformation moderates the effect of efficacy and an FDA EUA on vaccine acceptance are presented in Supplementary Fig. 6 .

Finally, model 2 of Table 3 includes a range of additional control variables. Following past research, it includes a number of demographic variables, including indicator variables identifying subjects who identify as Democrats or Republicans; an indicator variable identifying females; a continuous variable measuring age (alternate analyses employing a categorical variable yield substantively similar results); an eight-point measure of educational attainment; and indicator variables identifying subjects who self-identify as Black or Latinx. Following previous research 6 , the model also controlled for three additional factors often associated with willingness to vaccinate: an indicator variable identifying whether each subject had health insurance; a variable measuring past frequency of influenza vaccination on a four-point scale ranging from “never” to “every year”; beliefs about the general safety of vaccines measured on a four-point scale ranging from “not at all safe” to “extremely safe”; and a measure of attitudes toward the pharmaceutical industry ranging from “very positive” to “very negative.”

Reporting summary

Further information on research design is available in the Nature Research Reporting Summary linked to this article.

Data availability

All data and statistical code to reproduce the tables and figures in the manuscript and Supplementary Information are published at the Harvard Dataverse via this link: 10.7910/DVN/ZYU6CO.

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Acknowledgements

S.K. and D.K. would like to thank the Cornell Atkinson Center for Sustainability for financial support.

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Sarah Kreps & Douglas L. Kriner

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S.K. and D.K. designed the experiment/survey instrument and conducted the statistical analysis. S.K., N.D., J.B., Y.H., and D.K. all contributed to the conceptual design of the research and to the writing of the paper.

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Kreps, S., Dasgupta, N., Brownstein, J.S. et al. Public attitudes toward COVID-19 vaccination: The role of vaccine attributes, incentives, and misinformation. npj Vaccines 6 , 73 (2021). https://doi.org/10.1038/s41541-021-00335-2

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STUDENT ESSAY: Is Compulsory COVID-19 Vaccination a Violation of Human Rights?

In response to the COVID-19 pandemic, the UK Government passed the Coronavirus Act 2020 (CA), which implemented a number of emergency powers, allowing public officials to take action in specific situations in order to contain and slow down the spread of the virus as well as ease the burden on frontline staff. [1] Examples of these emergency powers include: the capability for public officials to test, isolate, and detain a person where they have reasonable grounds to think that the person is infected; restrict or prohibit gatherings or events; and require the temporary closure of a school or registered childcare provider. [2]

In its efforts to support the public health benefit, the CA has arguably led to interference with individuals’ right to liberty under Article 5(1) of the European Convention on Human Rights (ECHR). [3] Pugh’s 2020 article on the CA discusses how individuals may be deprived of their liberty to prevent the spread of infectious diseases, if that deprivation is “necessary and proportionate” and is in accordance with a procedure prescribed by law. [4] Pugh refers to this as “the public health exception”. [5] The importance of this approach directly relates to the consideration of a compulsory COVID-19 vaccine, specifically whether limitations on specific rights can be justified.

This essay analyzes whether a compulsory COVID-19 vaccine would be a violation of human rights law in the UK. For a comprehensive understanding of the implications of this topic, I provide background information and discuss perspectives regarding compulsory vaccinations in general. This discussion is followed by an outline of the specific rights under the ECHR that may be affected if a compulsory vaccination was to be implemented in the UK. I then discuss various interpretations of the elements required for state interference upon these rights and expand on them in regard to their application to compulsory vaccination. Through this analysis, it is concluded that a compulsory COVID-19 vaccination would not be a violation of human rights in the UK if the government sets out explicit parameters whereby a compulsory vaccination would be “necessary and proportionate” in the interests of health and safety, and if it was to ensure that the state is fulfilling its positive obligation to protect the right to life. [6]

Background on vaccinations and vaccine hesitancy

The topic of vaccination has been vastly studied across the world, affirming that high rates of vaccination coverage in childhood are important in preventing infectious diseases and contributing to a decline in mortality. [7] Despite the fact that vaccinations have proven to decrease rates of common childhood diseases and in some cases result in the complete termination of diseases, there is a rising trend of parents refusing to vaccinate their children. [8] This trend is commonly referred to as the anti-vaccination movement or Anti-Vaxx. The basis for these views revolves around arguments that vaccinations cause sickness, use unethical practices, and overall hold a lot of uncertainty, which causes hesitancy. [9] In addition, wide use of social media has allowed the Anti-Vaxx trend to become more widespread, and in a number of cases has led to vaccination rates dropping below the levels needed for herd immunity. Herd immunity occurs when a high enough percentage of the population is vaccinated that there are then too few people available to become hosts, so transmission of the disease or virus stops. [10] One of the most important characteristics of herd immunity is that it not only protects those who receive vaccination, but helps to protect individuals who are not vaccinated for whatever reason. [11]

Looking further into vaccine hesitancy, Kestenbaum and Feester identified some of the common factors contributing to this trend, including knowledge and information sources, experience or lack of experience with vaccine-preventable diseases, the role of recommendations by health professionals, social norms, and parental responsibility, trust, and religious beliefs. [12] They found many factors contribute to this trend, with uncertainty and the rapid transfer of information leading to the refusal of vaccination by families and individuals. The rise in the Anti-Vaxx movement has been shown to significantly impair health protection. A number of studies found that from 2006-2011, decreases in MMR (measles, mumps, and rubella) vaccination rates in the UK, Ireland, France, Italy, and the United States, had a direct correlation with measles outbreaks in those areas. [13] In response to these changes, both Italy and France passed legislation that made specific vaccinations, including MMR, compulsory for children. [14]

Religious beliefs and conscientious objection, which would fall under Article 9 of the ECHR, also contribute to decisions not to vaccinate. [15] There are a number of governments that have implemented compulsory vaccination for children in public and private schools, as well as childcare centres. In conjunction with these policies, governments allow for exemption from vaccination on medical and non-medical grounds. In this context, the non-medical grounds often relate to religion and conscientious objection. But religion has not been found to contribute much to decisions not to vaccinate. A North American study published in the Journal of the American Academy of Pediatricians found that over 70% of 512 doctors who had patients who had refused vaccines, claimed that parents had denied vaccination for their children because they felt the vaccine was unnecessary. [16] In addition, the Vanderbilt University Medical Centre states that “most religions have no prohibition against vaccinations” but the two common objecting religions are ‘Christian Scientists’ and ‘Dutch Reformed Congregations’. [17] These studies suggest that in the United States most non-medical exemptions fall under the category of conscientious objection rather than religion and that this trend is one of the primary reasons why some US jurisdictions have chosen to ban non-medical exemptions for compulsory vaccinations. [18]

State obligations under ECHR and compulsory vaccination

Regarding the potential implementation of a compulsory vaccination, the primary source of law to be considered is the ECHR, which was incorporated into UK law through the Human Rights Act 1998. [19] Article 2 of the ECHR concerning the right to life is of upmost importance in this context as it places positive and negative obligations on the state. Interpretation of this Article is summarized by the ECtHR in L.C.B. v The United Kingdom (1998), stating that “the state must not only refrain from the intentional and unlawful taking of life, but also take appropriate steps to safeguard the lives of those within its jurisdiction.” [20] Specifically regarding the positive obligation, states have a “primary duty to put in place a legislative and administrative framework designed to provide effective deterrence against threats to the right to life.” [21] As suggested by Camilleri, the positive obligation deriving from Article 2 may lead to claims that, in the context of a public health emergency, a vaccine should be made mandatory for those who are able to receive it, in order to protect those who rely on herd immunity for protection against such diseases. [22] However, when considering a narrower compulsory vaccination claim, the case of Calvelli and Ciglio (2002) is highly relevant as the court applied the positive obligation principle of Article 2 specifically to “the public health sphere”, stating that the obligation “requires states to make regulations compelling hospitals, whether public or private, to adopt appropriate measures for the protection of their patients’ lives.” [23]

This concept is demonstrated through a number of examples where the MMR vaccine, among others, has been made a legal requirement for healthcare professionals. Countries such as Canada, Australia, and several Caribbean countries, as well as some countries in Europe, have polices whereby certain vaccinations are a requirement by law for those directly in the healthcare sector, one of them being the UK. [24] In addition, there are a number of governments that have adopted similar policies with specific focus on the education sector. For example, in Italy, France, three provinces of Canada, as well as the United States, there is a requirement for children to be vaccinated in order to attend public or private schools. [25] An important element of this requirement is that they allow for medical, religious, and philosophical exemptions, aside from Mississippi, West Virginia, and California, which now only allow for medical exemptions. [26] In countries such as Australia, although vaccinations for children are not mandatory, the government offers financial incentives to have their children vaccinated. This is through non-taxable payments for each child who meets the requirements for immunization. [27]

One of the key outcomes of the implementation of these mandatory vaccination policies is that the government has not only taken positive action to protect the right to life of individuals within their jurisdiction, but they have ensured that individuals who rely on herd immunity are able to fully enjoy their human rights and fundamental freedoms the same way every other individual is able to, without putting their own lives at risk.

State interference and limitations on rights

From a public health perspective, a compulsory vaccination would be beneficial and it is clear that states have an obligation to protect the life of those within its jurisdiction. However, consideration should be given as to whether forcing individuals to receive a vaccination would interfere with any of their rights, and if so, would such an interference be lawful in the circumstances. Camilleri brings forward two specific ECHR articles with which compulsory vaccination would likely interfere: (i) Article 8-right to respect for private and family life, and (ii) Article 9-freedom of thought, conscience and religion. [28] The primary argument behind a violation of these rights relates to the idea that individuals should have reasonable control over the actions in which they partake, particularly when it considers an individual’s human body. As we can see in the case of Herczegfalvy (1992), the forceful administration of food was considered under Article 8, but was held to be compatible with respect for the claimant’s private life, as medical treatment was a necessity under the principles of psychiatry at that time. [29] Although the claimant was unsuccessful in this element, the violation would have been deemed unlawful if the court found that it was either not necessary, proportionate, or for a legitimate aim.

Regarding Article 8 specifically, the state holds a primary negative obligation to ensure that public authorities do not interfere with individuals’ right to private and family life. [30] As confirmed in the case of Kroon and others (1994), private life includes both the physical and psychological integrity of the individual. [31] Therefore, the physical aspect of the individual is an important element which may be conflicted with if that individual is required to be vaccinated by law. That said, Article 8(2) sets out that a state may interfere with the enjoyment of this right in certain circumstances. Similarly, Article 9 follows an analogous provision where states have an obligation to not interfere unless specific criteria can be satisfied. The “Guide on Article 8 of the ECHR”, which is again similar to that of Article 9, says that for interference to be lawful, it must be: (1) in accordance with the law; (2) in the interests of national security, public safety, or the economic well-being of the country, for the prevention of the disorder of crime, for the protection of health or morals, or for the protection of the rights and freedoms of others; and (3) that such interference is necessary in a democratic society. [32]

Regarding the first element, the court has been consistent in ensuring that any interference with these rights by a public authority must be in accordance with the law. This requirement revolves around the rule of law, as an interference must not only comply with domestic law but should be equally enforced among all individuals and entities that fall under its jurisdiction. [33] An interpretation of this element is found in Silver and Others (1983), stating that the national law must be clear, foreseeable, and adequately accessible. [34] As mentioned in Piechowicz (2012) the clarity requirement relates to “the scope of discretion exercised by public authorities” which is to ensure that individuals are provided with a “minimum degree of protection” from the relevant authorities and the authorities are therefore working within the rule of law. [35]

The second element relates to the question of whether the interference is in line with a legitimate aim set out in paragraph 2 of the relevant Article. [36] The court has often shown that as long as the aim of the interference falls within one of the objects set out in the provision, they will not hesitate to confirm satisfaction of this requirement. This can be observed in S.A.S. v France (2014) , where the sensitive action of banning full face veils in public places did in fact serve a legitimate aim to ensure individuals can enjoy their right to live in spaces of socialization without having any barrier to social interaction. [37] That said, it would be fairly clear that a compulsory vaccination would work directly in line with an aim to protect the interests of public health and safety, as well as for the protection of the rights and freedoms of others through the effective implementation of herd immunity.

The third element is perhaps the most critical, as “necessary” is a requirement that relies heavily on the specific circumstances. In the case of Olssen v Sweden (1988), “necessary” was said to imply the existence of a pressing social need and that it must be proportionate to the legitimate aim pursued. [38] This is a direct understanding that was incorporated into the ECtHR’s “Guide on Article 8”. [39] An important interpretation of this element is again found in Piechowicz , where it is stated that although the respondent state in the case must “demonstrate the existence of a pressing social need behind the interference”, it is the court who must consider the margin of appreciation left to the state authorities. [40] This margin of appreciation varies depending on the circumstances in question, and therefore, allows the court to resolve practical differences in the implementation of provisions within the convention. [41] Upon the elements of necessity and proportionality, it would be very difficult to justify that a compulsory vaccination applying to all individuals within the UK jurisdiction would be justified.

In the case of Biblical Centre of the Chuvash Republic v Russia (2014), the relevant authorities had to show that no other measures were available to achieve the same end that would interfere less seriously with the fundamental right concerned. [42] This was a burden that existed in order to prove that the interference was in fact necessary and proportionate. Specifically in relation to a compulsory COVID-19 vaccination, it is important to consider that there are alternatives that could be applied that would follow the same legitimate aim, yet would likely be less intrusive on individual rights. One of the more feasible options would be to continue, or even further the restrictions that have been implemented by the Coronavirus Act 2020, and that would apply to the UK population as a whole. In addition, while considering the elements of interference above, due to the variety of individual characteristics, activities, and needs across the population of the UK, it would be fair to say that certain population groups would find a compulsory vaccine significantly less necessary and proportionate than others.

In considering each of the three essential elements relating to the lawful interference of Article 8, the recent decision in Vavřička and Others v. the Czech Republic is highly significant as the ECtHR provided a ruling specifically in respect of compulsory vaccinations for MMR, as well as other diseases such as poliomyelitis, hepatitis B, and tetanus. [43] The applicants in Vavřička challenged the lawfulness of the sanctions imposed as a result of failing to fully vaccinate their children under Czech law, specifically the Public Health Protection Act. [44] The sanctions imposed consisted of a fine equivalent to €110 for Mr. Vavřička, and denial of admission to nursery schools for the children of the other applicants. [45] In determining whether the interfering sanctions entailed a violation of Article 8, the court was required to assess whether it was justified under Article 8(2), by applying the three prong test: (1) whether it was in accordance with the law, (2) whether it pursued one or more legitimate aims, and (3) whether it was necessary in a democratic society. [46] Without going into extensive detail, the court was satisfied that the state met each of these three requirements as the law existed to protect against diseases posing a serious health risk, to prevent decline in vaccination rates among children, and to support the state’s positive obligation to protect the lives and health of those within its jurisdiction. [47] Furthermore, the ECtHR decided that the interference was proportionate in light of the aim pursued, therefore it concluded that there was no violation of Article 8. [48]

Vavřička is a case that very clearly considers all of the elements required in determining the lawfulness of compulsory vaccination under Article 8. That being said, although the ECtHR determined that compulsory vaccination in this case was lawful, it does not necessarily mean that this decision is the sole precedent for a challenge to a compulsory COVID-19 vaccination. Firstly, this is due to the fact that the court in Vavřička explicitly states that “the present case relates to the standard and routine vaccination of children against diseases that are well known to medical science.” [49] It would be extremely difficult to claim that medical professionals have reached the same level of understanding of COVID-19 as the diseases concerned in the case of Vavřička . Furthermore, the court made it clear that while vaccination was a legal duty in the Czech Republic, there were no provisions that allowed forceable vaccination. Therefore, this decision is one that was made based on the specific facts involved and cannot be assumed to dictate the ruling in a case of compulsory COVID-19 vaccination. Given this decision, the lawfulness of efforts to enforce a compulsory COVID-19 vaccination may depend on the degree of the consequence for noncompliance, while also considering what might be deemed an exception for noncompliance, specifically medical or religious reasons.

The history of compulsory vaccination across the globe shows a trend of specific areas where compulsory vaccinations are lawfully implemented and therefore considered legitimate, necessary, and proportionate. There is a compelling argument supporting the implementation of such a vaccine to those in the public and private education sectors, as well as those who work in the healthcare system. These are typically environments where large numbers of people occupy relatively small areas. This leads to conditions where viruses can easily be transferred and therefore health matters within these areas are of high concern. Supporting the argument for the need for increased protection in these areas, a study from the Usher Institute showed that the reopening of schools (without any regard to vaccination) increases transmission of the virus by 24%. [50] Furthermore, a study conducted by the University College London Hospitals (UCLH) NHS Foundation Trust found that about 45% of the healthcare workers at the UCLH showed evidence of being infected with COVID-19 between the months of April and May 2020. [51] When applying the criteria for interference under Article 8(2) and Article 9(2), specifically to the education and healthcare sectors, the argument supporting necessity and proportionality appears to be considerably stronger than that of a compulsory vaccine directed at the general public.

The purpose of this essay is simply to state whether a compulsory COVID-19 vaccination would be a violation of human rights law. From the above analysis, primarily regarding the elements of the relevant articles of the ECHR and the interpretation of those elements by the court, it is evident that a compulsory vaccination would be lawful if the government were to implement such a policy within explicit parameters whereby a compulsory vaccination would be necessary and proportionate in the interest of public health and safety and for the protection of the rights and freedoms of others. The Joint Committee on Vaccination and Immunisation (JCVI) is the independent expert advisory committee that advises the UK health departments on immunisation, making recommendations concerning vaccination schedules and vaccine safety. In December 2020, JCVI provided a document to the UK Government with advice to facilitate the development of policy on COVID-19 vaccination. [52] This document set out the recommendations regarding prioritization of the administration of COVID-19 vaccines in the UK population based on a comprehensive review of COVID-19, demographic data, clinical risk factors for mortality and hospitalisation, as well as the mathematical modelling on the potential impact of different vaccination programs. [53] If at some point there is a decision to make a COVID-19 vaccination compulsory in the UK, who would be subject to this compulsory vaccination would likely be a decision made in line with further advice from JCVI through enforcement by the UK Government. However, imposing such a requirement upon specific groups of people raises a number of significant concerns, considering the potential challenges that can be brought forward by ethicists and/or representatives of various religions. These questions and concerns are highly complicated matters which are essentially outside the scope of this specific discussion.

As COVID-19 continues to develop, the questions about vaccination become more significant. When considering the case law on the legality of interference with specific provisions of the ECHR, it seems possible that a compulsory COVID-19 vaccination can be enforced while still complying with human rights law. Only time will tell if compulsory vaccination will be adopted, but when it comes to the state’s protection of the greater good under such unprecedented circumstances, enforcement of a compulsory vaccination appears to be one of the most effective and beneficial protective measures.

Aaron Chia is a law graduate from the School of Law, University of Stirling, Scotland and currently a student associate at Yeghoyan & Jacula Law Firm, Ontario, Canada.

[1] UK Public General Acts, Coronavirus Act 2020 , c.7 (March 25, 2020).

[2] Ibid, s.51; s.52; s.38-39.

[3] European Convention on Human Rights, European Treaty Series No. 5 (1950), art. 5. Available at http://www.conventions.coe.int/Treaty/en/Treaties/Word/005.doc .

[4] J. Pugh, “The United Kingdom’s Coronavirus Act, deprivations of liberty, and the right to liberty and security of the person,” Journal of the Law and the Biosciences 7/1 (2020), pp. 1-14.

[6] Enhorn v. Sweden App no. 56529/00 (ECtHR, January 25, 2005); European Convention on Human Rights (see note 2), art. 2.

[7] Centers for Disease Control and Prevention, “Impact of vaccines universally recommended for children–United States, 1990-1998,” Morbidity and Mortality Weekly Report 48/12 (1999), pp. 243-248.

[8] Hussain et al., “The Anti-vaccination Movement: A Regression in Modern Medicine,” Cureus Journal of Medical Science 10/7 (2018), e2919.

[9] R. Pierik, “Mandatory Vaccination: An Unqualified Defence” Journal of Applied Philosophy 35/2 (2016), pp. 381-398.

[10] M. Mallory, L.Lindesmith, and R. Baric, “Vaccination-induced herd immunity: Success and challenges,” Journal of Allergy and Clinical Immunology 142/1 (2018), pp. 64-66.

[11] M. Sadarangani, Oxford Vaccine Group, Herd Immunity: How does it work? (2016). Available at https://www.ovg.ox.ac.uk/news/herd-immunity-how-does-it-work .

[12] L. Kestenbaum, and K. Feemster, “Identifying and Addressing Vaccine Hesitancy” Pedatric annals 44/4 (2015), pp. e71-e75.

[13] D. Antona et al., “Measles Elimination Efforts and 2008-2011 Outbreak, France,” Emerging Infectious Diseases 19/3 (2013), pp. 357-364; M. Pepys, “Science and serendipity,” Clinical Medicine 7/6 (2007), pp. 562-578.

[14] G. Rezza, “Mandatory vaccination for infants and children: the Italian experience,” Pathogens and Global Health 113/7 (2019), pp. 291-296; D. Lévy-Bruhl et al. “Extension of French vaccination mandates: from the recommendation of the Steering Committee of the Citizen Consultation on Vaccination to the law,” Eurosurveillance 23/17 (2018), 18-00048.

[15] European Convention on Human Rights (see note 2), art. 9.

[16] C. Hough-Telford et al. “Vaccine Delays, Refusals, and Patient Dismissals: A Survey of Pediatricians,” Journal of the American Academy of Pediatrics 138/3 (2016), e20162127.

[17] Vanderbilt Occupational Health Clinic, Immunizations and Religion (2013). Available at https://www.vumc.org/health-wellness/news-resource-articles/immunizations-and-religion ; J. Grabenstein, “What the world’s religions teach, applied to vaccines and immune globulins,” Vaccine 31/16 (2013), pp. 2011-2023.

[18] E. Walkinshaw, “Mandatory vaccinations: The international landscape,” Canadian Medical Association Journal 183/16 (2011), pp. e1167-e1168.

[19] UK Public General Acts, Human Rights Act 1998 , c.42 (November 9, 1998).

[20] L.C.B. v The United Kingdom App no. 14/1997/798/1001 (ECtHR, June 9, 1998), para. 36.

[21] O¨neryildiz v Turkey App no. 48939/99 (ECtHR, November 30, 2004), para. 89.

[22] F. Camilleri, “Compulsory vaccinations for children: Balancing the competing human rights at stake,” Netherlands Quarterly of Human Rights 37/3 (2019), pp. 245-267.

[23] Calvelli and Ciglio v Italy App no. 32967/96 (ECtHR, January 17, 2002), para. 49.

[24] A. Fiebelkorn, J. Seward, and W. Orenstein, “A Global Perspective of Vaccination of Healthcare Personnel against Measles: Systematic Review,” Vaccine 32/38 (2015), 4823.

[25] F. D’Ancona, “The law on compulsory vaccination in Italy: an update 2 years after the introduction,” Eurosurveillance 24/26 (2019), 1900371; Lévy-Bruhl et al. (see note 13); E. Walkinshaw, “Mandatory vaccination: The Canadian picture,” Canadian Medical Association Journal 183/16 (2011), pp. e1165-e1166; Walkinshaw (see note 17), pp. e1167.

[27] K. Ward, B. Hull, and J. Leask, “Financial incentives for childhood immunisation – a unique but changing Australian initiative,” Medical Journal of Australia 198/11 (2013), pp. 590-592.

[28] Camilleri (see note 21), pp. 251-252.

[29] Herczegfalvy v Austria App no. 10533/83 (ECtHR, September 24, 1992).

[30] European Convention on Human Rights (see note 2), art. 8.

[31] Kroon and Others v. the Netherlands App no. 18535/91 (ECtHR, October 27, 1994), para. 31.

[32] European Court of Human Rights, “Guide on Article 8 of the European Convention on Human Rights – Right to respect for private and family life,” (December 31, 2016). Available at https://www.echr.coe.int/documents/guide_art_8_eng.pdf.

[33] Halford v The United Kingdom App no. 20605/92 (ECtHR, June 25, 1997).

[34] Silver and others v The United Kingdom App no. 5947/72; 6205/73; 7052/75; 7061/75; 7107/75; 7113/75; 7136/75 (ECtHR, March 25 1983).

[35] Piechowicz v Poland App no, 20071/07 (ECtHR, April 17, 2012).

[36] European Court of Human Rights, “Freedom of thought, conscience and religion: A guide to the implementation of Article 9 of the European Convention on Human Rights,” (June, 2007). Available at https://www.echr.coe.int/Documents/Guide_Art_9_ENG.pdf .

[37] S.A.S. v France App no. 43835/11 (ECtHR, July 1, 2014).

[38] Olsson v Sweden App no. 10465/83 (ECtHR), March 24, 1988), para. 67; Dudgeon v. The United Kingdom App no. 7525/76 (ECtHR, October 22, 1981).

[39] Also see Z v Finland App no. 22009/93 (ECtHR, February 25, 1997).

[40] Piechowicz (see note 34).

[41] Paradiso and Campanelli v Italy App no. 25358 (ECtHR, January 24, 2017), para. 182.

[42] Biblical Centre of the Chuvash Republic v Russia App no. 33203/08 (ECtHR, June 12, 2014).

[43] Vavřička and Others v. the Czech Republic App no. 47621/13 and 5 others (ECtHR, April 8, 2021).

[44] Act No. 258/2000 on protection of public health as consolidated to Act No. 471/2005.

[45] Vavřička (see note 42), para. 293.

[46] Vavřička (see note 42), para. 265.

[47] Vavřička (see note 42), para. 272; para. 284; para. 282.

[48] Vavřička (see note 42), paras. 290-309; para. 311.

[49] Vavřička (see note 42), para. 158.

[50] Y. Li et al. “The temporal association of introducing and lifting non-pharmaceutical interventions with the time-varying reproduction number (R) of SARS-CoV-2: a modelling study across 131 countries,” The Lanclet Infectious Diseases 22/2 (2021), pp.139-202.

[51] University College London Hospitals NHS Foundation Trust, “Pandemic peak SARS-CoV-2 infection and seroconversion rates in London frontline health-care workers,” Elsevier Public Health Emergency Collection 396 (2020) pp. e6-e7.

[52] Department of Health and Social Care, “Joint Committee on Vaccination and Immunisation: advice on priority groups for COVID-19 vaccination,” (December 30, 2020). Available at https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/950113/jcvi-advice-on-priority-groups-for-covid-19-vaccination-30-dec-2020-revised.pdf .

[53] Ibid, pp. 1.

The University of Warwick

How to persuade people to take the COVID-19 vaccine

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It will inject a microchip so Bill Gates can track your every move; it will turn you into a monkey; it will alter your DNA; it will allow Russia to spy on you.

These are just a few of the crazy conspiracy theories circulating on social media about the COVID-19 vaccine. Governments are not only waged in a war against the virus but a battle with misinformation as they look to roll out vaccines.

While in the UK the Government is battling against ‘vaccine hesitancy’ over more legitimate concerns around safety and critics arguing regulators have approved the Pfizer BioNTech vaccine too quickly.

Indeed, in a recent study by the Vaccine Confidence Project at the London School of Hygiene and Tropical Medicine, only 54 per cent of UK respondents said they would definitely take the COVID-19 vaccine and this dropped to 47.6 per cent after viewing misinformation on social media. And people from lower income, black and ethnic minority backgrounds were least likely to go and get vaccinated.

So how do Governments overcome these barriers and persuade the public that the vaccine is safe and they need to be vaccinated?

This is where insights from behavioural science can help Governments’ messaging and present a more powerful and persuasive case for vaccination. This will take more than logistics and simple messaging, only with a behavioural approach as part of the programme will the system deliver the 80 per cent coverage needed to gain herd immunity.

As part of the UK’s National Health Service’s (NHS) COVID Behaviour Change Unit I have been detailing the behavioural science insights that policymakers will need. We have developed evidenced-based behavioural policies for each of the priority groups: care home residents and the over-80s, health and care workers, the over-65s and young people.

Our research has found that across all the population cohorts there are significant potential barriers to taking the vaccine, ranging from anxiety to determined resistance, mild scepticism to overt mistrust, and disinterest to conscious non-compliance. For instance, young people are highly sceptical and more likely to believe false information, such as that seen on social media that the vaccine includes a microchip to track your every move or that it contains lung tissue from an aborted foetus.

By using the MINDSPACE framework – a simple tool to diagnose problems and create interventions – we detailed a litany of nudges that should be used to persuade the doubters and hesitant to take the vaccine for eahc group.

Care home residents and over-80s

The barriers to take-up in care homes is the anxiety about being one of the first to take the vaccine, a feeling that they are the country’s guinea pigs.

There is also a question of trust, many of those in the 11,000 care homes across the UK have mental health issues or complex medical needs, with 40 per cent of residents suffering from dementia, and so they rely on the familiar faces of staff.

This is where the messenger effect can help. A well-researched phonemenon is how we trust the message being delivered more when the person conveying it is like us or an authority figure. Thus, it would be best if care home staff were trained to administer the vaccine or known GPs, but if this can’t be done then trusted members of staff should accompany the immuniser. Align known staff with ‘strangers’ to reassure residents. Also use known local GP surgery staff and other known community staff.

Salience – where our behaviour is influenced by what seems relevant to us and to our personal experiences – is also a powerful nudge. Thus, accessible and evidence-based messaging about the positives that over-80s and care home residents are among the first to be vaccinated can be more persuasive with celebrities they trust. This has already been done with Great British Bake Off judge Prue Leith and there should be more.

It is vital that having the vaccination is a good experience because of our propensity to accept any default setting and the influence of ‘affect’, where our emotional associations can powerfully shape our actions. This is especially important as everybody will require a second dose. So, being clear on any potential side-effects and providing leaflets and good communication on how to deal with them is crucial.

We respond well to incentives, so rewarding those vaccinated with a badge will appeal to our powerful ego, which can also be nudged by providing care homes with a certificate from an official body recognising when all residents have been immunised.

Social norms are also powerful drivers of behaviour, thus, producing a chart that the public can easily follow showing how many people have been vaccinated each day will active this and show we are all in this together.

Health and care workers

As you would expect, our research has found that health and care staff have a strong desire to return to their pre-pandemic roles and this can be used as an incentive.

A clear plan with time frames should be distributed across digital media showing when health services will start to return ‘to normal’.Health and care workers have been through a lot of stress coping with the pandemic and many have voluntarily gone beyond Government guidelines in isolating themselves from family and friends. To reward such sacrifices and incentivise takeup of the vaccine ‘staff and family parties’ should be organised.

This is a knowledgeable group and research on other vaccines has shown nurses and doctors are more willing the more information they read on it. Thus, evidence on the effectiveness of the vaccination should be provided across hospital and workplace communications and a dedicated webpage, with contributions from relevant experts and organisations such as the National Institute for Health and Care Excellence (NICE). The messenger effect can also help with this by using hospital CEOs, medical and nursing directors to champion the vaccine and take it first.

Hospital leaders can also be used to activate another powerful force – commitment, where we seek to be consistent with our public promises, and reciprocate acts. They can send a clear message that the vaccination programme is about staff health, and not workforce numbers, to show they care and are committed to their wellbeing.

Is the fear of the vaccine greater than the fear of the virus? This is a consideration for the over-65s and particularly relevant for black and ethnic minorities (BAME) who were perceived as higher risk but have not caught the virus.

Indeed, research shows vaccine hesitancy is higher among BAME groups and lower income households and with diminished levels of education.

Using trusted channels such as faith groups, charities and community groups is important as well as using messaging that taps into the affect bias to evoke an emotional response, such as “over-65s are over three times more likely to die if you get COVID than someone younger than you”. And use traditional media such as newspapers, billboards and broadcast alongside digital channels.

Use salience by emphasising that the vaccine will allow the ove-65s to return to their normal activities, social life and see their children and grandchildren. They also need reassuring that there will be enough vaccine for their family and friends so they are not taking the dose away from someone who needs it more. This will appease their ego.

While a single webpage on the NHS explaining what to expect when having the vaccine, possible side effects, and how to manage them can help alleviate their fears.

Young People

This group ranges from teenagers to 29 and they are least likely to become severely ill, which may lead to a complacent attitude to receiving the vaccine. However, if herd immunity is to be achieve it is vital they participate.

Social media is a key communication channel for them so employing the messenger effect with influencers to champion the vaccination is vitally important. Research has shown how much of an impact social media influencers’ opinions have and it will help dispel the plethora of misinformation and conspiracy theories.

Trust of politicians and leaders is low among young people and so they are more susceptible to misinformation. Any false stories gaining traction on social media need to be identified and countered head on through clear evidenced-based messages from influencers.

Young people have been denied a lot of freedom, with their social life being severely impacted. Returning to this can be used as an incentive with the introduction of vaccination passports for universities, work, attending sports events and going to clubs and concerts.

Alongside these incentives messaging needs to acknowledge the impact the virus has had on this group. Explain why they are lower down the vaccine roll-out and back-up the statements with science, actual research numbers and a link to 'geting your life back'.

Use of affect – where our emotional associations can powerfully shape our actions – can also be used with this cohort by emphasising the regret they would feel if they were not vaccinated and subsequnetly infected loved ones.

By using behavioural science insights each potential barriers can be identified, understood and mitigated with tailored strategies for the different population groups. This will give the UK a much better chance of reaching herd immunity and bringing an end to the pandemic.

Ivo Vlaev is Professor of Behavioural Science and part of the UK National Health Service’s (NHS) COVID Behaviour Change Unit. He teaches Mobilising Resources and Incentives for Healthcare Innovation on the E xecutive MBA Healthcare Specialism . He also lectures on Judgement and Decision Making on the MSc Finance .

For more articles on Behavioural Science sign up to Core Insights here .

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Essay: Vaccination is key to beat COVID-19

Raymond Grosswirth, a participant in a Phase 3 clinical trial for a COVID-19 vaccine.

Now that COVID-19 vaccines have been developed the question becomes, should I get the vaccine?

While most Rochesterians will get vaccinated , about 30% stated that they would not get the vaccine or were unsure that they would. Underlying diseases, allergies and lack of knowledge on long-term effects were some of the reasons why people were unsure or unwilling to get the vaccine.

More: NY expected to get 170,000 COVID-19 vaccine doses Dec. 15. What to know about who gets it

Here are answers to why getting vaccinated is key to beating COVID-19 and helping us move into a post-pandemic world:

What exactly are the COVID-19 candidate vaccines?

Both the Pfizer and Moderna vaccine candidates are messenger RNA (mRNA) vaccines, and considered to be new technology. While mRNA vaccines have never been utilized before, a decade's worth of work and research has gone into this technology to make it efficient and safe for humans.

The AstraZeneca’s vaccine candidate is an adenovirus-based vaccine. The only other adenovirus-based vaccine that has gained FDA approval is the recent Ebola vaccine produced by Merck. Adenovirus was originally isolated from chimpanzees and modified so that it no longer could replicate within human cells, meaning that it could no longer cause a cold.

What is mRNA?

Most cells have an in depth, very detailed code book which is the DNA. The final product of this code book would be the physical products, proteins, made by the code book. mRNA in this case, would be the summary of the code book, where all the unnecessary words are taken out. In terms of an mRNA vaccine, the mRNA would be the very small, concise and specific code for a part of the virus that your cells would make.

Production of this small part of the virus would trigger an immune reaction, allowing for your body to create the antibodies needed against the virus without every introducing the virus itself into your body. Most importantly, your body would never create the entire COVID-19 virus because of the vaccine.

How do the vaccine candidates work?

Both the Pfizer and Moderna COVID-19 vaccine candidates function the same. They introduce mRNA into your cells that produces a protein "spike" that is found on the surface of the virus. Your cells then read the code for this protein and produce it.

Once the “spike” proteins are produced, your immune system reacts to this foreign object and trains itself to remove the intruder by producing antibodies.

The AstraZeneca vaccine candidate also functions similarly. Instead of asking your cells to produce the spike protein, the adenovirus itself contains that protein. Once introduced to your system, the adenovirus containing the spike protein triggers the immune system to create antibodies so that it can fight against the slight insult to the immune system.

In both cases, once your immune system has made the antibody against the “spike” protein, it retains memory of this and can re-produce the same antibodies needed to fight the virus if you were ever exposed to the actual virus.

Isn’t it bad for your cells to do this long term though?

Long term, most likely. However, the beauty of mRNA that is introduced into your system is that it’s very fragile and has a one-time use typically. Your cells would make the protein “spike” and then the mRNA would be degraded, so your cells would never make the “spike” again.

What about long-term effects?

Long term effects and how long the vaccines will provide immunity are unknown at this point. However, initial data has shown that there are minimal initial effects to the vaccine thus far. The symptoms that were seen, such as a sore arm or feeling unwell for a few days, are typical reactions to vaccines when first given and is a response of your body cranking up productivity to fight against the intrusion.

Long-term effects of the vaccine will be made available once enough time has passed, but generally there is little to fear.

Should I get the vaccine even if I’m unsure or I don’t want to?

Yes, absolutely and emphatically yes.

The science behind the vaccines are sound and initial data suggest that there are no long-term effects to be majorly concerned about. Transparency in science is key and as long as vaccine producers are transparent there is nothing to fear.

Nazish Jeffery is a Rochester native who is pursuing her Ph.D. in biochemistry and molecular biology at the University of Rochester. She is president of the UR Science Policy Initiative.

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

Affiliation.

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.

Yale Directories

Institution for Social and Policy Studies

Advancing research • shaping policy • developing leaders, persuasive messaging to increase covid-19 vaccine uptake intentions.

Erin K. James, Scott E. Bokemper, Alan S. Gerber, Saad B. Omer, Gregory A. Huber

Link to article here .

The first experiment in this study was registered at clinicaltrials.gov and can be found under the ID number NCT04460703. This study was registered at OSF under the title COVID 19 Vaccine Persuasion Study 2.

A portrait of Shaun Barcavage, who holds his forehead as though in pain.

Thousands Believe Covid Vaccines Harmed Them. Is Anyone Listening?

All vaccines have at least occasional side effects. But people who say they were injured by Covid vaccines believe their cases have been ignored.

Shaun Barcavage, 54, a nurse practitioner in New York City, said that ever since his first Covid shot, standing up has sent his heart racing. Credit... Hannah Yoon for The New York Times

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By Apoorva Mandavilli

Apoorva Mandavilli spent more than a year talking to dozens of experts in vaccine science, policymakers and people who said they had experienced serious side effects after receiving a Covid-19 vaccine.

Published May 3, 2024 Updated May 4, 2024

Within minutes of getting the Johnson & Johnson Covid-19 vaccine, Michelle Zimmerman felt pain racing from her left arm up to her ear and down to her fingertips. Within days, she was unbearably sensitive to light and struggled to remember simple facts.

She was 37, with a Ph.D. in neuroscience, and until then could ride her bicycle 20 miles, teach a dance class and give a lecture on artificial intelligence, all in the same day. Now, more than three years later, she lives with her parents. Eventually diagnosed with brain damage, she cannot work, drive or even stand for long periods of time.

“When I let myself think about the devastation of what this has done to my life, and how much I’ve lost, sometimes it feels even too hard to comprehend,” said Dr. Zimmerman, who believes her injury is due to a contaminated vaccine batch .

The Covid vaccines, a triumph of science and public health, are estimated to have prevented millions of hospitalizations and deaths . Yet even the best vaccines produce rare but serious side effects . And the Covid vaccines have been given to more than 270 million people in the United States, in nearly 677 million doses .

Dr. Zimmerman’s account is among the more harrowing, but thousands of Americans believe they suffered serious side effects following Covid vaccination. As of April, just over 13,000 vaccine-injury compensation claims have been filed with the federal government — but to little avail. Only 19 percent have been reviewed. Only 47 of those were deemed eligible for compensation, and only 12 have been paid out, at an average of about $3,600 .

Some scientists fear that patients with real injuries are being denied help and believe that more needs to be done to clarify the possible risks.

“At least long Covid has been somewhat recognized,” said Akiko Iwasaki, an immunologist and vaccine expert at Yale University. But people who say they have post-vaccination injuries are “just completely ignored and dismissed and gaslighted,” she added.

Michelle Zimmerman sits on the floor of a ballroom where she used to dance, with a pair of dancing shoes next to her. She wears a dark skirt and a red velvet shirt.

In interviews and email exchanges conducted over several months, federal health officials insisted that serious side effects were extremely rare and that their surveillance efforts were more than sufficient to detect patterns of adverse events.

“Hundreds of millions of people in the United States have safely received Covid vaccines under the most intense safety monitoring in U.S. history,” Jeff Nesbit, a spokesman for the Department of Health and Human Services, said in an emailed statement.

But in a recent interview, Dr. Janet Woodcock, a longtime leader of the Food and Drug Administration, who retired in February, said she believed that some recipients had experienced uncommon but “serious” and “life-changing” reactions beyond those described by federal agencies.

“I feel bad for those people,” said Dr. Woodcock, who became the F.D.A.’s acting commissioner in January 2021 as the vaccines were rolling out. “I believe their suffering should be acknowledged, that they have real problems, and they should be taken seriously.”

“I’m disappointed in myself,” she added. “I did a lot of things I feel very good about, but this is one of the few things I feel I just didn’t bring it home.”

Federal officials and independent scientists face a number of challenges in identifying potential vaccine side effects.

The nation’s fragmented health care system complicates detection of very rare side effects, a process that depends on an analysis of huge amounts of data. That’s a difficult task when a patient may be tested for Covid at Walgreens, get vaccinated at CVS, go to a local clinic for minor ailments and seek care at a hospital for serious conditions. Each place may rely on different health record systems.

There is no central repository of vaccine recipients, nor of medical records, and no easy to way to pool these data. Reports to the largest federal database of so-called adverse events can be made by anyone, about anything. It’s not even clear what officials should be looking for.

“I mean, you’re not going to find ‘brain fog’ in the medical record or claims data, and so then you’re not going to find” a signal that it may be linked to vaccination, Dr. Woodcock said. If such a side effect is not acknowledged by federal officials, “it’s because it doesn’t have a good research definition,” she added. “It isn’t, like, malevolence on their part.”

The government’s understaffed compensation fund has paid so little because it officially recognizes few side effects for Covid vaccines. And vaccine supporters, including federal officials, worry that even a whisper of possible side effects feeds into misinformation spread by a vitriolic anti-vaccine movement.

‘I’m Not Real’

Patients who believe they experienced serious side effects say they have received little support or acknowledgment.

Shaun Barcavage, 54, a nurse practitioner in New York City who has worked on clinical trials for H.I.V. and Covid, said that ever since his first Covid shot, merely standing up sent his heart racing — a symptom suggestive of postural orthostatic tachycardia syndrome , a neurological disorder that some studies have linked to both Covid and, much less often, vaccination .

He also experienced stinging pain in his eyes, mouth and genitals, which has abated, and tinnitus, which has not.

“I can’t get the government to help me,” Mr. Barcavage said of his fruitless pleas to federal agencies and elected representatives. “I am told I’m not real. I’m told I’m rare. I’m told I’m coincidence.”

Renee France, 49, a physical therapist in Seattle, developed Bell’s palsy — a form of facial paralysis, usually temporary — and a dramatic rash that neatly bisected her face. Bell’s palsy is a known side effect of other vaccines, and it has been linked to Covid vaccination in some studies.

But Dr. France said doctors were dismissive of any connection to the Covid vaccines. The rash, a bout of shingles, debilitated her for three weeks, so Dr. France reported it to federal databases twice.

“I thought for sure someone would reach out, but no one ever did,” she said.

Similar sentiments were echoed in interviews, conducted over more than a year, with 30 people who said they had been harmed by Covid shots. They described a variety of symptoms following vaccination, some neurological, some autoimmune, some cardiovascular.

All said they had been turned away by physicians, told their symptoms were psychosomatic, or labeled anti-vaccine by family and friends — despite the fact that they supported vaccines.

Even leading experts in vaccine science have run up against disbelief and ambivalence.

Dr. Gregory Poland, 68, editor in chief of the journal Vaccine, said that a loud whooshing sound in his ears had accompanied every moment since his first shot, but that his entreaties to colleagues at the Centers for Disease Control and Prevention to explore the phenomenon, tinnitus, had led nowhere.

He received polite responses to his many emails, but “I just don’t get any sense of movement,” he said.

“If they have done studies, those studies should be published,” Dr. Poland added. In despair that he might “never hear silence again,” he has sought solace in meditation and his religious faith.

Dr. Buddy Creech, 50, who led several Covid vaccine trials at Vanderbilt University, said his tinnitus and racing heart lasted about a week after each shot. “It’s very similar to what I experienced during acute Covid, back in March of 2020,” Dr. Creech said.

Research may ultimately find that most reported side effects are unrelated to the vaccine, he acknowledged. Many can be caused by Covid itself.

“Regardless, when our patients experience a side effect that may or may not be related to the vaccine, we owe it to them to investigate that as completely as we can,” Dr. Creech said.

Federal health officials say they do not believe that the Covid vaccines caused the illnesses described by patients like Mr. Barcavage, Dr. Zimmerman and Dr. France. The vaccines may cause transient reactions, such as swelling, fatigue and fever, according to the C.D.C., but the agency has documented only four serious but rare side effects .

Two are associated with the Johnson & Johnson vaccine, which is no longer available in the United States: Guillain-Barré syndrome , a known side effect of other vaccines , including the flu shot; and a blood-clotting disorder.

The C.D.C. also links mRNA vaccines made by Pfizer-BioNTech and Moderna to heart inflammation, or myocarditis, especially in boys and young men. And the agency warns of anaphylaxis, or severe allergic reaction, which can occur after any vaccination.

Listening for Signals

Agency scientists are monitoring large databases containing medical information on millions of Americans for patterns that might suggest a hitherto unknown side effect of vaccination, said Dr. Demetre Daskalakis, director of the C.D.C.’s National Center for Immunization and Respiratory Diseases.

“We toe the line by reporting the signals that we think are real signals and reporting them as soon as we identify them as signals,” he said. The agency’s systems for monitoring vaccine safety are “pretty close” to ideal, he said.

Those national surveillance efforts include the Vaccine Adverse Event Reporting System (VAERS). It is the largest database, but also the least reliable: Reports of side effects can be submitted by anyone and are not vetted, so they may be subject to bias or manipulation.

The system contains roughly one million reports regarding Covid vaccination, the vast majority for mild events, according to the C.D.C.

Federal researchers also comb through databases that combine electronic health records and insurance claims on tens of millions of Americans. The scientists monitor the data for 23 conditions that may occur following Covid vaccination. Officials remain alert to others that may pop up, Dr. Daskalakis said.

But there are gaps, some experts noted. The Covid shots administered at mass vaccination sites were not recorded in insurance claims databases, for example, and medical records in the United States are not centralized.

“It’s harder to see signals when you have so many people, and things are happening in different parts of the country, and they’re not all collected in the same system,” said Rebecca Chandler, a vaccine safety expert at the Coalition for Epidemic Preparedness Innovations.

An expert panel convened by the National Academies concluded in April that for the vast majority of side effects, there was not enough data to accept or reject a link.

Asked at a recent congressional hearing whether the nation’s vaccine-safety surveillance was sufficient, Dr. Peter Marks, director of the F.D.A.’s Center for Biologics Evaluation and Research, said, “I do believe we could do better.”

In some countries with centralized health care systems, officials have actively sought out reports of serious side effects of Covid vaccines and reached conclusions that U.S. health authorities have not.

In Hong Kong, the government analyzed centralized medical records of patients after vaccination and paid people to come forward with problems. The strategy identified “a lot of mild cases that other countries would not otherwise pick up,” said Ian Wong, a researcher at the University of Hong Kong who led the nation’s vaccine safety efforts.

That included the finding that in rare instances — about seven per million doses — the Pfizer-BioNTech vaccine triggered a bout of shingles serious enough to require hospitalization.

The European Medicines Agency has linked the Pfizer and Moderna vaccines to facial paralysis, tingling sensations and numbness. The E.M.A. also counts tinnitus as a side effect of the Johnson & Johnson vaccine, although the American health agencies do not. There are more than 17,000 reports of tinnitus following Covid vaccination in VAERS.

Are the two linked? It’s not clear. As many as one in four adults has some form of tinnitus. Stress, anxiety, grief and aging can lead to the condition, as can infections like Covid itself and the flu.

There is no test or scan for tinnitus, and scientists cannot easily study it because the inner ear is tiny, delicate and encased in bone, said Dr. Konstantina Stankovic, an otolaryngologist at Stanford University.

Still, an analysis of health records from nearly 2.6 million people in the United States found that about 0.04 percent , or about 1,000, were diagnosed with tinnitus within three weeks of their first mRNA shot. In March, researchers in Australia published a study linking tinnitus and vertigo to the vaccines .

The F.D.A. is monitoring reports of tinnitus, but “at this time, the available evidence does not suggest a causal association with the Covid-19 vaccines,” the agency said in a statement.

Despite surveillance efforts, U.S. officials were not the first to identify a significant Covid vaccine side effect: myocarditis in young people receiving mRNA vaccines. It was Israeli authorities who first raised the alarm in April 2021. Officials in the United States said at the time that they had not seen a link.

On May 22, 2021, news broke that the C.D.C. was investigating a “relatively few” cases of myocarditis. By June 23, the number of myocarditis reports in VAERS had risen to more than 1,200 — a hint that it is important to tell doctors and patients what to look for.

Later analyses showed that the risk for myocarditis and pericarditis, a related condition, is highest after a second dose of an mRNA Covid vaccine in adolescent males aged 12 to 17 years.

In many people, vaccine-related myocarditis is transient. But some patients continue to experience pain, breathlessness and depression, and some show persistent changes on heart scans . The C.D.C. has said there were no confirmed deaths related to myocarditis, but in fact there have been several accounts of deaths reported post-vaccination .

Pervasive Misinformation

The rise of the anti-vaccine movement has made it difficult for scientists, in and out of government, to candidly address potential side effects, some experts said. Much of the narrative on the purported dangers of Covid vaccines is patently false, or at least exaggerated, cooked up by savvy anti-vaccine campaigns.

Questions about Covid vaccine safety are core to Robert F. Kennedy Jr.’s presidential campaign. Citing debunked theories about altered DNA, Florida’s surgeon general has called for a halt to Covid vaccination in the state.

“The sheer nature of misinformation, the scale of misinformation, is staggering, and anything will be twisted to make it seem like it’s not just a devastating side effect but proof of a massive cover-up,” said Dr. Joshua Sharfstein, a vice dean at Johns Hopkins University.

Among the hundreds of millions of Americans who were immunized for Covid, some number would have had heart attacks or strokes anyway. Some women would have miscarried. How to distinguish those caused by the vaccine from those that are coincidences? The only way to resolve the question is intense research .

But the National Institutes of Health is conducting virtually no studies on Covid vaccine safety, several experts noted. William Murphy, a cancer researcher who worked at the N.I.H. for 12 years, has been prodding federal health officials to initiate these studies since 2021.

The officials each responded with “that very tired mantra: ‘But the virus is worse,’” Dr. Murphy recalled. “Yes, the virus is worse, but that doesn’t obviate doing research to make sure that there may be other options.”

A deeper understanding of possible side effects, and who is at risk for them, could have implications for the design of future vaccines, or may indicate that for some young and healthy people, the benefit of Covid shots may no longer outweigh the risks — as some European countries have determined.

Thorough research might also speed assistance to thousands of Americans who say they were injured.

The federal government has long run the National Vaccine Injury Compensation Program , designed to compensate people who suffer injuries after vaccination. Established more than three decades ago, the program sets no limit on the amounts awarded to people found to have been harmed.

But Covid vaccines are not covered by that fund because Congress has not made them subject to the excise tax that pays for it. Some lawmakers have introduced bills to make the change.

Instead, claims regarding Covid vaccines go to the Countermeasures Injury Compensation Program . Intended for public health emergencies, this program has narrow criteria to pay out and sets a limit of $50,000, with stringent standards of proof.

It requires applicants to prove within a year of the injury that it was “the direct result” of getting the Covid vaccine, based on “compelling, reliable, valid, medical, and scientific evidence.”

The program had only four staff members at the beginning of the pandemic, and now has 35 people evaluating claims. Still, it has reviewed only a fraction of the 13,000 claims filed, and has paid out only a dozen.

Dr. Ilka Warshawsky, a 58-year-old pathologist, said she lost all hearing in her right ear after a Covid booster shot. But hearing loss is not a recognized side effect of Covid vaccination.

The compensation program for Covid vaccines sets a high bar for proof, she said, yet offers little information on how to meet it: “These adverse events can be debilitating and life-altering, and so it’s very upsetting that they’re not acknowledged or addressed.”

Dr. Zimmerman, the neuroscientist, submitted her application in October 2021 and provided dozens of supporting medical documents. She received a claim number only in January 2023.

In adjudicating her claim for workers’ compensation, Washington State officials accepted that Covid vaccination caused her injury, but she has yet to get a decision from the federal program.

One of her therapists recently told her she might never be able to live independently again.

“That felt like a devastating blow,” Dr. Zimmerman said. “But I’m trying not to lose hope there will someday be a treatment and a way to cover it.”

Apoorva Mandavilli is a reporter focused on science and global health. She was a part of the team that won the 2021 Pulitzer Prize for Public Service for coverage of the pandemic. More about Apoorva Mandavilli

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COVID-19 Vaccination Public Education Campaign Saved Thousands of Lives, Billions of Dollars

Study found vaccine campaign saved $90 for every $1 spent

The U.S. Department of Health and Human Services’ (HHS) COVID-19 Vaccination Public Education Campaign, We Can Do This, resulted in an estimated$731.9 billion in societal benefits due to averted illness and related costs, resulting in a nearly $90 return in societal benefits for every $1 spent, according to research published today in the American Journal of Preventive Medicine .

“At the height of the pandemic, we launched one of the largest public health education campaigns in U.S. history to encourage and educate Americans on the steps they could take to get and stay healthy. We now have research to confirm the COVID-19 Public Education Campaign, We Can Do This, was an indispensable part of efforts to vaccinate people and protect them from COVID-19, saving thousands of lives and billions of dollars in the process,” said HHS Secretary Xavier Becerra. “HHS is responsible for protecting the health and well-being of all Americans. As stewards of the public’s money, we wanted to deliver impact for the American people in the most efficient and effective ways. This confirms we did exactly that. We will no doubt use what we learned in this campaign to further improve our public health efforts in the future.”

The study showed the Campaign encouraged 22.3 million people to complete their primary COVID-19 vaccination series between April 2021 and March 2022, preventing nearly 2.6 million SARS-CoV-2 infections, the virus that causes COVID-19, including nearly 244,000 hospitalizations, during the time period that the highly contagious Delta and Omicron virus variants were spreading.

Preventing these outcomes resulted in societal benefits to the U.S. of $740.2 billion, accounting for such factors as medical expenses, wages, and other costs that people and institutions would have incurred in the absence of the Campaign. In comparison, the Campaign cost $377 million, with an additional $7.9 billion spent to vaccinate 22.3 million people in that time period.

According to the study, from April 2021 to March 2022, the net benefit of the Campaign—how much money these efforts saved minus how much they cost—came to $731.9 billion, translating to a return on investment of $89.54 for every $1 spent.

In April 2021, HHS launched the We Can Do This Public Education Campaign to increase COVID-19 vaccine confidence and uptake in the U.S. The Campaign, one of the largest public health education efforts in U.S. history, promoted COVID-19 vaccine uptake using integrated, multichannel, research-based strategies. It aimed to reach 90% of adults in the United States at least once per quarter, with even more intense outreach to high-risk communities. The Campaign featured more than 7,000 ads in 14 languages, with many culturally tailored and geographically targeted to specific minority, racial, and ethnic audiences. A multimedia approach bolstered widespread engagement with trusted messengers, partner organizations, and influencers who delivered persuasive, accurate, and culturally relevant information to vaccine-hesitant populations.

The benefit-cost study of We Can Do This is the only research study to date that looked at the contributions of a media campaign to encourage people to get COVID-19 vaccines during the pandemic emergency period. The newly published study is unique in that it demonstrates that the nationwide media Campaign was an indispensable component of the nation’s efforts to vaccinate people and protect them from COVID-19. It also adds to the body of evidence that shows the Campaign’s impact on behavior change.

“This research confirms the benefits of public health campaigns as part of a multi-layered response to a public health crisis and to the effort to provide accurate information to the American public,” said May Malik, Senior Advisor for Public Education Campaigns at HHS.

To evaluate the benefits and costs of the national Campaign, researchers used real-world data from multiple sources, such as data on COVID-19 outcomes, uptake of COVID-19 vaccines, and vaccine effectiveness, from the U.S. Centers for Disease Control and Prevention (CDC), along with survey data collected to measure the Campaign’s effects on vaccination behaviors over time.

The findings can help inform the Federal response to future public health threats. As part of a multipronged approach to addressing public health crises, this study demonstrates the return on investment possible from public education campaigns given their effectiveness in building vaccine confidence and supporting healthy behavior change.

The study, Benefit-Cost Analysis of the HHS COVID-19 Campaign: April 2021–March 2022 , was conducted by researchers from HHS Office of the Assistant Secretary for Public Affairs and Fors Marsh in Arlington, Virginia.

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What Canadians need to know about AstraZeneca withdrawing its COVID-19 vaccine

AstraZeneca has initiated the worldwide withdrawal of its COVID-19 vaccine because of a “surplus of available updated vaccines,” and it has requested that the European authorization for its COVID-19 vaccine be pulled. While most countries ceased using the shot in 2021, this move Tuesday makes that cessation official.

Does the withdrawal mean anything for Canadians who got the vaccine? Here’s what you need to know.

AstraZeneca in Canada

AstraZeneca’s COVID-19 vaccine was first approved in Canada on Feb. 26, 2021, a month after approval from the European Medicines Agency in January, 2021. Within weeks, however, concerns grew about the vaccine’s safety, when dozens of countries suspended the vaccine’s use after unusual but rare blood clots were detected in a small number of immunized people.

Canada’s National Advisory Committee on Immunization called for a pause in injections of the AstraZeneca shot to anyone under 55 on Monday March 29, 2021, a day before the country was scheduled to receive 1.5 million doses of the vaccine from the United States.

At that time, about 307,000 AstraZeneca doses had been administered. As of June 11, 2021, there had been one case of capillary leak syndrome, a rare blood clot, after vaccination with the AstraZeneca or COVISHIELD COVID-19 vaccine in Canada.

On May 11, 2021, Ontario and Alberta paused the use of AstraZeneca as a first dose. Ontario stated it was due to an increase in thrombosis with thrombocytopenia syndrome – blood clots which can block blood flow and cause damage to organs, and a lower than normal number of platelets in the blood, which is dangerous because platelets help your body from forming clots – linked to the AstraZeneca vaccine. The change was also made because Canada had the luxury of relying on two other shots for its mass vaccination campaign .

In July, 2021, Health Canada updated the label for the AstraZeneca and COVISHIELD COVID-19 vaccines to add capillary leak syndrome, a rare and serious condition where the small blood vessels start to leak fluid, as a potential side-effect. The agency also included a warning for patients with a history of the syndrome to not get those vaccines.

On Dec. 19, 2023, authorization for AstraZeneca was cancelled under the Food and Drug Regulations at the request of the manufacturer.

How many Canadians were given AstraZeneca Vaccines?

As of Feb. 25, Canada has administered 105,605,632 COVID-19 vaccines. Of those, 2,811,963 or 2.66 per cent of them were AstraZeneca.

How many Canadians experienced negative side effects from AstraZeneca?

As of Jan. 5, 58,712 adverse vaccine events have been reported in Canada . Of those, 3,318 were nonserious complications from AstraZeneca, the most common being headache, fatigue and fever. There were 122 serious complications from AstraZeneca such as cardiac arrest, cardiac failure, myocarditis, pulmonary embolism, Bell’s palsy and thrombosis with thrombocytopenia syndrome (TTS). The majority of adverse symptoms from COVID-19 vaccines started between five minutes and 113 days after vaccination.

Legal challenges and payouts for AstraZeneca and other vaccines

AstraZeneca is being sued by a few different parties. A British man, Jamie Scott, is suing AstraZeneca for what he says is damage caused by the jab in April, 2021. Another British woman, Kam Miller, is suing after her husband, Neil Miller, 50, developed fatal blood clotting after receiving the jab in March, 2021. Miller told the BBC she was not anti-vaccination, but is arguing the compensation she received following his death should be increased.

Canada has a Vaccine Injury Support Program, set up to help people who experienced a serious and permanent injury as a result of receiving a Health Canada authorized vaccine, administered in Canada on or after Dec. 8, 2020. The program was established to ensure no-fault compensation for those affected by vaccine injuries. Health columnist André Picard, writing about the idea in 2019 , noted that “vaccination is the cornerstone of public health and compensating the rare cases where vaccines cause injury is the fair and just thing to do.”

The program began accepting claims on June 1, 2021, and as of December, 2023, had given out $11,236,314 to claimants. Vaccine side effects and injuries reported to the database are self-reported, with no confirmation that the injuries were caused by vaccines.

What are the current COVID-19 vaccines available for Canadians?

Several vaccines for COVID-19 are authorized and available for use in Canada. These include messenger ribonucleic acid (mRNA) vaccines, which are preferred, and a protein subunit vaccine. The XBB. 1.5 vaccines are now the recommended products. There are three vaccines currently approved for use by Health Canada:

Pfizer-BioNTech Comirnaty XBB (also known as Pfizer) – mRNA vaccine
Moderna Spikevax XBB (also known as Moderna) – mRNA vaccine
Novavax XBB COVID-19 vaccine (also known as Novavax) – protein subunit vaccine

How does the risk of blood clots compare after a COVID-19 infection vs. from the AstraZeneca vaccine?

A study by researchers in Britain found that people infected with COVID-19 are at least nine times more likely to develop potentially deadly blood conditions compared with those who have received either the Oxford-AstraZeneca or the Pfizer-BioNTech vaccines.

The study, led by a team at the University of Oxford, involved analyzing medical data from 29.1 million people in England who received one dose of vaccine from Dec. 1, 2020, to April 24, 2021. The scientists also looked at medical records for 1.8 million people who tested positive for COVID-19 during that period.

Dr. Seema Marwaha, an assistant professor of internal medicine at the University of Toronto, says that one in five patients hospitalized with COVID-19 actually develop blood clots .

“I have looked after multiple patients who have had COVID-related strokes and COVID-related pulmonary embolisms [blood clots in the lungs],” Dr. Marwaha said. None of these patients had been vaccinated.

“So, your risk of getting a serious clot from COVID is significant.”

Are Canadians who received the AstraZeneca vaccine at risk?

Evidence indicates that the benefits of COVID-19 vaccines continue to outweigh the risks of the disease.

Dr. Michelle Sholzberg, head of the division of hematology-oncology at St. Michael’s Hospital in Toronto, said that clots due to AstraZeneca tended to develop between four and 30 days after the vaccination.

If you were symptom-free after 30 days, “the odds are that you are in the clear,” she added.

Since no Canadians have received the AstraZeneca vaccine since its cancellation in December, 2023, it’s unlikely that anyone would develop new serious side effects now.

What are symptoms associated with blood clot formation

First and foremost, it’s important to keep in mind that vaccine-related blood clots are extremely rare.

The range of symptoms include:

A severe headache that does not go away;
Neurological problems such as blurred vision, difficulty speaking and seizures;
Shortness of breath, chest pain, severe abdominal pain and severe back pain;
Severe swelling, pain, colour changes, or coldness in an arm or a leg;
Multiple small bruises, red or purple spots or blood blisters under the skin.

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