Public health authorities strive to restore trust as they fight misinformation

OKLAHOMA CITY — In the summer of 2021, Phil Maytubby, deputy chief executive officer of the department of health here, was concerned to see a drop in the number of people getting vaccinated against covid-19 after the initial strong response. With suspicion, fear, and misinformation rampant across the country — both online and offline — he knew the agency needed to rethink its messaging strategy.

So, the health department has conducted something called “sentiment searches” online, to gauge how well certain words are perceived on social media. The tool found that many people in Oklahoma City disliked the word “vaccination” — a prominent term in the health department’s marketing campaign.

“If you don’t know how your message resonates with the public,” Maytubby says, “you are acting in the shadows.”

Across the country, health officials have been trying to combat misinformation and restore trust in their communities over the past few years, a period in which many have not fully trusted in their state and local health departments. For example, companies are using Twitter to attract niche audiences, such as NFL fans in Kansas City and Star Wars enthusiasts in Alabama. They are collaborating with influencers and celebrities like Stephen Colbert and Akbar Gbajabiamila to expand their reach.

Some of these efforts have paid off. Now, more than 80% US residents have received at least one dose of the covid vaccine.

But data shows that skepticism and misinformation surrounding the covid vaccine is now threatening other public health priorities. Children’s flu vaccine coverage in mid-December was the same as in December 2021, but 3.7 percentage points lower than at the end of 2020, according to the report. Centers for Disease Control and Prevention. Flu vaccination rates among pregnant women have fallen even more dramatically over the past two years: 18 percentage points lower.

The command center in the basement of the Oklahoma City County Health Department has a large digital display that allows staff to review covid case numbers and other key data, such as vaccination rates. master for children, in their morning meeting. (Nick Oxford for KHN)

Phil Maytubby (centre), Deputy Executive Director of the Oklahoma City County Health Department, meets with staff in the agency’s command center to review the latest information on covid cases and hospitalizations . (Nick Oxford for KHN)

Other routine childhood immunization rates also decreased compared with pre-pandemic level. Nationally, 35% of American parents oppose requiring their children to have their children vaccinated against measles, mumps and rubella before school, up from 23% in 2019, according to a report. survey KFF released on December 16. Suspicion revolves around once-reliable vaccines, as well as fatigue after too many shots, as possibly to blame.

Part of the problem is the lack of investment that eroded the public health system before the pandemic began. One Analysis done by KHN and The Associated Press found that local health department spending fell 18% per capita between 2010 and 2020. State and local health agencies also lost nearly 40,000 jobs between the 2008 recession and the arrival of epidemic.

This makes their response to the once-in-a-century public health crisis difficult and often inadequate. For example, in the early days of covid, many local health departments used fax machine to report the number of covid cases.

“We are not as flexible as we are now,” says Dr. Brannon Traxlerdirector of public health at the South Carolina Department of Health and Environmental Control.

At the start of the pandemic, only two people worked on the media relations and outreach team at the South Carolina health department, Traxler said. Now, the team has eight people.

The agency has also changed its communications strategy in other ways. For example, last year was the first year that South Carolina released data on biweekly flu shots, with the goal of raising awareness about the shots’ effectiveness. In South Carolina, not even a quarter The number of adults and children eligible for the flu shot were vaccinated in early December, even as flu cases and hospitalizations increased. The flu vaccine rate across all age groups in the United States was 51.4% last season.

Traxler said people who chose not to get both the covid and flu vaccines appear to be correlated.

“We’re really just trying to dispel the misinformation that exists,” Traxler said. To that end, the health department has partnered with local leaders and groups to encourage vaccination. Agency employees have also become more comfortable talking to the press to better communicate with the public, she said.

But a few public health experts argue that agencies are still failing to text. Scientific terms such as “mRNA technology”, “bivalent vaccine”, “monoclonal antibody” are used a lot in public health, although many people find it difficult to understand.

A study published by JAMA found that covid-related language used by state agencies is often more complex than 8th grade reading and more difficult to understand than language commonly used by the CDC.

“We have to communicate complex ideas to the public, and this is where we fail,” says Brian Castucci, CEO of the Foundation de Beaumont, a charitable group focused on promoting public health. “We must acknowledge the fact that our communication mistakes have created an environment in which misinformation thrives.”

Most Americans support public health, says Castro. At the same time, a small but vocal minority promotes an anti-scientific agenda and has been effective in sowing the seeds of mistrust, he said.

More than 3,000 public health departments across the country would benefit from a unified message, he said. In late 2020, the organization worked with other public health groups to establish Public Health Communication Partnership to amplify understandable information about vaccines.

“Good people need to be as well organized as those who seek to harm the country,” he said. “One would think we would learn from this.”

While, a report published in October by the Pew Research Center found that 57% of U.S. adults believe that “misinformation and misinformation about coronavirus and vaccines have contributed to so many problems facing the country in the midst of the pandemic.

Davie Baker, who lives in Oklahoma City, said she initially didn’t want to get the covid vaccine, but then a pharmacist at Sam’s Club helped her change her mind. “She cleaned up some things for me,” Baker said. (Nick Oxford for KHN)

“I’m just as cunning as everyone else,” said Davie Baker, 61, an Oklahoma City woman who owns a business selling window treatments. When the shots became widely available in 2021, she thought they were being developed too quickly, and she was concerned about some of the things she had read online about side effects. A pharmacist at Sam’s Club changed his mind.

“She just taught me what the scene really meant,” says Baker. She cleaned up some things for me.

Baker signed up for the first covid shot in May 2021, around the same time the health department in Oklahoma City noticed the number of vaccines given daily began to decline.

The department updated its marketing campaign in early 2022. Instead of using the word “vaccinated” to encourage more people to get a covid shot – the agency’s social media analysis term shows people dislike – the new campaign urges people to “Choose Today!”

“People aren’t as trusting as they used to be,” Maytubby said. “They want to make their own decisions and make their own decisions.” The word “choose” acknowledges this preference, he says.

Maytubby thinks “Choose today!” campaign worked. A survey of 502 Oklahoma City adults conducted during the first half of 2022 found that less than 20% of respondents responded negatively or very negatively to a “Pick Today!” sample. advertisement. And an estimate 86.5% of adults in Oklahoma City received at least one dose of the covid vaccine — a rate higher than the state average of about 73%.

Other factors that may be at play have helped boost Oklahoma City’s vaccine numbers. In the same survey of adults in Oklahoma City, several people who were recently vaccinated said family members or church leaders urged them to get vaccinated or they knew someone died from covid. One said money was the motivator — they received $900 from their employer for a covid vaccine.

Meanwhile, the fight against misinformation and misinformation continues. Child immunization rates for immunizations students typically need to enter kindergarten have dropped 4.5% in Oklahoma County since the 2017-18 school year as parents increasingly seek waivers .

That worried Maytubby. He said the main tactic of those trying to sow distrust about vaccinations is to raise doubts – about everything from their science to their safety.

“In that respect, they have been quite successful,” Maytubby said. “Disinformation changed everything.”


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