WASHINGTON — The White House will soon unveil a wide-reaching public relations campaign aimed at boosting vaccine confidence and uptake across the U.S., Biden administration aides told STAT.
This television, radio, and digital advertising blitz, set to kick off within weeks, will focus on Americans outright skeptical of vaccines’ safety or effectiveness as well as those who are potentially more willing to seek a Covid-19 immunization but don’t yet know where, when, or how. Specifically, the campaign will target three groups in which access, apathy, or outright skepticism may pose a barrier to vaccinations: young people, people of color, and conservatives, according to a Biden aide. Congress and the administration have set aside over $1.5 billion for the effort.
The effort highlights a looming and underappreciated public health challenge: Though millions of Americans are currently clamoring to receive a Covid-19 vaccine, in a few short months, or even weeks, the opposite may be true. Instead of scrambling to manufacture doses, the government may soon be scrambling to find arms willing to receive them.
While the administration Covid response advisers organizing the effort are broadly optimistic, they and many public health experts fear that without winning buy-in from a critical, final slice of the population, the effort could fall short of its goal: effectively ending the country’s coronavirus crisis.
“I’m worried about the 15% of Americans who say they will not take the vaccine,” said Sten Vermund, the dean of the Yale School of Public Health. “And about 8% or 9% of Americans say, ‘I will take it if they make me, if my job forces me to.’ So that’s about 23% or 24%, and that’s flirting with the level we need to get to herd immunity.”
The rollout fulfills one of Biden’s first promises in office. He pledged on Jan. 21 to kick off an “unprecedented vaccination public health campaign” aimed at convincing every American adult to seek a Covid-19 immunization.
As for the specific content, administration officials said they were mindful that appeals directly from President Biden or Anthony Fauci are not likely to sway vaccine-hesitant people. As a result, they are expected to recruit both celebrities and trusted local officials to advance the pro-vaccine message.
Dorit Reiss, a law professor at the University of California, Hastings, whose research focuses on vaccine policy and ethics, explained why Biden and his lieutenants may not always be the best suited to spread the word.
“Messaging from the Biden administration might not be where conservative communities would look for guidance,” she said. “It’s community leaders that you want to get on board, and it might be better for the federal government to provide funding for a variety of willing community leaders to address those communities instead.”
To that point, the plan includes a major emphasis on community-level messaging: Federal officials have already allocated more than $500 million for local efforts to recruit local leaders and community organizations to encourage vaccine uptake and ensure racial equity in the vaccine distribution effort.
On a national level, White House officials declined to share details of what form many of the ads will take, or, in particular, whose voices they’ll highlight. But in a hint of the strategy, top administration officials have been already deployed to spread the word. Vice President Kamala Harris, the first Black and South Asian woman elected to the White House, has spent much of the past three weeks conducting in-person outreach, TV appearances, and radio interviews, in many cases geared specifically toward boosting vaccine uptake in Black communities.
Convincing Americans that the current vaccines are safe and effective, experts say, could make the difference between a country with widespread immunity and one in which the disease continues to spread, albeit more slowly.
It is already clear that the White House is not deploying a one-message-fits-all strategy. Marcella Nunez-Smith, the Yale physician-researcher advising Biden on health equity, appeared last month on The Shade Room, an online outlet geared toward Black viewers, and Anthony Fauci, the top government infectious diseases researcher, has conducted interviews with several Spanish-language news and entertainment outlets.
The administration has even deployed Francis Collins, the longtime director of the National Institutes of Health, to address one of the demographics that early surveys show is most likely to decline a Covid-19 vaccination: white, conservative, evangelical Christians. (According to a recent Marist poll, the three most vaccine-hesitant demographics are supporters of former President Donald Trump, Republicans, and white evangelical Christians, at 47%, 41%, and 38% likely to decline a vaccine, respectively.)
A devout Christian himself, Collins cast the vaccines as a gift from God in an interview with the Christian Broadcasting Network, and stressed that the Catholic Church has endorsed the use of Johnson & Johnson’s vaccine despite its use of a cell line that originated from an abortion procedure decades ago.
The White House’s announcement of the PR blitz will come just days after it decreed that by May 1, all state and local governments would be required to make all American adults eligible to sign up for vaccine appointments. The U.S. is currently administering over 2 million doses daily. Just over 10% of the population is fully vaccinated, and roughly 20% has received at least one vaccine dose.
But even as the vaccine rollout continues, some experts have fretted that when it comes to the PR campaign, there’s no time to waste.
“I think President Biden is right that by May, there will be enough vaccines for anyone who wants them, and we’ll start looking to people who don’t,” Reiss said. “I don’t think we can wait. It’s not that long.”
In recent weeks, White House aides including Nunez-Smith and Cameron Webb, another physician advising Biden’s pandemic response on equity issues, have workshopped the plan with the Department of Health and Human Services, the Centers for Disease Control and Prevention, and local community leaders.
“I’ve been hosting roundtables with key constituencies to make sure that we get that effort right,” Nunez-Smith said during a press briefing last week. “We’re building relationships with trusted messengers, all over the country, to make sure they have the best information possible to share with their communities.”
Congress and the administration have pledged major resources for the effort.
Much of the project’s funding comes from the sweeping $1.9 trillion Covid-19 relief bill Biden signed last week.
The administration has also already pledged over $500 million in additional funds to address vaccine uptake, health literacy, and equity in the vaccine distribution, including $250 million to fund local health literacy projects and another $255 million for the CDC to fund local government efforts to focus on equity and confidence in underserved communities.
Upon taking power in January, the administration also inherited a third funding stream meant for Covid-19 mitigation and prevention efforts: a $250 million contract that the Trump administration inked with the Virginia-based PR firm Fors Marsh months ago. That campaign, which began under President Trump and has continued under the Biden administration, has helped to fund Spanish-language radio commercials, ads in newspapers serving the Black community, and other Covid-19 mitigation outreach work.
Taken together, federal efforts to promote vaccine uptake total nearly $2 billion.
The Biden administration will also have backup from the nonprofit world. It’s working with the Ad Council, a nonprofit agency that has partnered with the government on PSAs meant to reduce drug and tobacco use, on a $50 million campaign meant to sell Americans on vaccine safety and effectiveness. The Creative Coalition, another nonprofit, has also won buy-in from a collection of celebrities, corporate executives, and prominent public health figures for its own vaccine-focused campaign.
Those campaigns have largely relied on the same strategies foreshadowed by Biden aides. Much of the Ad Council’s early effort, which consists of TV commercials, radio and print ads, and digital messaging, has stayed away from celebrities but nonetheless focused on Black and Spanish-speaking communities.
At a virtual kickoff dinner for the Creative Coalition campaign, meanwhile, Rochelle Walensky, the CDC director, said it would seek to “harness the power of influencers in building vaccine confidence.” Fauci called celebrities’ ability to build vaccine trust “extraordinary.”
In light of recent data, however, public health experts and Biden officials acknowledge that messaging to white conservatives — in other words, those least likely to view the new administration as credible — might pose the biggest hurdle to achieving true, population-wide immunity.
“When Magic Johnson said: ‘I have HIV, I got tested, and I am going to keep my family safe, I’m going to take antiretroviral drugs,’ we saw HIV testing rates go up the day after his announcement,” said Vermund, the Yale public health dean, who is advising the Creative Coalition effort. “It may take Donald Trump as a celebrity, saying, ‘I got the vaccine, I feel great.’ It may take a different kind of celebrity to reach the conspiracists and the anti-vax folks who are militant in that space.” (On Sunday, Fauci called for Trump to encourage his supporters to get vaccinated, calling such a message a potential “game-changer.”)
The messaging and public health experts behind the federal campaign and both nonprofit efforts have recognized, however, that their initiatives carry an inherent obstacle: Regardless of which community they’re addressing, a brief word from a celebrity or politician is unlikely to be effective on its own.
Part of the Creative Coalition’s mission, said the group’s CEO, Robin Bronk, is to recognize the ineffectiveness of simply parachuting into communities for a one-off celebrity cameo — a message she said the nonprofit and federal efforts would do well to bear in mind.
“We call it ‘red carpet-bagging,’ meaning that if you blow in and blow out for something, it’s not authentic, and it’s going to do more damage to the issue,” Bronk said. “Sometimes we don’t get involved in issues, particularly because getting the Hollywood community into it would do more harm than good. It’s not just throwing a celebrity up getting an arm jabbed — we have to be thoughtful.”
Correction: This story was updated to reflect that the Biden administration will not unveil the PR campaign this week.