Section 1: 

The COVID-19 vaccine is one of the hottest issues right now, not only in public health but among any other topic in the US. So far, three companies have approved the distribution of vaccines among the American population. A couple months ago, about 40% of Americans report that they do not plan to get the vaccine (Rich 2020). If these 40% who can get vaccinated do not get vaccinated, we are in danger of not reaching herd immunity (Rich 2020). Also, if some of the people who plan to get the vaccine don’t follow through, the virus could linger much longer than it needs to (Tufekci 2021). There is a long history of vaccine fears and hesitancy; therefore, a vaccine developed quickly, using new technology has its obstacles (Mnookin 2011). 

According to their website, the Centers for Disease Control and Intervention (CDC) is the nation’s premier health promotion, prevention, and preparedness agency, (CDC 2021). The organization takes on all American public health threats. Although COVID-19 and the vaccines against it are very timely and important, the CDC has many health initiatives and campaigns. For the COVID-19 vaccine campaign, the target population is anyone living in America, age 16 and up (Rodriguez 2021). I followed CDC’s Twitter, Instagram, and Facebook accounts, as well as following how they tie the information back to their website. 

The CDC tweets about 12 times per day, consisting of news stories about who is eligible for vaccines and where to learn more, and what is trending as far as COVID-19 cases on the rise and downfall in the US. The CDC posts on Instagram 3-4 times per day and uses the Instagram stories feature daily. Their Instagram content is visual reminders on how to protect yourself against COVID using infographics (i.e.: proper mask fit), and pictures of people who have been vaccinated. There are about 7-8 posts on Facebook per day, which is a good combination of the Twitter and Instagram content. 

(a) 

Choosing to receive the COVID-19 vaccination is critical to ending the COVID-19 pandemic (Tufekci 2021). It’s been over a year since the COVID-19 virus hit the United States and it has been a rollercoaster ever since. Early on, the country’s leadership downplayed COVID-19’s severity (Rich 2020). Public Health officials sent mixed messages about the importance of masks to the public in order to ensure enough personal protective equipment for healthcare workers (Rich 2020). In both cases there was some lack of trust in the public to receive education and make sound decisions. This lack of trust came in the form of misinformation and mixed messages, causing confusion and distrust toward leadership and Public Health officials. Virus cases have spiked throughout the course of the pandemic (Adeline 2021). Accurate information, trust in the public, and getting that information out through various channels can all work toward more vaccinated people. Vaccinating against COVID-19 is a major issue today because the future of the virus and its effects on people hang in the balance. We need about 500 million doses in total for the American population (Haseman 2021). At the current pace, we hope to reach this goal by September 2021 (Haseman 2021). 
 

(b) 

The subgroup of the population that this campaign may be targeting is people who are hesitant or skeptical about, or uninterested in (unengaged stage) getting the COVID-19 vaccine (Simons-Morton 2012). The campaign is also targeting the innovators and early adopters of the vaccine who are already on board with adopting this innovation. They’ve done the research, know about the studies, and can be good resources to those who are later adopters or laggards, through sharing posts and retweeting information to their network (Gladwell 2000).  

The groups that are highest in hesitancy, also called the “wait-and-see group” are: Black adults (34%), young adults aged 18 to 29 (33%), Hispanic adults (26%), adults without a college degree (25%), and non-health essential workers (25%) (Jagannathan 2021). New, national surveys are showing that this gap of vaccine hesitancy in these groups is narrowing as more Black and Latinx Americans are embracing the vaccine compared to late 2020 (Hamilton 2021). 

Section 2: 

The CDC employed the Social Cognitive Theory (SCT) and the Theory of Perceived Behavior (TPB) into its COVID-19 vaccine campaign (Simons-Morton 2012). We have seen environment, behavior, and person interact again and again during this pandemic (Messenger 2021). This social determination stems from the sources people use for information, what environment they’re in, and how this information socially influences their behavior. The CDC uses principles of the SCT to help give people education, expectations, and develop social norms (Simons-Morton 2012). This is a historic vaccine that was developed quickly. This hesitancy is understandable, but this skepticism is not scientific. The CDC is striving to empower the population, changing their perceived behavioral control, with scientific information to help change behavior to one the promotes health protective behaviors (Simons-Morton 2012).  

The CDC uses outcome expectations regularly to develop social norms around the COVID-19 vaccine (Simons-Morton 2012). Their messaging talks about possible side-effects of the vaccine and pictures of individuals who have received their vaccine with the hashtag #sleeveup. Giving the population realistic expectations creates trust, self-efficacy, perceived power and control (Simons-Morton 2012). 

The CDC uses infographics often, which can make complicated information easier to understand (Stetten 2021). For example, the CDC created this simple infographic to demonstrate, at a glance, how the mRNA vaccines work (CDC 2021). 

The CDC is attempting to give people knowledge and control over making a decision to become vaccinated based on scientific evidence. With being forthcoming about vaccine myths and rare side-effects, the CDC is using behavioral capability to put the trust back into the population, which can also improve self-efficacy (CDC 2021). If an organization is being forthcoming with me, presenting scientific evidence, while being honest about rare side effects and how they’re being handled, I would be more likely to trust that organization. The CDC does a great job in using the different social media formats to always link back to more information on their website.  

Observational learning (vicarious learning/reinforcement and modeling) is used by showing individuals who have received the vaccine and reporting the number of people who are vaccinated. Seeing these numbers and individual success stories can raise people’s self-efficacy in adopting the behavior of getting vaccinated (Simons-Morton 2012). The CDC sends messaging out multiple times per day, and seeing this messaging can act as social influence, creating social norms around getting a COVID-19 vaccine (Simons-Morton 2012). This can contribute to changing subjective norms for a hesitant population, as there is already evidence that people overestimate the prevalence of vaccine side-effects (Khanna 2021). This group is also underestimating the efficacy of some of the vaccines, like Johnson & Johnson, when the research literature is showing excellent results (Sadoff 2021). 

The COVID-19 vaccine campaign through the CDC is attempting to develop social norms around a brand-new vaccine.  To change individual’s behaviors, they are attempting to normalize getting vaccinated for the broader population. According to Rose’s Paradox, this broader population target may be more effective in population-level results, but fewer individual results, especially in those at the highest risk (Simons-Morton 2012). 

The CDC’s COVID-19 vaccine campaign is targeting individuals rather than organizational structure and policies. When talking about disparities, only people who opt in to the CDC’s social media accounts are receiving this valuable information. The social media platforms do have “share” features that can get the information to people who aren’t opted in, but some people at higher risk are not using social media or may be at the “unengaged” stage, or feeling powerless about their health (Simons-Morton 2012). Getting this information to individuals, mostly those who are already concerned and interested in public health, can have a downstream effect, which has the potential to cause greater health disparities (King 2021).  

Section 3: 

To improve this campaign, I would push for more of an interactive, shareable approach. The CDC can broaden its reach to higher-risk groups by collaborating with a popular interest group like BLM and LGBTQ, and employing a spokesperson may capture the higher-risk audience through peripheral route processing (Simons-Morton 2012). The use of celebrities, like Paul Rudd, have already been used by campaigns like #maskupamerica in a fun, attention-grabbing way to target the unengaged adults aged 18-29 (maskupamerica 2020). The campaign can target more vaccine-hesitant individuals by collaborating with organizations and more conservative spokespeople (Messenger 2021). Using a hashtag like #vaccinatedCDC can help users get involved by having peers, or relatable people as spokespersons, showing their arms. The CDC social media accounts would also benefit from this user-generated content as they will not have to generate their own messaging as often, offering a variety of content (Stetten 2021). Evaluating this campaign’s messaging would be measurable with levels of engagement on each platform: shares and saves denote high value for its users (Thompson 2019). Also, the user-generated content using hashtags can give a good impression of what messaging is resonating with its users. 

The Diffusion of Innovation model would incorporate the use of spokespersons, two-stage communication, and social systems in collaboration with influential others to reach those higher-risk groups (Simons-Morton 2012). Seeing influential others on social media adopting the behavior of getting vaccinated can help more hesitant groups move through the stages of the innovation decision process, especially those late majority and laggard categories (Simons-Morton 2012). 

The Social Marketing Four P’s (Product, Price, Place, Promotion) can also help support my changes to this campaign (Simons-Morton 2012). Focusing on Place and Promotion may help target the higher-risk audience by making the information more accessible, like collaborating with interest groups or a spokesperson in the community (Simons-Morton 2012). Also, the timing, tone, and design of the messaging going out on social media may be able to be altered to appeal to different audiences, like offering posts in different languages and linking to local directories and resources (Friedman 2016).  

A culturally competent lens can help improve this campaign by recognizing that, while releasing important information over social media is a good way to get information out to many people, is the message reaching those in need of it the most? The CDC’s COVID-19 vaccine social media campaign is doing a great job with being inclusive of all people as far as representation in their posts (BIPOC, LGBTQ). They can broaden their reach by using other types of media like billboards, television and radio advertisement, and mailed information to extend their reach to those who are not on social media (Simons-Morton 2012). 

After evaluation, the CDC does an excellent job on their social media accounts and website with their COVID-19 vaccine campaign. Their vaccine content has the highest number of shares and comments and we are seeing the gap in the spread of adopters closing somewhat (Hamilton 2021). I have personally utilized their information, shared it, and have returned to it again and again for trusted information. It has affirmed my attitudes toward getting vaccinated against COVID-19 and given me a source to which to refer people in my social network.  

References: 

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