COVID-19 Communication Campaigns for Vaccination: An Assessment with Perspectives for Future Equity-Centered Public Health Efforts

Figures & data

Table 1. 15 Vaccination Information Campaigns Included in VEC Assessment

Campaign Name/Organization	Website
Public Health Communications Collaborative; CDC Foundation, de Beaumont Foundation, Trust for America’s Health	https://publichealthcollaborative.org/
COVID No More; NAACP	https://naacp.org/campaigns/covid-know-more
This is Our Shot; Salt Lake County Health Department	https://thisisourshot.com/
Trusted Messenger Campaign; Better Health Together	https://www.betterhealthtogether.org/bold-solutions-content/together-we-can-stop-covid-19
Our Voices Campaign; Tennessee Department of Health	https://www.tn.gov/health/health-program-areas/division-of-health-disparities-elimination-/our-voices-campaign.html
All In; National Urban League	https://nul.org/all-in
Esperanza Hope for All; Unidos US	https://www.unidosus.org/esperanzahopeforall/
Not a Host; Bahby Banks	https://www.notahost.com/
Stronger Together; Missouri Department of Health and Senior Services	https://covidvaccine.mo.gov/find/
Roll Up Your Sleeves NY; Task Force for Vaccine Equity and Education	https://rollupyoursleevesny.org/
It’s Up to You; Ad Council & COVID Collaborative	https://getvaccineanswers.org/
We Can Do This; U.S. Department of Health and Human Services	https://wecandothis.hhs.gov/
Greater Than COVID; KFF	https://www.greaterthancovid.org/
Vaccination Is; National Resource Center for Refugees, Immigrants, and Migrants (NRC-RIM)	https://nrcrim.org/vaccines/campaigns/vaccination-campaign
COVID Vaccine Saves Lives; CA Rural Indian Health Board	https://crihb.org/prevention-and-education/public-health/#vaccine-campaign

Table 2. Summary of Findings of VEC Assessment

Criterion	Definition	Elements of Analysis Within Criterion	Campaign Example
Understandable	Most people are not health experts and need information that is easy to navigate, understand, and engage with to comprehend health risks and take action to get vaccinated.	Navigability of Campaign Resources Are the campaign’s resources and materials easy to navigate? Campaign Terminology Does the campaign use language that is familiar to the target audience? Language Translations Does the campaign offer materials in languages that the target audience understands? Visual Aids Does the campaign use photos, videos, illustrations, etc., that provide visual reinforcement of the main messages?	This Is Our Shot - Salt Lake County Health Department: campaign working to combat misinformation by explaining how the COVID-19 vaccine works. Struggled to be understandable to its audience of people who may be skeptical of vaccines Complex terminology on website, heavy with medical language that the average person would not understand Majority of messaging explained how vaccines work/are made Explanations were clinical and relied heavily on analogies/metaphors. Not simplified and accessible Missing glossary or list of definitions for the many complex medical terms Campaign seemed to assume the audience had a lot of background knowledge about science and medicine
Accessible	For people to access the information they need to protect and improve their health, information must be shared through communication channels people can easily access and are familiar with. Using the right mix of channels, tailored to the intended target audiences(s), will help connect people with the information they need and support them in making informed decisions.	Campaign Communication Channels What channels does the campaign employ, and do relevant audiences have easy access to these channels? Is the campaign leveraging channels that certain people don’t have access to? What channels is the campaign not using? Who is potentially being left out? Campaign Engagement Do the campaign’s channels encourage two-way engagement, enabling interaction with the target audiences and the campaign/health professionals? Earned Media Are there any earned media articles that mention the campaign?	Our Voices Campaign – Tennessee Department of Health: campaign using personal testimonials from Black and Latinx individuals to persuade Black and Latinx communities to get the COVID-19 vaccine. Struggled to be accessible to a wider audience because campaign lacked engagement-focused distribution channels Created video PSAs and short personal testimonials on website, but lacked social media channels No way for audiences to ask questions about COVID-19 and vaccination No use of earned media Missed opportunity to broadcast content widely through Tennessee Department of Health’s social channels (have large followings)
Actionable	A vaccination campaign’s ultimate goal is to support vaccine uptake. To be successful, communications campaigns should address barriers to getting vaccines and make the information they provide actionable.	Articulation of Vaccine Benefits Does the campaign clearly describe the benefits of getting the vaccine? COVID-19 Consequences Does the campaign describe the consequences of not receiving a vaccine? Addressing Vaccination Barriers Does the campaign discuss any barriers to receiving a vaccine and point to resources to overcome those barriers?	Greater Than COVID “The Conversation” – Kaiser Family Foundation: campaign working to communicate importance of COVID-19 vaccination to Black and Latinx communities by using videos featuring Black and Latinx health care workers. Excelled at being actionable by clearly stating the benefits of receiving a COVID-19 vaccine, the consequences of forgoing one, and the risks associated with getting COVID Presented getting vaccinated as a personal necessity/promoting the vaccine as safe Positioned benefits of a vaccine in terms of broad community benefits, in addition to individual
Credible & Trusted	People are most likely to act when provided accurate information from a trusted source. In a vaccine campaign, the reputations of the organization behind the campaign, its public partners, and its messengers are likely key factors people will consider when deciding whether to follow the campaign’s advice and guidance.	Campaign Credibility How well known is the organization behind the campaign? Do you think the target audience would view the campaign organizer, its partners, or its messengers as a credible resource on COVID-19? Mechanisms for Building Trust How does the campaign build trust with its audience? Trusted Resources Does the campaign highlight health care experts and trusted sources of health and vaccination information? Centers for Disease Control and Prevention (CDC) or Food & Drug Administration (FDA) Mentions Does the campaign reference the CDC or the FDA and present them as trustworthy resources? Addressing Specific Community Concerns Does the campaign address specific concerns about the vaccine? Does it address concerns from specific communities (e.g., Black Americans’ justifiable skepticism of state-sponsored vaccinations)? Combating Misinformation Does the vaccination campaign combat any misinformation about COVID-19 and vaccines?	COVID Know More – NAACP: campaign working to provide COVID-19 information that is tailored to concerns of Black Americans. Excelled at leveraging existing credibility and trust with Black community to address specific concerns of Black community Acknowledged Black Americans’ concerns about vaccination and public health efforts; leveraged a validating and empowering tone Campaign messaging respected that some were not ready to be vaccinated and provided helpful information about COVID-19 to unvaccinated (testing, travel guidance, etc.) Leveraged connections with local NAACP chapters to share resources with their networks Created content that communicated impact of COVID-19 outside of traditional personal health topics (e.g., significant setbacks for Black students due to distance learning, proliferation of COVID outbreaks in prisons)
Relevant & Relatable	To be relevant to target audiences, communications from vaccination campaigns must feel applicable to the people they target. Good campaigns will ensure the information, advice, and guidance shared is relatable.	Campaign Messaging What main messages does the campaign employ? Campaign Messaging Relevance and Relatability Does the campaign’s messaging seem to be informed by the sociodemographic characteristics of the target audience (e.g., age, occupation, geographic location) and how it is disseminated? Trusted Messengers Does the campaign employ any trusted messengers (who serve as local liaisons between the community and health care providers) to communicate information to the target audience and lend credibility to the campaign?	Vaccination Is – National Resource Center for Refugees, Immigrants, and Migrants (NRC-RIM): campaign working to provide guidance to community organizations doing COVID-19 vaccination outreach to local refugee, migrant, and immigrant communities. Excelled at being relevant and relatable through tailored content and community-informed approach Crafted materials specifically targeted to audience member concerns (e.g., vaccines being halal, guidance for recent Afghan refugees, vaccines are free, private, and can be taken without proof of immigration status) Messaging guidance emphasized importance of tailoring messaging at the local level Trusted messengers were from community organizations and informed by research and guidance from its Community Board
Timely	Vaccination campaigns must make information, advice, and guidance available in a timely way, so target audiences have the information they need when they need it to make appropriate health decisions.	Ability to Update Is the campaign delivering information through a channel that can quickly be updated? Updated and Accurate Information Does the campaign regularly update messages and resources based on current events and variants (Delta, Omicron, etc.) or new health guidance (e.g., boosters)? If a campaign is not releasing updated information regularly, can we determine why?	It’s Up to You - Ad Council & COVID Collaborative: campaign working to reach large, national, general population about COVID-19 vaccination. Excelled at providing updated, timely information based on pandemic developments Messaging addressed relevant and new COVID-19 vaccination topics, including home testing and child vaccine safety Website included dates when information was updated with what health organization’s guidance

Table

Recommendation Checklist
1. Move from “participatory research” to community co-design to build trust Build sustained partnerships with community-based organizations by focusing on trust building, power sharing, capacity development, co-learning, and co-creating. Support long-term program staffing, reduce barriers to securing funds, increase staffing flexibility, invest in capacity development, create infrastructure to support interagency information sharing, and train trusted messengers.
2. Use existing science, evidence, and best practices Ensure content is evidence-, science-, and theory-based to produce measurable impact. Conduct formative, process, and outcomes research. Incorporate appropriate psychosocial and communications theory. Leverage logic models in program conceptualization and as shared “roadmaps.”
3. Design campaigns with an intent to evaluate process and impact Ensure clear and comprehensive measurement, evaluation, and reporting of both process and outcomes is incorporated into campaign design. Use formative research to reinforce co-design, ensuring campaign messages align with audience’s knowledge, attitudes, beliefs, awareness, concerns, and/or behaviors.
4. Ensure comprehensive funding and expertise to combat growing complexities and mistrust When providing funding, consider how campaigns will use digital and social media and address mis/disinformation. Use social media to ensure presence of campaign materials where/when target audiences are active. Ensure availability of staff to monitor social media comments sections for mis/disinformation. Before funding a campaign, conduct a landscape analysis to understand if other organizations better suited for the task. Before moving ahead with the campaign, conduct an internal audit of assets and liabilities. Consider joining forces with another organization that has expertise and/or proximity to run a campaign.