Public Health Agencies Try to Restore Trust as They Fight Misinformation
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OKLAHOMA CITY — Phil Maytubby, the deputy CEO of the local health department, grew concerned in the summer of 2021 as the number of people getting vaccinated against covid-19 began to decline despite an initially strong response. Faced with doubt, fear, and misinformation spreading widely both online and offline, he knew that the agency needed to reconsider its messaging strategy.
As a result, the health department conducted an online "sentiment search" to assess how certain words were perceived on social media. The findings revealed that many residents of Oklahoma City had a negative reaction to the term "vaccinate," which was prominently featured in the health department’s marketing campaign.
Maytubby stated, "If you are unaware of how your message is resonating with the public, you are essentially guessing in the dark."
Across the nation, health officials have been striving to combat misinformation and rebuild trust within their communities in recent years. This has been a period during which many individuals have lost confidence in their state and local health departments. These agencies have begun using platforms like Twitter to engage niche audiences, such as NFL fans in Kansas City and Star Wars enthusiasts in Alabama. They have also joined forces with influencers and celebrities like Stephen Colbert and Akbar Gbajabiamila to expand their reach.
Some of these efforts have proven successful, with over 80% of U.S. residents having received at least one dose of a covid vaccine by now.
However, data suggests that the skepticism and misinformation surrounding covid vaccines are now posing a threat to other public health priorities. According to the Centers for Disease Control and Prevention, flu vaccine coverage among children in mid-December was similar to that in December 2020 but 3.7 percentage points lower than late 2020. The decrease in flu vaccination coverage among pregnant women over the past two years was even more significant, at 18 percentage points lower.
Other childhood vaccination rates have also declined compared to pre-pandemic levels. A KFF survey released on December 16 revealed that nationally, 35% of American parents now oppose mandatory measles, mumps, and rubella vaccinations for school entry, up from 23% in 2019. The suspicion surrounding vaccines that were previously trusted, coupled with vaccination fatigue, is likely responsible for this trend.
Part of the problem stems from a lack of investment that has weakened the public health system even before the pandemic began. An analysis by KHN and The Associated Press discovered that local health department spending per capita decreased by 18% between 2010 and 2020. Furthermore, state and local health agencies lost nearly 40,000 jobs between the 2008 recession and the outbreak of the pandemic.
This lack of investment created significant challenges and often led to inadequate responses to the once-in-a-century public health crisis. For instance, during the early stages of the covid outbreak, many local health departments relied on fax machines to report case counts.
Dr. Brannon Traxler, the director of public health at the South Carolina Department of Health and Environmental Control, acknowledged that the health departments were not as adaptable at the beginning of the pandemic. He revealed that South Carolina’s health department only had two people working on the media relations and public outreach team at that time. However, that number has now increased to eight.
The agency has also implemented other changes in its communication strategies. Last year, South Carolina began publishing data on flu vaccinations every two weeks with the aim of raising awareness about the effectiveness of the shots. However, even by early December, less than one-quarter of eligible adults and children had received a flu shot in South Carolina, despite an increase in flu cases and hospitalizations. Across all age groups in the U.S., the flu vaccine rate for the previous season was 51.4%.
Dr. Traxler noted that there seems to be a correlation between those who have declined both the covid and flu vaccines.
"We are working hard to debunk the misinformation that is circulating," Dr. Traxler emphasized. To achieve this, the health department has partnered with local leaders and organizations to encourage vaccinations. The staff members have also become more adept at engaging with the press to effectively communicate with the public.
However, some public health experts argue that agencies still struggle with their messaging. They use scientific terms like "mRNA technology," "bivalent vaccine," and "monoclonal antibodies" extensively, despite the fact that many people find them difficult to comprehend.
"We are facing a challenge in effectively communicating complex ideas to the public," stated Brian Castrucci, the CEO of the de Beaumont Foundation, a charitable organization dedicated to strengthening public health. Castrucci acknowledged that the missteps in communication played a role in the spread of disinformation.
Castrucci highlighted that although the majority of Americans support public health, a vocal minority is actively promoting an anti-science agenda and successfully sowing distrust.
To benefit the more than 3,000 public health departments across the country, Castrucci emphasized the importance of a unified message. In late 2020, the foundation collaborated with other public health groups to establish the Public Health Communications Collaborative. The aim is to amplify easily understandable information about vaccines.
He stressed the need for the "good guys" to be as organized as those who seek to do harm, expressing disappointment that valuable lessons have not been learned from this situation.
Meanwhile, a report published by the Pew Research Center in October revealed that 57% of U.S. adults believe false and misleading information about the coronavirus and vaccines has greatly contributed to the problems faced by the country during the pandemic.
One individual, Davie Baker, a 61-year-old business owner from Oklahoma City, initially had reservations about the vaccines. Concerns about the speed of development and online information about side effects influenced her opinion. However, a pharmacist at Sam’s Club provided her with valuable information that changed her perspective and clarified misconceptions.
Baker received her first covid shot in May 2021. At the same time, the Oklahoma City Health Department noticed a decline in the number of vaccines administered daily. To address this issue, they updated their marketing campaign in early 2022. Instead of using the word "vaccinate," which was disliked by the public according to social media analytics, the new campaign encouraged people to "Choose Today!"
There has been a decline in childhood vaccination rates for the immunizations required for kindergarten entry in Oklahoma County. This trend raises concerns for Maytubby, as it reflects a growing number of parents seeking exemptions. Those spreading distrust about vaccinations have been successful in casting doubt on various aspects, including the science and safety.
Maytubby emphasized that misinformation has had a significant impact and changed the landscape of health decisions.
KHN (Kaiser Health News) is a national newsroom that produces comprehensive journalism about health issues. Alongside Policy Analysis and Polling, KHN is one of the major programs operated by KFF (Kaiser Family Foundation). KFF is a nonprofit organization that provides health information to the nation.
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