The strategy used by the Baltimore City Health Department described in “Meet the Baltimore ‘vaccine ambassadors’ working to personally convince those who are still hesitant to get the COVID shot” (Oct. 29) has been successful, but should be reevaluated with interactive collaboration between policymakers, scientists and community members. With misinformation and disinformation about COVID-19 vaccines circulating online and within social circles, these diverse stakeholders should come together to decide the best path forward in curbing the spread of COVID-19. I believe we should consider further expanding the role of community members and social scientist researchers in this vaccination initiative.
The vaccine ambassadors communicate one-on-one with community members and listen to their concerns, discuss the merits of the COVID-19 vaccine, and dispel myths and misunderstandings. While the authors have found instances of success in their strategies, misinformation campaigns and historical distrust of medical institutions continue to pose challenges.
Widespread COVID-19 vaccine misinformation campaigns have cast doubt on the severity of COVID-19 itself and argued that citizens have the individual liberty to remain unvaccinated. Considering the novelty and uncertainty around COVID-19, these claims have pervaded the Baltimore area. For example, the authors highlight scenarios in which young men believe the virus will not impact them, likely due to the misinformation campaigns. This choice to remain unvaccinated is often justified by arguing that an individual has the liberty to remain unvaccinated. This argument can be especially dangerous with COVID-19 since the human cost of inaccurate perceptions of disease severity can have life or death consequences.
This focus on individual impact and liberty is reminiscent of the liberty arguments invoked by tobacco companies in their resistance to emerging secondhand smoke regulations. Critics of tobacco companies argued that our societal freedoms are not absolute and have limitations, especially when people could be seriously harmed. Secondhand smoke exposure could be analogous to remaining unvaccinated. By remaining unvaccinated, one would have a higher likelihood of contracting the illness themselves and spreading it to a vulnerable community member. Given the success that tobacco companies have found in distorting science, there is reason to be concerned about a similar industry-driven widespread effort to promote vaccine hesitancy.
Distrust of medical institutions also continues to challenge vaccine ambassadors in convincing community members to become vaccinated. The authors include instances of vaccine ambassadors communicating with residents who distrust vaccines as a reflection of their distrust of medical institutions from previous personal or historical examples of abuse. Vaccine ambassadors have developed a successful strategy to listen to the concerns of these community members while being careful not to invalidate their beliefs and not to push vaccination with those who express open reluctance. However, ambassadors must work very slowly and one-by-one to change behaviors.
Vaccine ambassadors work at the individual level, while misinformation, disinformation and distrust of medical institutions can spread rapidly within communities and on social media. In the face of this rapid spread, policymakers should consider novel strategies to expand on the success of the vaccine ambassadors initiative. If misinformation can spread rapidly, can someone who was successfully convinced to obtain a COVID-19 vaccine despite previous distrust and misunderstanding spread their reasoning rapidly? In addition, consider the social science idea called the diffusion of innovations within social networks. Could successfully convincing a few people within a social network be an innovation that spreads within a social network? What can policymakers and practitioners do to facilitate this spread? Perhaps vaccine ambassadors could initiate long-term collaborative partnerships with individuals who become successfully convinced to obtain a vaccine and would be interested in spreading their reasoning. We could offer resources to these community members to facilitate their ability to convince others within their social networks.
This is simply one example of how policymakers, practitioners, social scientists, and community members could collaborate to advance the goal of increasing vaccinations taken by city residents. I invite these parties to engage with each other, debate, collectively set goals and develop novel strategies to advance their agendas.
Yasheel Pandya, Baltimore
The writer is a student at Johns Hopkins University.
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