Month: December 2020

Contributing to vaccine confidence

As we saw last week, anytime a new flow is channeled where there was essentially no previous flow, there is likely to be — almost certainly will be — surprises (more and more and more and more). Some happy, some unhappy. But there is cause for confidence that vaccine flows will grow considerably over the next several weeks (more).

At this point, with something between sixty and 120 days until population-wide Phase III inoculations can be seriously started, and with sources, scale, and scheduling of vaccine flows necessarily ambiguous, one of the most constructive steps available is to reduce vaccine hesitancy. Most epidemiologists continue to call for at least 60 to 70 percent of the population to be vaccinated. Some resources:

1.  A December 14 opinion piece in the Journal of the American Medical Association (JAMA) is entitled, “Behaviorally Informed Strategies for a National COVID-19 Vaccine Promotion Program.”  The authors outline five specific recommendations: 1) Make the Vaccine Free and Easily Accessible, 2) Make Access to Valued Settings Conditional on Getting Vaccinated, 3) Use Public Endorsements From Trusted Leaders to Increase Uptake, 4) Provide Priority Access to People Who Sign Up to Get Vaccinated Before Vaccines Are Widely Available, and 5) Transform Individual Vaccination Decisions Into a Public Act.  More details on each recommendation are available at the JAMA link.

2.  A December 10 feature story in the New York Times Magazine is entitled, “We Know How to Curb the Pandemic. How Do We Make People Listen?”  The article concludes with, “Right now, everyone is flooded with Covid information from all kinds of sources; it’s unlikely that a single public health initiative will change the trajectory of the virus. But employing research-based communication strategies could help scientists and government officials make their messages more influential, thereby saving lives. Yet… the focus instead has been “on health science, epidemiology and medical science. Not on behavioral science.”  Several behavioral science principles and practices are outlined.

3. A December 18 thought-piece from McKinsey & Company is entitled “COVID-19 Vaccines Meet 100 Million Uncertain Americans“. With convenient alliteration, the consultants encourage a three-fold strategy of commitment, convenience, and costlessness. (Beginning to see some recurring themes?) Related to commitment, one angle involves, “Our peers may be the most potent influencers of all, and peer encouragement will be vital if COVID-19 vaccines are to become the norm. Normalization can occur based on social-media posts, sharing with friends, and even wearing “I was vaccinated” stickers. The reciprocal approach—the social stigma of going against the group—is also powerful, sometimes even more so. If the consequences of harming other people by not being vaccinated can be demonstrated, a stigma could attach to those who eschew the vaccine and are perceived as harming others.”  It is another aspect of the behavioral science approach noted in the NYT and JAMA pieces.

I also suggest reading Thinking Fast and Slow by Daniel Kahneman, the psychologist who won a Nobel prize for economics. There are deep issues of bias, heuristics, and narrative that will need creative attention to achieve effective demand management… just as much as any of the pandemic-specific and vaccine-specific issues outlined in the other three sources. Kahneman is great on all these factors. The classic text on motivating demand for innovative products — such as entirely new vaccines, made with a brand-new technology, very rapidly implemented — is Diffusion of Innovations by Everett Rogers.

In any supply-constrained environment there is an understandable temptation to focus on maximizing supply. This can, however, be myopic and strategically self-subverting. The more high volume, high velocity supplies are needed, the more valuable is validated, differentiated targeting of demand. This may seem a subtle distinction. But as a matter of strategic discipline it is as different as night and day. By knowing what is needed when and where by who… you are much more likely to optimize your limited supplies.

One final suggestion (possible nag): Many of the good ideas set out in the first three sources above are a bit tarnished by treating the population as something to be manipulated, rather than fellow human beings with whom you want to collaborate and co-create (not just enforce compliance). Asking questions, listening carefully to answers, and authentic conversation is a very good place to start.