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Introduction
In early July 2021, Gov. Larry Hogan announced that Maryland would award 20 $50,000 college
scholarships to young people who are vaccinated against COVID-19. A month earlier, West Virginia Gov. Jim Justice had announced a plethora of COVID-19 vaccine incentives, including a $1.5 million cash prize, trucks, hunting rifles, and shotguns.
These decisions illustrate how ubiquitous the issue of vaccine uptake and how to increase it has been in American public and political discourse since the start of the COVID-19 pandemic. Experts recognize that vaccine uptake is shaped, not only by individuals’ level of confidence in vaccines and their willingness to get the shots they need, but also by systemic barriers that only policy and structural changes can address. However, the media, government, and even some stakeholders in the medical community, consistently make the issue of vaccination first and foremost about vaccine confidence and safety. Consequently, strategies are formed to nudge individuals to get their recommended shots. There is no doubt that all vaccine supporters in the field share the same ultimate goal of increasing rates of vaccine uptake across the country. What is much less clear is whether placing individual behavior change and the safety of vaccines at the center of most communications strategies is the most effective way of reaching that goal.
This research project, conducted by the FrameWorks Institute in partnership with the American Academy of Pediatrics, proposes an in-depth exploration of this question. It builds on the premise that rates of vaccine uptake, as well as individual attitudes and behaviors towards vaccination, are importantly shaped by access to quality health care, information and knowledge about the science of vaccines, and structural discrimination and racism in a health
care context. Our ultimate goal with this work is to identify framing strategies that can build better public understanding of the science of vaccines, public support for structural measures and policies to improve access to vaccination and vaccine uptake, as well as a sense of collective responsibility for the issue, while still supporting efforts to effect behavior change at the individual level.