Make your Content Concrete, Supply a Narrative and Provide Value

If messages aren’t concrete and don’t include stories, our powerful sense-making brains will fill the abstraction with stories and ideas that make sense to us.

Experts can presume that what’s in their minds is known to all. This is the “curse of knowledge,” and can lead them to communicate abstractly, use specialized language and use messages that are specific to their own goals—not what’s important to others. 

Use messages that are concrete, consistent, built around narrative, and provide value. Make information feel immediate, proximate, possible, and likely to directly affect people or those they care about.
  
Experts may use terms that are abstractions to others. For example, if you’re talking about the status of a vaccine trial, instead of saying a vaccine is in phase 3, say, “the vaccine has been tested on X thousand people.” If you don’t translate abstract or complex terms, or acronyms, people will fill that abstraction with their assumptions. Avoid that risk by using definitions in place of terms that require expertise to understand. 

Gordon Pennycook and his colleagues ran an experiment in which they informed 1,200 people about the process of getting vaccines approved to go to market through a simple public service announcement. It showed an impact with both Democrats and Republicans. 

Build a narrative. Our brains are powerful sensemaking machines that default to finding narrative when one isn’t offered. If you don’t present your information in the form of a narrative, your readers or listeners will create one as a way of interpreting what they’re learning.

Provide value by listening to what people are asking. Engage in listening on social platforms where people are sharing concerns about vaccines. Understanding the reasons behind people’s skepticism will help you design messages that overcome them. As Heidi Larson points out, rumours and misinformation flourish when there’s broad, shared curiosity and an information vacuum. Listen to questions and fears and provide detailed and meaningful answers.

I imagine that you might be able to get corporations or governments or NGOs to get on board with vaccines. Say to them, ‘This is how your government reopens, or this is how your company reopens, once everybody’s vaccinated.’ If you could get them on board to give employees an afternoon off, or a day off, to go get vaccinated, that deals with accessibility issues for some people who just don’t have childcare or can’t go as easily. But also signals an endorsement from the agency you work with, the company, the institution, the government. . . And so that’s kind of on the feasibility side of things, but it’s also messaging because if your manager, or manager’s manager, or CEO, or company leader is saying they did it and they want you to go do it, then that would be a pretty strong vote of confidence and economic support for people to do it.

— Jay Van Bavel, Ph.D., Associate Professor of Psychology & Neural Science at New York University.
Three messages that have been used effectively by vaccine-hesitant communities are choice, regret and control. Scholars suggest these might be flipped to reduce vaccine hesitancy. 

Paul SlovicPaul Slovic, Ph.D., Professor of Psychology at the University of Oregon and founder and president of Decision Research, suggested the potential effectiveness of regret: “Wouldn’t you regret if you did not get the vaccine and you or your loved ones got ill and you had decided not to get it?” Kurt Gray, Ph.D., Associate Professor in Psychology and Neuroscience at the University of North Carolina, said it’s important to offer this in a positive sense and focus on the benefits of the vaccine with concrete stories. People in the vaccine hesitant community often point to their regret in having their children vaccinated, attributing specific side effects to that choice. Heidi Larson pointed out how the regret angle is really important to leverage, because it’s something that parents really struggle with. “There is a very proactive influential anti-HPV vaccine group in Ireland called “R.E.G.R.E.T.. It’s about Gardasil. It’s Reactions and Effects of Gardasil Resulting in Extreme Trauma. Regret can be leveraged in different ways, On the one hand you can say, ‘You don’t want to regret not vaccinating if your child gets encephalitis or other serious condition from measles disease.’ But many parents are also anticipating the possible regret if they do vaccinate and there is a problem, ‘Yeah, but what happens if he gets autism from the vaccine?’ Regret is an important dimension in conversations with parents, but the important thing is to shift the anticipated regret towards how they might feel if their child is not vaccinated and becomes seriously ill or even dies from a vaccine preventable disease rather than being more focused on the potential side effects of the vaccine.”

Paul Slovic pointed out that “one of the things that makes COVID scary is that it’s difficult to control.” It’s invisible, people can carry and transmit the disease without showing symptoms, and there are limited treatment options. People have profound discomfort with uncertainty, and so offering the vaccine in the context of regaining control could be quite powerful.”

Choice factors in, in three ways. People may worry they will be forced to get a vaccine. They may worry that they won’t have access to the vaccine, and therefore rationalize its likely effectiveness. The third is that people may feel overwhelmed if they have to choose among several vaccine options. 

Emphasize choice and freedom—opportunities to make choices around particular vaccines or timing, that no one will be forced to get the vaccine, and the benefits of getting the vaccine. It’s important to share these not simply in the form of data, but to tell stories of people who have gotten vaccines, stayed healthy and reclaimed the freedom to pursue their favorite activities.  

Another way to approach choice is through behavioral economics. Offer a default option that’s determined by experts, with an opt-out possibility. This retains people’s sense of freedom, but default architecture will guide them into the experts’ recommendations. 

I think we need to avoid the trap of thinking that information or knowledge is enough, because for a lot of the people, and when you look at hesitancy and parental vaccine hesitancy in the US, the group who is most likely to purposefully choose to not vaccinate are highly educated. In speaking with them, these are people who have read the primary literature themselves, and they’re correctly interpreting it, so it’s not a misunderstanding. They have other concerns that go beyond the traditional public health message of, ‘This is what you should be doing.’

— Emily Brunson, MPH, Ph.D., Associate Professor of Anthropology at Texas State University

Recommendations

Overcome abstraction with messages that situate the importance in terms of local threat, likelihood, timeliness, and possible harm to people like you.

Use definitions and details rather than acronyms and jargon.

Identify messages that are consistent even as knowledge evolves—like the process for creating a vaccine.

Build a narrative. Situate facts within stories of individuals reclaiming control of their lives to make them believable and relatable.

Try flipping the themes of choice, regret and control and frame them in a positive way to increase vaccine uptake. 

When a COVID-19 vaccine is released a strong majority think there should be data available showing how many people in their country are taking it.

87% of respondents agreed or strongly agreed that data should be made available on how many people are taking a COVID-19 vaccine in their country.

Do you agree that since vaccines have saved many human lives around the world, taking a COVID-19 vaccine would also save lives?

87% of respondents agreed or strongly agreed that since vaccines are effective in saving lives a COVID-19 vaccine will also save lives. This was one of the strongest messages tested in this survey.