The Vaccine Project Newsletter: A shapeshifting response to a shapeshifting pandemic

This is a public health war being waged on two fronts, both of which we must win. First, we need to get as many people vaccinated against COVID-19 as quickly as possible; and second, we need to limit the spread of disease through the measures that should be as familiar to us by now as the Pledge of Allegiance. As the signs and posters put it: “One small ask—please wear a mask” and “Do your part—stay 6 feet apart.”

Make no mistake, the foe is relentless and unforgiving. Less than a year after the first death was reported in the U.S., the toll surged to a new single-day high of more than 4,000 on Tuesday. Predictions of a bleak winter are crystallizing into a bleak truth.

One month into what one observer called a “sclerotic” COVID-19 vaccine rollout, it’s clear that making a vaccine at “warp speed” is but the first step on the pathway to wellness. Steps two and three are the granular matters of distributing and administering vaccines and, not incidentally, having an infrastructure and a communications plan in place to do so.

All of which helps to explain why the federal government pivoted on Tuesday and encouraged states to start vaccinating people 65 and older as well as younger people with underlying health conditions that put them at increased risk (the originally lower-prioritized group 1c). The administration has also decided to release doses that had been kept on hold for second doses, a plan that President-elect Biden had put forth last week. He’s expected to announce further vaccination plans on Thursday.

We have miles and miles to go on this journey. Course corrections are already setting in, with lots of specific detail and good work being done, as you’ll read in this week’s offering.

The Vaccine Project Newsletter for the week of January 11, 2021, is 2,097 words and will take you seven minutes to read.

A sense of urgency: Learning from history

The dogs will be running in the 49th Iditarod sled race across Alaska on March 6, but what it commemorates is an epic event in vaccine history: The lifesaving Serum Run from Nenana to Nome in 1925, also known as the Great Race of Mercy. When Nome faced an outbreak of diphtheria with no fresh supply of antitoxin, a train took a 20-pound canister of the medicine from Anchorage to Nenana; tag teams of sled dogs took it the rest of the way, 674 miles over six days. The dogs (and their humans) became heroes and publicity from the race helped inspire inoculation campaigns that reduced the incidence of a deadly disease. This year’s race has something new: a coronavirus protection plan.

The rollout

Can we achieve the same sense of urgency, unity and clarity? In dog-mushing terminology, “hike!” means to get moving, to start a team or increase the speed of a moving team. It’s “hike!” time.

In the first of a series of videos provided by the Ad Council and COVID Collaborative, Dr. Anthony Fauci urged healthcare professionals to “please get vaccinated. It’s important to protect yourselves, to protect your family, but as important symbolically, as health care providers, to show confidence in the vaccine so that other people in this country follow suit and get vaccinated.”
Dr. Fauci’s message to colleagues in the health professions is timely: Vaccine clinics at long-term care facilities are bumping up against hesitancy among staff, who are part of the nationally recommended first priority group for vaccination, Kimberly Bonvisutto reports in McKnight’s Senior Living. Staff reaction is mirroring the general public’s “excitement mixed with hesitation about the vaccines’ development and safety.”
Some senior living facilities are making vaccine acceptance a condition of employment, Bonvisutto notes. Atria, which has more than 11,000 employees in 26 states and seven Canadian provinces, is among them. The organization has launched a Sleeve Up Atria educational campaign.
Another senior care center, the Jennings Center for Older Adults in northeast Ohio, is using text messages, robocalls, website FAQs, posters and one-to-one conversations to combat myths and provide factual information. Its medical director, Dr. James Campbell, held a webinar for families, residents and staff before the first clinic to provide information and answer questions.
Dr. Michael Osterholm, a member of President-elect Joe Biden’s COVID-19 advisory team, said that as many as 30% to 40% of healthcare workers are “taking a pass” on getting the vaccine until they see more safety data. He considers Operation Warp Speed “a terrible name.”
“We do need vaccinators.” New Jersey State Commissioner of Health Judy Persichilli is looking for retired healthcare workers and others who can sign up via the Medical Reserve Corps to administer COVID-19 vaccinations. As the state becomes one of several opening vaccination megasites, local health units are looking for volunteers with experience in security, language translation, education/outreach, warehousing, clerical tasks, and counseling.
The federal government is speeding up the launch of a partnership with pharmacies to deliver COVID-19 vaccinations at more than 40,000 locations across the country. This community-based effort is in addition to the Pharmacy Partnership Program for Long-Term Care involving Walgreens and CVS. Kimberly Bonvisutto has more in McKnight’s Senior Living.

The takeaway: In 2020, it took 90 days to reach two million cases of COVID-19 in the U.S. In 2021, it took 10 days to add two million to the existing caseload.

The challenges

Can we find a happy medium between the people who are first in line for the vaccine and don’t want it and those who are far down the list and are clamoring for it?

According to letters sent to all 50 state governors by the American Seniors Housing Association, seniors in independent living communities have been wrongfully left out of the first priority group for vaccination, which encompasses residents of nursing homes and assisted living facilities. Residents in independent living units are excluded, Lois A. Bowers notes in McKnight’s Senior Living, even if they live in continuing care retirement communities where other residents are now receiving the vaccine.
Confusion is not just a homegrown product. GP’s Luke Haynes reports that in the U.K., doctors are asking why mass vaccination centers are both opening when smaller sites are having supply problems and sending invitations to patients who have already booked jabs with their own doctors.
That said, the U.K. has already vaccinated one third of its over-80 population, GP’s Nick Bostock notes. The National Health Service delivered more doses in the first week of January than in the entire month of December.
Another pocket of vaccine hesitancy resides and abides in rural America, the Kaiser Family Foundation reports. A Kaiser survey found that 39% of people in rural areas are not worried that a family member will get sick from COVID-19, 50% believe the seriousness of the virus has been exaggerated in the news and 62% feel that getting vaccinated is mostly a matter of personal choice.
The Centers for Disease Control and Prevention reports that the rate of anaphylaxis with COVID-19 vaccines so far is 11 per one million people vaccinated, versus one per one million for flu vaccine.

The takeaway: Let’s not get discouraged too soon. This is a heavy lift involving millions and millions of people—as of January 11, the CDC Tracker count stood at 25.5 million vaccine doses distributed and almost nine million first doses administered. As of the week of January 11, we’re vaccinating at a rate of 700,000 people per day; the goal is one million.

The communications effort: Smart work by smart people

When it comes to developing and communicating essential messages, this is indeed a molecular Manhattan Project. Let’s spread the word about the words.

In MM+M, Marc Iskowitz explores what’s ailing the vaccine rollout and shares advice from a panel of behavioral scientists on how to fix it. A key takeaway: Any change in the vaccination campaign must not undermine the goal of equitable distribution. “In other words, jumpstart the rollout, but don’t jump the line.”
A question on the mind of many skeptics: “How did scientists manage to develop safe COVID-19 vaccines in just ten months?” Read a cogent and compelling explanation from the global organization Gavi, the Vaccine Alliance. Gavi’s core partners are the World Health Organization, UNICEF, the World Bank and the Bill and Melinda Gates Foundation.
The CDC has posted a social media message toolkit that long-term care providers can use to educate staff and residents about COVID-19 vaccine safety and benefits, as well as about what they can expect after vaccination, Alicia Lasek reports in McKnight’s Long-Term Care News.
The first wave of four Ad Council/Covid Collaborative videos focus on getting health professionals vaccinated and prepared to respond effectively to patients’ questions and concerns. The videos were created pro bono by advertising agency Group SJR.
The Institute for Public Relations has put together A Communicator’s Guide to COVID-19 Vaccination. Among the key takeaways in the 42-page guidebook: “Tell stories, not statistics. Stories and anecdotes about those affected positively by vaccinations are more likely to be effective than statistics.” Also: All communicators (government agencies, the healthcare community, businesses, etc.) “must provide clear and consistent messaging to increase public trust and confidence.”
The IPR also has a COVID-19 Vaccine Communication Resource Center covering such topics as vaccine hesitancy, vaccine confidence, the role of disinformation and recommendations and strategies for vaccine uptake. IPR president and CEO Dr. Tina McCorkindale presented an hour-long webinar in December on How Communicators Can Navigate the COVID-19 Vaccine.
Two top physicians with the CDC, Drs. Nancy Messonier and Amanda Cohn, headline an hour-long webinar sponsored by the Immunization Action Coalition. The program, “COVID-19 Vaccination Implementation and the ‘Vaccinate with Confidence’ Strategy,” aired in December and is available to view at the IAC website.
UnidosUS, an advocacy organization for the Hispanic community with 300 affiliates across the US and Puerto Rico, is working to educate its constituents about the vaccine, emphasizing that leaders must provide equitable vaccine access for all. The website includes information about COVID-19 vaccine and the organization’s participation in pivotal clinical trials.
A paper published by The Lancet on determinants of COVID-19 vaccine acceptance concludes that doctors, nurses, and ancillary health professionals will all be needed to help build trust in vaccines throughout the community.
In McKnight’s Senior Living, Lois A. Bowers shares tips from nursing home and assisted living operators on how to smooth communication with residents and staff and make the vaccine clinic experience positive – and even festive.

The takeaway: It is helpful to remember the six core principles of crisis communication: Be first. Be right. Be credible. Express empathy. Promote action. Show respect.

The vaccine dashboard

COVID-19 vaccination is a worldwide challenge. As global health advocates say, no one is safe until everyone is safe.

A laboratory study suggests that the Pfizer/BioNTech vaccine can effectively neutralize a mutant strain of SARS-CoV-2 that is associated with rapid disease transmission, Diana Ernst reports in MPR.
The European Union has greenlighted the Moderna COVID-19 vaccine for use in its 27 countries; the Pfizer/BioNTech vaccine is already in the EU stockpile. Moderna officials say their vaccine should protect people for at least a year.
While wealthier countries are buying up vaccine doses by the billions, a program known as COVAX is working to ensure access to vaccines for countries that otherwise could not afford them. COVAX—a collaborative effort of WHO, Gavi The Vaccine Alliance and the Coalition for Epidemic Preparedness Innovations—supports R&D and manufacturing of many COVID-19 vaccine candidates and negotiates pricing. Middle and upper income countries support COVAX with funding. The United States is not one of them.
The head of WHO, Tedros Adhanom Ghebreyesus, decries the fact that poorer nations are struggling to access and afford vaccines and says that “vaccination nationalism hurts us all and is self-defeating.” COVAX is hoping that at least 20% of people in poorer countries get vaccinated this year.
South Africa has 30% of the three million cases on its continent and more than 40% of the 72,000 deaths, and is also struggling with a mutant variant of the virus. The country is purchasing some vaccine on its own and expecting more from COVAX.
G’day and good news: Australia’s vaccination effort is expected to start six weeks earlier than planned. The government has spent $24 million on a public messaging campaign.