In the Covid-19 vaccine push, no one is speaking Gen Z’s language

WASHINGTON — Useful Covid-19 information isn’t reaching the Instagram generation.

There’s almost no messaging specifically tailored to them from federal or state public health officials. There’s hardly anything official on Tik Tok. And even the limited efforts to reach them where they are — like Instagram’s links to its “Covid-19 information center”— aren’t working.

Just ask Kymon Palau, a 21-year-old from Albuquerque, N.M., who has over 18,000 followers on the site.

“If I am being honest with you, I probably clicked those tags once back in April of last year and never clicked them again — it’s annoying,” Palau said.

Palau isn’t alone — in interviews with more than half a dozen other young people around the country, nearly all said they weren’t opposed to vaccinations — they just couldn’t find information tailored to them.

That lack of information is clearly having an impact. A recent STAT-Harris Poll finds that 21% of Generation Z — defined in the survey as young adults aged 18 to 24 — said they would not get vaccinated against Covid-19 and another 34% said they would “wait awhile and see” before getting vaccinated. The results come on the heels of an NBC-Morning Consult poll that found that 26% of Gen Z said they would not get the vaccine.

“There isn’t anything that is consumable and/or targeted at our demographic,” said Gabrielle Kalisz, a 22-year-old who lives in Washington, D.C., and who has been vaccinated. “All the messaging online … isn’t targeted toward our age group, it doesn’t explain why, if you’re a healthy 19-year-old, you should get this vaccine.”

Numerous public health officials told STAT that the issue of growing vaccine reluctance among young people can be solved with a coordinated campaign of reliable, useful information that makes it both easy and enticing for young people to get vaccinated, even if they may not personally benefit much.

Those same officials acknowledged, however, that much of the groundwork for messaging to young people is yet to be done.

Time is running out: Unvaccinated young people are fueling an exponential uptick in Covid-19 cases in the Midwest, prompting fears of a fourth Covid-19 surge that could spread throughout the United States. Around the world, young people are also increasingly showing up in intensive care units with life-threatening symptoms. The uptick in cases, which experts believe is caused by the increased spread of the coronavirus variant known as B.1.1.7, has been so serious that it has prompted one Canadian province to go back into lockdown. Public health officials also fear that reopening universities this fall could fuel regional outbreaks in college towns around the country.

“People keep referring to it as the race against time, but that’s where we are,” Michael Meit, a researcher who holds positions at the University of Chicago and East Tennessee State University’s Center for Rural Health Research. “We need to get as many people vaccinated as quickly as possible and in particular we need to get the people vaccinated who are the ones who are spreading the virus, and right now the people who are spreading the virus are those younger age groups.”

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Catriona Fee, 19, from Washington, D.C., isn’t getting vaccinated. She’s too worried about whether the Pfizer and Moderna shots will impact her ability to have a family down the line — a concern that several other Gen Zers shared with STAT. (Early data has shown that the vaccines do not affect fertility, and leading medical associations still recommend vaccines for individuals who are pregnant or plan to become pregnant.)

Fee maintains she’d be open to getting vaccinated if more information was available about potential long-term impacts on fertility, but right now she’s not convinced.

“Gen Z … they have to consider, is this going to impact my choices down the road?” Fee said. “For the vaccine, it’s, is this going to impact my ability to have children?’”

Young people are also worried about whether vaccine side effects will keep them out of work or make it harder for them to finish their mountains of homework. While all three vaccines authorized by the Food and Drug Administration have a tendency to hit young people harder with side effects, there’s little information available about what they can expect.

“People just don’t have time to try to find an appointment, to take the time out of their day to go get the shot, and have two days where they feel awful,” said Kyler Tipton, 24, of Conway, Ark., who wants to get vaccinated. “I know nobody really has the time to leave work or take a couple off of days off because they got a vaccine, but for people my age, they might miss their rent.”

They’re also just less motivated than many older people.

“The challenge in this age group is they know that the risk to them is pretty low from this virus — we shouldn’t be dishonest about that. It’s helping them be motivated enough to protect others … to overcome their own personal ambivalence,” said Sarah Van Orman, division chief of college health at the University of Southern California.

The problem of vaccine hesitancy is even more pronounced in rural, conservative communities. Recent polling suggests between 20% and roughly 40% of rural Americans are unsure about getting vaccinated.

Tipton told STAT that young people in his community are weighing the modest benefits of getting vaccinated with the criticism they may receive from their community, from people who are themselves hesitant or opposed to the vaccines.

“They just don’t see it … being more valuable than the social ostracism, and the sickness,” explained Tipton, referring to the potential side effects of the vaccine.

Though public health officials haven’t launched any specific campaigns targeting young people, Gen Zers themselves are starting to organize to help their peers.

Palau, the Instagram influencer, largely credits his own change of heart on the vaccine to his followers and fellow influencers — particularly people of color — on platforms like Instagram and TikTok. Palau, who is Indigenous, was hesitant for months because of the long history of exploitation and medical experimentation on Native communities, he said, even though he lost several family members to Covid-19.

“We were treated like lab rats to be forcibly tested on,” he said. “Of course that history is going to cross our minds.”

Eventually he made his own TikTok videos urging other Native young people to get vaccinated. His video is part of a campaign dubbed “See Friends Again,” a small campaign stood up by Bigtent Creative, an advocacy organization focused on mobilizing young people on channels like TikTok and Snapchat. The campaign focuses on contracting with young people of color who are “micro influencers” to share vaccine positive messages on their social media accounts.

Jordan Tralins, a 19-year-old from St. Petersburg, Fla., started the Covid Campus Coalition at her college, Cornell University. The campaign, which shares eye-catching, university-themed infographics answering common vaccine questions, piggybacks on the growing trend of Instagram infographic activism. More than 20 universities have now joined the coalition, including Ohio State and Notre Dame.

“I hadn’t seen any type of campaign targeted toward people my age … and that’s how the idea came to be,” explained Tralins. “I definitely don’t think the information was in my face. It was not in my Instagram feed anywhere. Anything that was on Facebook or TikTok that I saw was false information.”

Kaelin Connor, a 21-year-old from Belton, Texas, wrote an op-ed in her college newspaper debunking common vaccine myths. Kalisz, the 22-year-old from Washington, D.C., meanwhile, said she was pushing her friends to come to her for help.

“We went into the group chat and said what are your questions about the vaccine? What can I explain for you? What resources can I get to you? Can I help you find where to get vaccinated?” explained Kalisz. “A lot of it was just pushing a topic that maybe some kids didn’t even want to talk about, so that at least it was out there and we could have the conversation.”

Those kinds of personal conversations between trusted friends can make a big impact in changing peoples’ minds. Alison Buttenheim, an associate professor of nursing and health policy at the University of Pennsylvania who researches strategies to increase vaccine acceptance, described the impact of these conversations as “huge, huge, huge, huge.”

 

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The Biden administration has promised that it’s about to get much more involved in drumming up demand for vaccines — and young people are one of its primary targets.

Last month, the Centers for Disease Control and Prevention announced a $3 billion initiative aimed at increasing vaccine acceptance. The administration also launched a sweeping public relations campaign, which includes a new “Covid community corps,” a coalition of several hundred groups that will work with the White House to spread vaccine positive messages.

Both individuals and groups can join the community corps, which will provide participating groups with resources like fact sheets and social media posts to share, although it’s not yet clear how central a role the community corp will play in the overall vaccine rollout.

NextGen America, a nonprofit that typically focuses on registering and mobilizing young voters, is a member of the new corps. The group is planning to send text alerts and emails to some 1 million young people, both to help them figure out where to be vaccinated and to answer basic questions.

“We are hearing from folks that they are not worried about the vaccine, or it’s more important for their grandparents to get vaccinated, or they don’t know where to get vaccinated, they don’t know when they’ll be able to get vaccinated,” said Justin Atkins, the group’s national politics manager. “We have young folks that still believe they can’t get vaccinated because it’s something that’s reserved only for the elderly … in areas where they can get vaccinated.”

The community corps model concept makes sense, argued Buttenheim, the vaccine acceptance expert.

“This really seems to me like the sweet spot,” she said, adding that community-based efforts, like a recent ad promoting vaccination in New Orleans, “just land in a way that Dr. [Jill] Biden smiling and saying we should all get vaccinated probably wouldn’t.” (Buttenheim added that Biden should continue to do those, too.)

She just wishes it started sooner.

“Easy for me to say: It feels a little late,” Buttenheim said. “But that’s OK.”

A number of public health officials told STAT that the reopening of college campuses may be, paradoxically, a boon for controlling Covid-19 because campuses have a leg up in helping vaccinate their populations.

“We know where people live, we know their email addresses, and we also know a lot about them. … We know how to reach different parts of our students with the messages they need,” explained Van Orman, the USC professor.

Already a handful of college campuses, including Rutgers University and Cornell University, have also mandated students get vaccinated, and others are likely to follow.

The optimism may be misplaced, especially if most universities don’t mandate the vaccine. Flu vaccination on college campuses rates typically hover between 8% and 39% — far short of the 70% recommended by the Department of Health and Human Services.

The problem is even more pressing for the roughly one-third of college-aged people who aren’t enrolled in college. While colleges can bombard their students with vaccine positive messages, create vaccine sites all over campus, and even mandate vaccines — none of that exists for those who don’t enroll in higher education.

“We have all the factors that we have in college students without the role of the institution helping to mitigate them,” said Van Orman. “I worry much more about our young adults that are not associated with institutions of higher education.”

Some public health officials are already lamenting their lack of planning, and worrying about the future.

“I’m not entirely sure how well-prepared everybody is to start communicating, getting key messages tailored to the younger generations out there. … Everybody’s been so preoccupied … they really haven’t had a chance to think two or three moves ahead,” said William Schaffner, a professor of medicine at Vanderbilt University. “We have a lot of work to do.”

Others, however, are still hopeful — they have to be.

“Using messages and strategies and approaches that are rooted in the research and that we know work will get us where we need to be,” said Ann Christiano, the director of the University of Florida’s Center for Public Interest Communications. “If I didn’t believe that, I wouldn’t be able to get out of bed in the morning.”

Ed Silverman contributed to this report.