Doctors and nurses walk to a house to administer the Chinese Sinovac Coronavac vaccine to a resident during a house call in the village of Daldere, Turkey, Feb. 12, 2021. Image: Chris McGrath/Getty

Making Vaccines the New Social Norm

A year ago, almost no one wore masks or stayed 6 feet apart from others. Some of these behaviors have become social norms at light speed—something those of us who have made social and behavior change communication our life’s work rarely see.

Getting a vaccine needs to become one of those new social norms.

Yet our newest survey data tell a discouraging story: Roughly 1 in 3 adults in the US told us last month that they will not get a COVID-19 vaccine.

The global figures are even more troubling. In some countries, like Turkey, only 1 in 3 adults said they would actually be willing to be vaccinated; in the Philippines, it’s running 50-50. Fewer than 6 in 10 of adults in France said they’d sign up for a shot, a figure similar to Nigeria.

To reach herd immunity—the level at which the spread of COVID-19 becomes biologically difficult and the pandemic can end—NIAID director Anthony Fauci has said 70-85% of a population needs to be vaccinated.

Most countries where these surveys were conducted—with MIT, Facebook and the WHO every 2 weeks since July—are nowhere near reaching that threshold. At the same time, we are in a race against time. Almost every day, we see the appearance of more mutations to the SARS-CoV-2 virus that make it more contagious—and which could weaken the impact of these very vaccines.

Vaccines are arguably one of the greatest medical advances of our time. Before the measles vaccine was introduced in 1963, for example, it was the leading killer of children in the world, killing millions. In 2016, it killed 132,000. At that time, vaccine skeptics were beginning to find their ranks growing and their voices amplified on social media and in group chats and among some religious communities.

With more skeptics forgoing measles vaccinations for their children, we have seen global measles deaths climb by nearly 50% since 2016, claiming an estimated 207,500 lives in 2019 alone, the WHO estimates. These are completely avoidable deaths.

The danger is such that the WHO felt it necessary to rank vaccine hesitancy—a reluctance or outright refusal to be vaccinated—as one of the 10 biggest threats to global health in 2019.

This seems like a lifetime ago, with COVID-19 itself now one of the biggest threats in history. At the same time, vaccine hesitancy has only become more dangerous. In the case of COVID-19 vaccines, this hesitancy spans the continuum: from those who simply want to learn more about the vaccines’ safety and effectiveness, to those who just haven’t decided, to those who plain refuse to be vaccinated.

With the novelty of COVID-19 and its vaccines, it’s completely reasonable to want to know more in order to make an informed decision. But with 3 vaccines now approved for emergency use in the US alone—and the first doses given several months ago already—the news on the efficacy and safety front is fantastic. And much small talk now revolves around how to get an elusive COVID-19 shot.

Soon, though, supply for vaccines will undoubtedly outstrip demand. Before long, not everyone who is eligible for a vaccine will want one. But unless enough people get vaccinated, this pandemic will not go away completely, and we’ll need to continue limiting the way we live.

We need to cut through the noise and make sure everyone knows how great the vaccines are and why they should roll up their sleeves.

Our research, which has collected data from 1.7 million people in 67 countries, has shown that scientists and health care workers are the people who are most likely to influence COVID-19 prevention behaviors. By using the right messengers, we can make sure we are effectively responding to the specific concerns of our diverse communities.

Our surveys, and others, give us a road map to help put an end to the pandemic that has defined our lives for a year now. We know that people are hesitant about getting COVID-19 vaccines and that new, more contagious COVID-19 variants put all of our previous efforts at risk. But with the right focus and strategies, we can move towards vaccine confidence. There is no time to lose.  

Our lives depend on it.


Susan Krenn is executive director of the Johns Hopkins Center for Communication Programs, which focuses on social and behavior change approaches in health.

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Doctors and nurses walk to a house to administer the Chinese Sinovac Coronavac vaccine to a resident during a house call in the village of Daldere, Turkey, Feb. 12, 2021. Image: Chris McGrath/Getty