Words matter. And when it comes to science, medicine and health, so do the people who speak them.
Before the new coronavirus vaccines won emergency authorization from the Food and Drug Administration late last fall, it looked like the United States would have a problem getting people to take the shots. In early December, more than half of Black Americans said they wanted to wait and see how the rollout went before receiving a vaccine. For Latino respondents, 43% wanted to wait and see, and another 18% said they wouldn't get it.
So political and health leaders prioritized efforts to promote vaccine confidence in these communities — and it worked. By late last month, the percentage of Black Americans who said they would wait and see about the vaccine had dropped from 52% in December to 34%, according to polling by the Kaiser Family Foundation. Only 14% said they would definitely not get it. A similar shift happened among Latinos, 52% of whom said in February that they had gotten or would get the vaccine, up from 26% in December, with just 12% saying they definitely wouldn't.
Now another demographic stands as the most vaccine-hesitant group in America: White Republicans. Kaiser's poll found in February that 27% of White Republicans definitely wouldn't get the vaccine — up slightly from 24% in December — and just 46% said they already had or definitely would get the shot. Considering that White Republicans make up roughly 25% of the population, and that some members of other groups remain wary of the vaccines, that poses a real problem for reaching herd immunity.
To understand why those numbers haven't budged, we held a focus group last weekend with 19 vaccine-hesitant Trump Republicans. Our mission was to test the ideas and messages that will help us move beyond ideological battles and restore our nation's health and economy. On Zoom, we gathered people with diverse economic backgrounds who all supported the former president and said they would not or were unlikely to get the vaccine.
A few lessons quickly became clear.
Everyone in this focus group believed the pandemic is real. We heard one participant say, to the nods of everyone else: "It's not about the virus. The virus is real. It's the manipulation and the opportunistic politicians that have taken it and used it to complete their laundry list that they've had for 50 years of socialization of society." Several participants had loved ones who'd experienced severe illness. But many in the group who had either had COVID-19 or knew someone who did still didn't consider the severity great enough to warrant vaccination, and others who had recovered now believed they were immune.
When asked for a word to describe the vaccines, participants answered "experimental," "rushed" and "unproven." The Trump Republicans were almost as concerned about the possible long-term side effects of the shots as about the risks posed by the virus itself. And instead of praising Operation Warp Speed for being one of the most significant, impactful accomplishments of the Trump administration, more of these voters expressed concern about the speed of the vaccines' development and approval.
That's Donald Trump's fault: He downplayed the virus so much for so long that his own voters now undervalue his achievement. He did finally say this past week that his supporters should get the vaccine, but our research found that people aren't looking to him for cues now: While participants credited him for his handling of the pandemic, all 19 said they would trust their doctors over the former president when deciding whether to get vaccinated.
Distrust in government institutions, the press and political rhetoric also contributes to vaccine resistance. Participants strongly felt that the coronavirus has been used for political purposes and was weaponized against Trump in the 2020 election. One claimed: "They keep us locked up. Let's put it this way, if the public is economically deprived and locked up, they're going to be so much easier to control." That's why public-service advertisements featuring four former presidents or speeches from President Biden about bipartisanship and unity fail to reach Trump supporters: They simply don't resonate. As one participant noted, "We are not all in this together."
Consistency can also be a powerful motivator. Many participants were critical of Anthony Fauci, saying the goal posts for herd immunity or the end of lockdowns constantly moved — which made them even more distrustful of vaccines. They also think government leaders are being disingenuous. "What's the point in taking the vaccine," Trump supporters wondered, if, as Biden says, by the Fourth of July you "still have to wear masks and only have about four people over for a barbecue?"
Initially, it seemed like no message could break through. But over the course of two hours, several apolitical notions began to change our voters' minds.
Even the most hesitant in the group were eager to hear the facts, the data and the science behind the vaccine development process. Some said they were motivated to get a shot after learning that the immunizations were able to advance quickly not because pharmaceutical companies had cut corners, possibly jeopardizing safety, but because the government had cut red tape in the approval process. For those particularly skeptical of the mRNA technology behind two of the vaccines, it helped to learn that the vaccines were built on decades of trusted medical research, not something experimental or brand-new.
It might seem too detailed and too scientific to talk about the scale of the clinical trials the vaccines went through, and specifically the number of participants, but this can make a big difference when there is so much confusion about efficacy and concern about speed. Our voters' doubts about side effects and questions about the approval process were allayed once they learned that each of the Phase 3 vaccine trials had tens of thousands of participants, compared with a routine Phase 3 trial for a drug or other treatment that could include 5,000 participants or fewer. Members of our group were also impressed to hear that of the 69 million Americans who had received at least one dose of a vaccine, none had died of COVID-19 or the shot.
Just as important as the messages were the messengers. Trump Republicans do not trust Washington or the politicians who inhabit it. But doctors definitely have credibility. Perhaps the most compelling message we tested was that more than 90% of doctors who have been offered the vaccine have taken it. And when voters hear from people they trust, they're willing to change their behavior.
Our conversation was led by three doctors — former Centers for Disease Control and Prevention director Tom Frieden, Sen. Bill Cassidy, R-La., and Rep. Brad Wenstrup, R-Ohio — along with two Republican politicians who focused their messages on the virus rather than the politics: House GOP Leader Kevin McCarthy and former New Jersey governor Chris Christie. When it was over, all 19 focus group participants were more ready to take the vaccine or advise others to take it. They did not feel manipulated or coerced. They were empowered with facts that allowed them to make their own decisions. As one participant put it: "I don't believe data has been shared enough with us as Americans. And for me, that was probably the biggest turning point." Another was more persuaded by anecdotal evidence, saying, "The story that Governor Christie gave about a healthy adult that still ended up passing away randomly has really made me think."
If we had that kind of time and space with all vaccine-hesitant Americans, we would surely be able to move the needle. The virus and its variants, however, will not afford us that kind of time. We need a nonpartisan, medically driven, fact-based approach right now.
Trump voters do not want to be ridiculed, embarrassed or told that their thinking is "Neanderthal" by Washington politicians simply because they express doubt or concern about the safety or efficacy of the vaccine. Moving them from vaccine-hesitant to vaccine-confident won't happen unless we pause the polarizing political rhetoric. A fact-based approach that is genuinely ideologically neutral is exactly what the doctor ordered.
Frank Luntz is a Republican pollster. Brian C. Castrucci is an epidemiologist, public health practitioner, and president and chief executive of the de Beaumont Foundation. This piece was written for The Washington Post.
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