Science’s COVID-19 reporting is supported by the Pulitzer Center and the Heising-Simons Foundation.
As an expert in marketing, Stacy Wood has studied how people respond to everything from online shopping to reality TV. Now, the professor at North Carolina State University’s business school has turned to COVID-19, co-authoring a paper on 6 January in The New England Journal of Medicine that uses marketing theory to explain how to persuade people to get vaccinated.
Wood recently spoke to ScienceInsider about her work. This interview has been edited for clarity and brevity.
Q: When you look at how vaccination is being marketed now, what do you see?
A: I see public health officials approaching it in a very straightforward way that says, “All we need to do is educate people about why this is a good idea.” [But] there’s more nuance to hesitancy than we realize. Someone says, “Hey, I know how pharmaceutical products are developed and tested, this went way too fast.” Another person says, “You know, science is not the answer, we trust too much in science.” So the communications towards these different groups have to be well targeted.
Q: How does a health provider do that?
A: People are more compelled by stories than they are by statistics. If your patient says to you, “Hey, the lady down the street from me said her niece had a bad reaction. I’m the same age as her niece. I’m really worried about this.” It’s important not to say, “Well, let me show you a chart that will explain exactly how rare this is.” It’s more important to say, “I have a patient exactly your age who was in here last week, and they were one of the first people to get the vaccine, and they did great.”
Q: Why isn’t it enough to simply tell people who might not want to be vaccinated that the risks associated with vaccination are lower than the risks associated with COVID-19? It seems clear at this point that vaccination is less risky than a disease that’s killing thousands of people every day.
A: You’re [asking people] to assess two different probabilities at once: the probability you’ll get COVID, and the probability that you’ll have a reaction to the vaccine. When we were just thinking about the fear of getting COVID, then that probability seemed really scary, right? But now, the more salient decision is, do I get the vaccine or not? We’re paying more attention to the decision that’s right in front of us.
The other thing is that people have a lot of anticipated regret, this sense of looking forward to a bad outcome. Then, that bad outcome looms large in their decision-making. That’s the thing that’s right in front of them. This is where physicians and clinicians [can say to themselves]: “OK, I know about anticipated regret. How do I shift the anticipated regret back to getting the disease, not getting the shot?”
Q: Are there examples of smart marketing of the vaccines?
A: What I’ve seen, and what research really would predict, is that the really effective [messages] are coming from grassroots sources. They’re the Twitter explanations by doctors. They are pictures that doctors take of their own sweaty faces with the N95 mask outlines, just saying, “Please do this.” That’s the kind of message that is both authentic and compelling.
I hope that social media becomes the communication tool that no one national call to action could probably ever be. This is a really complicated enemy that Americans feel very differently about. So a one-size-fits-all communication strategy just can’t do it.
Q: Some people have a really big megaphone, like Anthony Fauci, head of the National Institute of Allergy and Infectious Diseases. What advice would you give him on communications?
A: There’s a new concept: “uniqueness neglect.” People don’t like to be lumped in with the average. You may say the average person is going to have no reaction. Well, how dare you imply I’m an average person, I am very special. I can see very clearly that someone who’s unlike Dr. Fauci—by age, or people of color—might say: “Well, look, that may be true for you, but for people in my situation … .” So he’s got to find and give the spotlight to a slightly wider group. He needs a couple of Fauci surrogates who meet these other communities a little closer.
Q: You have this idea of giving people a visible marker that they’ve been vaccinated, like the Livestrong-style bracelets.
A: The gist of the strategy is that it’s a visible sign of in-group/out-group. … [It] works really well for people who are in the “probables”: I probably will get it or I probably won’t. I don’t know if observables would ever change someone who’s in the hardcore “definitely, no.”
Q: Your paper lists a dozen things that people should do. Is there anything that people should be sure not to do?
A: Oh, yes. [Don’t] frame this as an “either/or” decision—either for the vaccine or against. And for people who are vaccine hesitant or antivaccine, [don’t] label them as the bad guys, or as irrational. It’s [utilizing] that entire concept of targeted marketing, which understands people’s individual motivations and has respect for their individual attitudes.