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Tanzina Vega: We've been talking about the role of images and PSAs, and then in news outlets, in understanding and combating COVID-19. So far, we've surpassed 300,000 deaths from the pandemic in the United States. While the vaccine is now a reality, it's still a far-off one for most of us. In a few minutes, we'll turn to messaging from authorities about the COVID vaccine and what and how they need to communicate to the public about this massive undertaking. First we wanted to hear from you and whether you're planning to take the vaccine and how your state or local government is communicating with you about the vaccines rollout.

Katie: Hi, there, The Takeaway, my name is Katie, and I am calling from San Diego, California. Absolutely, 100%, I plan on getting it as soon as it's available. I am currently a teacher, so it looks like I will be in a category of 1b to get the vaccine in my area. My sleeve is rolled up and I'm ready to go.

Solutia: Hi, my name is Solutia. I'm calling from Eugene, Oregon, and we received notice today that the vaccine has arrived in Oregon, but we haven't received any word yet on who will be the first ones to receive the vaccine or how it will be distributed. As far as taking the vaccine, I'm a little cautious about it and may wait and see, because this administration has bullied and pushed for this vaccine. I wonder if any mistakes were made. I'm also concerned about the temperature that the vaccine needs to be held at. The bottom line is, I'm not sure I'm going to take the vaccine right away. I'm going to wait and see what happens.

Doug: Hi. This is Doug calling from Orlando. I currently have COVID. I'm hoping to get over it soon. I would like to get a vaccination, but I'm wondering how it might interact with somebody who already has COVID, if it might cause a stronger reaction. Also, I'm assuming that I might have some kind of a natural immunity, just by having had the COVID. Here in Orlando, I think we're probably not going to get to regular people getting the vaccine for several months.

Brian Jones: Hi, this is Brian Jones. I live outside of Austin in Dripping Springs. So far, I've heard that the hospitals, old folks homes, 65 plus people and marginalized people are going to get the shots first. After that, I do not know. We're in our early 50s, my wife and I, and haven't heard anything about our demographic, perhaps this coming summer, let's hope. Absolutely, we are going to get that shot as soon as it comes out for us.

David: This is David from Holland Falls, New York. I'll take the vaccine as soon as it's offered, but I haven't seen any information about getting the vaccine in my term yet. I'm a healthcare provider. [unintelligible 00:03:11] college. I know that the National Athletic Trainers' Association is working to put us on the list with other healthcare professions. We've been working with their teams throughout the crisis. However, working for athletic department and not hospital, I'm just wondering how this will turn out. I'm hoping for the best.

Liz: Hi, this is Liz from Mountain View. Yes, my family and I will get the vaccine as soon as possible. I was a little worried about it, but Dr. Fauci says he believes in it and that the science is all there, so I'm going to go with that. I'm an educator, so I may be in one of the first few groups to receive it, and I'm very happy about that.

Quentin Hendricks: Hi, this is Quentin Hendricks. I'm calling from University City, and I will absolutely plan on getting the COVID vaccine as soon as it's available to me. I think it's the responsible thing to do, especially with so many people out there think that they won't get it for various reasons, sometimes political.

Robin: Hi, I'm Robin from Fort Worth, Texas. I will get the COVID vaccine, but [unintelligible 00:04:13] I'm not in the group to get it first. I want to see what reactions are reported. I'm a nurse, so on paper, I could get it in the first group. However, I'm not practicing right now. That's what my local government has said. I haven't paid attention to what Texas has said.

Tanzina: On Monday, Sandra Lindsay, a healthcare worker from Queens, New York became the first person in the United States to receive the Pfizer and BioNTech coronavirus vaccine. She gave a statement while receiving the vaccine, wearing a mask, and socially distanced from reporters.

Sandra Lindsay: I want to instill public confidence that the vaccine is safe. We’re in a pandemic, and so we all need to do our part.

Tanzina: Recent surveys from Pew and Gallup show that about 60% of Americans say they are now willing to get the vaccine, but it will also take well-coordinated efforts by state and local governments to inform and incentivize the public to do so. Here to talk about all this is Frances Stead Sellers, a health reporter at The Washington Post. Frances, thanks for being with us.

Frances Stead Sellers: Greetings, it's great to be with you.

Tanzina: Jessica Malaty Rivera is the science communication lead at the COVID Tracking Project and an infectious disease epidemiologist. Jessica, thanks for joining us.

Jessica Malaty Rivera: Hi, thanks for having me.

Tanzina: Frances, when we talk about vaccine messaging, what are some of the essential messages that need to be communicated to the public right now?

Frances: I think what we're seeing is the delay in the kinds of essential messaging that people need to know about safety and efficacy. It's healthcare workers and doctors who've been watching the FDA reports and understanding the science behind this vaccine. Now we need to take it to a much broader segment of the population, who are going to hear these messages from whatever kind of PSAs get put out, but also very significantly, from people who already take the vaccine, so the healthcare workers now, who are going through this vaccine, actually play a very significant role going ahead and communicating about the vaccine.

You're beginning to see that happen this week, but the whole process of putting out the detailed and, in fact, personalized messages, people need to know culturally sensitive messages, messages that are specific to people who are pregnant or who have other conditions that might make them hesitate. All that needs to be rolled out in a very, very careful education campaign.

Tanzina: Jessica, we talked about how 60% of Americans say they're willing to get the vaccine. What do public health officials need to do to get that number higher?

Jessica: Yes, it's a great question. I think a lot of it has to do with trust. There are some communities that feel rightfully distrusting of public health recommendations, and just even anything coming out of pharmaceutical companies. I think we can restore trust by showing people that this was really not about some of the sinister motivations that a lot of people assume about the medical community and even the pharmaceutical community, right now, because we are in a public health emergency.

This was quite honest. I realized my bias here, one of the most wonderful, collaborative, all-hands-on-deck kind of projects for science and for public health, and I think by reframing the urgency and changing that from the language about rushing and being in haste, reframing that and showing people that this is really about the public good and for caring for people and to prevent more loss, I think that sentiment change can happen.

Tanzina: Frances, when it comes to messaging from the Trump administration so far about the vaccine, what have we heard?

Frances: It's been very confusing, right? We've had a president who has been anti-science, anti-expert, through much of his administration who then becomes the great champion of producing a vaccine, we've had two attempts at pushing out a campaign earlier on, I think it was the end of October, HHS started a campaign that was going to start celebrities, and that fell apart when it was tangled up in the election.

These messages have been politicized. Right now we're at a moment where it's late getting into this. There's a new HHS campaign rolling out, but it's really crucial that, just as Jessica said, trusted scientific messages come out. There are going to be judgment calls for individuals, but there needs to be clarity, and these trusted messengers, that Jessica referred to, become very, very important.

I was at a flu clinic in Baltimore a few weeks ago, where an awful lot has been that- this was in a Latino community, and a lot was being done by enlisting pastors, people who had connections with the community, and helping them do using their own words, but informing pastors would then inform other people, when people can enter the clinic and receive their flu vaccination.

They went away with flyers to tell their neighbors about where to get the shots. There's a lot being done in local communities, partly because a death of messaging from on top, but there's a lot being done in local communities. Try and foster these trusted messengers and overcome this history which Jessica was referring to. The big hitch here is, we've spent 10 billion, I think, and somebody can correct me, on that figure, perhaps, on vaccine development. There's very little money right now for distribution of these vaccines in the States or for the kinds of campaigns we're talking about.

Tanzina: We're going to talk a little bit about more state-by-state efforts in the upcoming segment. Jessica, is there an effective way for, at least, the federal government to get this message out about the vaccine now, particularly considering that the White House staffers will be some of the first folks, at least what we're hearing, to get the vaccine?

Jessica: Yes. Frances brought up some great points in that. We can lead by example and by being very precise with words, every single word, when it comes to science and trust in science, matters. A lot of the damage control that's had to be done because of the naming of Operation Warp Speed, that's not lost on us, but those were days lost and minutes lost of having to correct what was presumed from those words. I think the same thing can happen when we take it, not just from the federal government top-down, but like Frances said, making it much more lateral from the community, because at this point it's not just instilling public trust. It's restoring the trustworthiness of leaders.

I think that even goes to the federal government, there's been a lot of broken or just shattered trustworthiness because we have dealt with so many antagonistic sentiments that have come out of leadership here that have made it so difficult to understand what is politically motivated, what is financially motivated, and so that messaging has to come, yes, from the top, and hopefully from a new administration on top of the fact that it needs to be very lateral from a community basis.

Tanzina: Frances, we talked a little bit about what the federal government's messaging so far has been, but what about state governments? Where are they in the process?

Frances: They also have been slowed by the fact that the vaccine came out so quickly, they weren't able to get going early. They'd been enormously stretched, hampered by decades of lack of funding, and now being stretched by the other commitments, they've had to responding immediately to vaccines. Now, if you go on YouTube, you can find some individual states have been putting up PSAs and trying to work on this.

They're also working very closely with- many state health departments have much smaller local health departments, and they're working with those local departments to try to reach into communities that specific they need, tailored messaging, to meet individuals, as I said, where they are. The thing about this whole process is that political campaigns and marketers have known how to reach the swing vote or the person who's on the fence about whether to buy the new iPhone.

We're in a little bit that situation with the coronavirus vaccine. Probably we're getting numbers. There are certain people who we absolutely know won't get this vaccine. They've said so very firmly. There are some anti-vaccine people, a rather small proportion of the whole country who take no vaccines, and then there are people on the other end, we heard from some in your commentary saying, "Yes, I'm gung ho, I'll take it right away."

In the middle, there are many people who are hesitant for different reasons, and tailoring being able to educate them, answer their specific questions and tailoring messaging to them, just like political campaigns. Go for the swing voter is what we need to do with this, is really respect people's concerns. This isn't a question of just gung ho, go out there and get it. It's, listen to, understand people, be empathetic about their concerns and meet them and explain to them. That's, I think, how we win them over.

Tanzina: Jessica, beyond government, though, how necessary is it, as you mentioned earlier, to get community leaders involved with the messaging? Is that even more effective than, say, an ad or a public service announcement?

Jessica: It's part of the puzzle. There can't just be one approach to this. It requires several. In the same way, we talk about risk being additive, and you can have the image of the Swiss cheese method, you can apply that similarly to public health messaging, right? There is so many ways to reinforce it, and it has to be combined in with other channels and with other messages as well to reinforce that trust.

I think that local messaging, lateral messaging is key. Prior to COVID-19, I was written on vaccine communications for several years. Frances is absolutely right that the wins, the opportunities are not with the far-off conspiracy anti-community. It's really what those who are hesitant, those who are feeling overwhelmed by the absolute deluge of information available to them, having a difficult time to parse through what's fact from fiction.

If we bring that language down, we don't have to dumb it down, but we can make it accessible, judgment-free and understandable, so that it becomes part of people's conversation in barber shops and restaurants, rather not restaurants really, but in places where people are going with their community and having those conversations and we're using language that they understand, it's going to actually change public perception.

Tanzina: We've been talking today about a lot of the images also that we see in messaging around the coronavirus in general and prevention of the virus. One thing that struck me was that in New York, Sandra Lindsay, who we heard at the very top of the segment, of the last segment, is a Black healthcare worker from Queens. She was the first person to get the vaccine in the United States yesterday. My sense was that the optics of having a Black healthcare worker be the first person to take this was potentially also to assuage some of the fears in the Black community about the vaccine. Do you think that that's effective, Jessica?

Jessica: Absolutely. It was not lost on anybody that it was a Black woman who was administering the vaccine and a Black woman who was receiving the vaccine. I think that was intentional, and I think that was extremely smart. I think that also allowing her the chance to speak and to hear from her as to what she was feeling, I got choked up when I heard her say healing is coming and that she believes in the science and she wants to instill public trust in this process.

That goes a long way, when you have people who are doing it willingly. Here's the thing, the trauma that the Black community has experienced in this country is legitimate. What happened with the Tuskegee experiments? What happened with gynecological experimentation on Black and brown bodies is horrendous, and so that lack of trust is justified. I think, to restore that requires building up Black leaders in the healthcare community, making sure that they have the mic so that they can speak and speak with confidence about what and why they're doing these things. That's going to go a long way with these communities who have had so many years of distrust because of legitimate harm.

Tanzina: Frances, are there certain types of vaccine messaging that might alienate people?

Frances: I think if anybody feels bullied or rushed, we're doing the wrong thing. Speaking to what Jessica was talking about, all these different levels of messaging add up together, and the fact that Dr. Fauci has said, he'll have his shot on TV, or on camera at least, and three presidents we know about, Obama, Clinton and Bush have all said they will do that.

These are messages from on high that also had an impact, and we heard that from some of your listeners. Dr. Fauci is going to do it, I'll do it. Where people find that that trust messengers will be different for different communities. I talked to researchers in the Navajo Nation, which has been incredibly hard hit, they've done some very good, centralized messaging in that nation, but the wording of the messengers there can-- CDC messages over maternity health and previous campaigns that I wrote about had- the CDC messages to many other people had been, "Are you pregnant?"

They were very direct messages addressed to people. Then the Navajo Nation, many people down there felt more comfortable with a message that said, "For all women who are pregnant, this is the advice." In other words, the more inclusive message was more- they responded to better. Every word matters, and every word matters in different communities.

Tanzina: Frances, you mentioned the funding here for these types of messages. Is there any will or funding to actually create these public service announcements right now?

Frances: I think there's will, certainly at the local level and the state level, is that an enormous push for-- You saw that debate coming up over the weekend about the amount of money that had been spent on developing these vaccines. There's a sort of truism in public health, vaccines don't save lives. Vaccination does. That's where we are now. We've put 10 billion into the vaccines. We need to put equivalent amounts of money into Operation Warp Speed for messaging right now, as one doctrine Boston, put it to me.

Tanzina: Jessica, we've got about a minute left. Would you concur?

Jessica: Absolutely. I know exactly the piece from the side, Omar piece that he wrote, we've had an unprecedented vaccination campaign that the US hasn't seen in any of our lifetimes, and right now we need to be putting the same kind of resources and concentration on the messaging about it, because if we have vaccines in vials and not in people, it gets us nowhere.

Tanzina: Frances Stead Sellers is a health reporter at The Washington Post, and Jessica Malaty Rivera is the science communication lead at the COVID Tracking Project and an infectious disease epidemiologist. Thanks to you both for joining us on The Takeaway.

Frances: Thank you.

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