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The Challenge Of Public Health Messaging Amid An Ever-Changing Virus


As concern over the spread of the delta variant mounts, public health officials have been doubling down on the importance of getting more Americans to get their COVID shots. They say getting vaccinated is still the best protection against the virus, regardless of which variant one is exposed to. Here's how President Biden's chief medical adviser, Dr. Anthony Fauci, put it yesterday speaking to NPR.


ANTHONY FAUCI: There's a really, really good reason to get vaccinated, and that is to save yourself from getting a severe infection that would lead to hospitalization and deaths.

SNELL: And reports suggest that new vaccinations are increasing in some areas. Today, White House Chief of Staff Ron Klain tweeted that more Americans are getting their first COVID shots now than at any time in the past eight to 10 weeks. But the question remains - is the message getting through to enough people? And do Americans still trust what public health officials are telling them? We asked Dr. Robert Blendon to help us with those questions. He's a professor of health policy and political analysis at Harvard University, and he joins us now via Skype. Dr. Blendon, thanks for being with us.

ROBERT BLENDON: Pleasure being here.

SNELL: Well, you did a poll in the spring with the Robert Wood Johnson Foundation - which we should note is an NPR funder - and the Harvard T. H. Chan School of Public Health. It found a growing distrust in public health agencies like the Centers for Disease Control and Prevention and the National Institutes of Health. Did you get a sense of why that's the case?

BLENDON: First of all, it's important to realize there are big differences in this country in talking about the average views. We have been focusing with our own polling and others since then on people who are not vaccinated. And the people who are not vaccinated are a share of the American public. But they do not trust federal authorities, federal public health scientists, Washington for medical advice. And I use the phrase very clearly medical advice. They might trust them for other things. But when it comes time to how they deal with health issues, they absolutely do not trust the people that are on radio and TV every day from Washington. And that's important to realize if you're going after the people who are not vaccinated, it's a different audience.

SNELL: So this is a question of their personal health decisions. And they don't, as you're saying, trust Washington or public health officials with that. So who did they trust for health guidance?

BLENDON: It would be clinicians in their community who they would normally get advice from. But I have to add a very important point here, which has been missed. The people not taking the vaccine report that they're not very worried about COVID. Anybody that's been involved in vaccine campaigns knows that the step is, first, people get worried. Just think about polio. When I was a child, my parents just in their head saw these pictures of kids in iron lungs and children who have disabilities for the rest of their life. What we find from very recent surveys are that people who are in the cultures that aren't getting the vaccine are not worried.

SNELL: So you're saying that with over 600,000 deaths in the U.S., there are still some people who don't feel a threat. And so I'm wondering - is part of the problem how the message is delivered? You know, this week's new mask guidance from the CDC was criticized for being too vague and too confusing. You know, are there examples that you have seen where somebody has found the right alchemy to reach people?

BLENDON: We're in these states - we've seen in the last few weeks an increase in vaccination. So there is some movement. But I need to make a point of something that happened here, North Miami, a collapse of a building where 98 people died. Their pictures were all over the paper. How terrible it was. The president came down to be with the family. The governor did.

We have thousands of people dying every month. Their pictures aren't anywhere, it's human stories that move them, and they're not human stories. I don't know that Susan just died that I knew. I don't know about her story. I don't know how grieving her family is.

SNELL: So it's a question of personal connection with the stories that are being told and that - the numbers that people are seeing.

BLENDON: Yes, critical care physicians and nurses went on social media and said, I'm dealing with people near death. And they're begging for a vaccine, and they're saying they're sorry they didn't take it. Well, that's a story that really could impact how people were saying I'm not going to take this vaccine think because it's people like them. And they realize that they could be worried if they were going to be in that ICU. That's who people would trust, and it would have to be local.

And that's why the decision of the 60 medical organizations to recommend health organizations requiring their employees to absolutely take the vaccine has a chance of having a big secondary effect. And these are all organizations that have local in-community hospitals, clinics, medical groups. And as they try to move their own employees forward, they are going to have an educational effect, and they're not going to be seen as anything to do with Washington.

SNELL: So you believe that those changes will drive regular everyday people who might not have the vaccine to go and then get the shot?

BLENDON: Yes. And they'll hear about it locally. And it'll be their voices - Alabama, Tennessee, Mississippi - saying you just can't come to our hospital. You're endangering people's lives. And it will be a local voice of clinicians, and they're likely to have people dealing with the critically ill. And I emphasize this all the time. You want to talk about those who get critically ill.

It's like, again, when I was a child, most people with polio did not end up in an iron lung. But for parents, that picture, it could be your child, had a staggering impact on them. But we're now pushing a vaccine on people who aren't sure they're at risk of dying here. And that's where the message has to change. And it has to come from people who you trust for medical advice, which means if I live in Nashville, it's going to be a physician and nurse at institutions I go to that tell me this.

SNELL: That was Dr. Robert Blendon. He's professor of health policy and political analysis at Harvard University. Thank you so much for being with us.

BLENDON: Thank you. Take care.

(SOUNDBITE OF BONOBO'S "KONG") Transcript provided by NPR, Copyright NPR.