WASHINGTON — The Trump administration, scrambling to make up for lost time after a halting start, is rushing to roll out a $250 million public education campaign to encourage Americans to take the coronavirus vaccine, which will reach the first patients in the United States this week.
Federal officials acknowledge the effort will be a complicated one. It must compete with public doubt and mistrust of government programs amid deep political divisions created in part by a president who has spent much of the year belittling government scientists, promoting ineffective treatments and dismissing the seriousness of the pandemic — and is now rushing to claim credit for a vaccine that he has made a priority.
“When you have an anti-science element together with a divisiveness in the country, it will be challenging,” Dr. Anthony Fauci, the government’s top infectious disease expert, said in an interview Friday, while declining to talk specifically about President Donald Trump. “But you know, we’ve done challenging things before.”
The Building Vaccine Confidence campaign, overseen by the Department of Health and Human Services, will unfold in an atmosphere of hope as vaccinations begin — but also despair as daily death tolls from COVID-19 approach 2,500 and the United States nears 300,000 total deaths. The campaign is part of a broader public relations effort that was initially supposed to feature celebrities whom the administration considered friendly to the president but came under scrutiny from Democrats who called it propaganda intended to reelect Trump.
The celebrity component — which was to include actor Dennis Quaid and country singer Billy Ray Cyrus — was scrapped after an inquiry by House Democrats prompted Alex Azar, the health secretary, to order an internal review of the plan. The new initiative will take a “science-based approach,” said Mark Weber, the federal health official who is running it, and will begin this week with a first wave of advertisements in print, social media and radio, with television advertising added when the vaccine becomes more broadly available.
Azar’s review, which concluded Nov. 13, put the campaign on hold for six weeks. Now, with vaccinations beginning, it is on an extremely tight timeline. Focus groups devised to help officials fine-tune the advertising to tailor it to hard-hit communities will begin Tuesday.
The effort — developed by Fors Marsh Group, a market research group, under contract with the government — is focused on what officials are calling the movable middle: people who are hesitant to take the vaccine, but who can be persuaded to do so. But that will not be an easy task.
“I have advised my team that we recognize our operating environment is complicated, we have a public health mission, and we need to stay focused on that,” said Weber, a 30-year career government official who has a master’s degree in marketing. He acknowledged that the campaign was battling “a credibility factor right now,” with a high level of distrust in government and fears about the safety of a vaccine that was produced in record time.
A majority of Americans — 60% — now say they will “definitely or probably” get a coronavirus vaccine, according to a survey released this month by the Pew Research Center. But strong anti-vaccination sentiment remains: 21% of American adults do not intend to be vaccinated and are “pretty certain” more information will not change their minds, the survey found.
Recent surveys show that women are more apprehensive about vaccination than men, with Black Americans the most hesitant group by race. Health officials are aware that they must dispel doubts about safety and enduring concerns over examples of unethical medical research in the United States, especially in African American, Latino and Native American communities that have been hit especially hard by the coronavirus.
Even health care workers, who otherwise have among the highest rates of vaccine uptake, are apprehensive: In a survey in October by the American Nurses Foundation about a coronavirus vaccine, 37% said they were “not confident” that it would be safe and effective; 48% were “somewhat confident.”
Partisanship plays a role; Democrats are now more likely to want to be vaccinated than Republicans. In the fall, as Trump promised that a vaccine could be ready around Election Day, confidence among Republicans grew as did distrust among Democrats. But those trends have effectively flipped with President-elect Joe Biden’s victory, said Matthew Motta, a political scientist at Oklahoma State University who studies politics and vaccine views.
“That implies that our intentions to vaccinate are very much tied to what our political leaders are saying,” Motta said. “So a bipartisan messaging strategy is very much needed.”
Trump has been eager to claim credit for driving the development of a vaccine in record time and does not want to share that recognition with his successor.
But Trump’s role in promoting vaccination would be extremely contentious. It would come after months in which he played down the threat of the virus, railed against common-sense measures like mask wearing to slow the spread of the disease and embraced bogus therapeutics that health professionals said were unproven and potentially dangerous.
“There is a bit of a whipsaw effect,” said Joel White, a Republican strategist who focuses on health policy. “If Trump is out there making a big stink about people getting the vaccine and needing to do it, I could see Democrats being turned off — and Blacks and Latinos in particular. But if he does nothing, then the Trump supporters might not be vaccinated because they would see that as a sign.”
Because the president has had COVID-19, he technically should be at the back of the line of people waiting for shots, but the sight of him being injected could be useful. At the White House, officials said having Trump take the vaccine publicly was “certainly under consideration,” although they noted that it might not affect public opinion since people know he has recovered. (Experts say that those who have survived COVID-19 may be at risk for reinfection and could benefit from vaccination.)
Fauci, for his part, intends to “get vaccinated publicly,” he said Friday, as “soon as the vaccine becomes available to me,” as a way of shoring up public support. Aides to Vice President Mike Pence are deliberating about when and how he will be inoculated and whether he would do it in public.
Trump’s three presidential predecessors — Barack Obama, George W. Bush and Bill Clinton — have all said they are willing to be vaccinated on camera. In 2009, Obama and his wife, Michelle, made a public show of getting vaccinated against the H1N1 influenza virus, waiting their turn until after children had been given the vaccine.
“People need to understand that this vaccine is safe,” Barack Obama said then. The White House website posted a photograph of him rolling up his sleeve for the shot.
Biden is already using his platform to encourage Americans to be vaccinated.
“I want to make it clear to the public: You should have confidence in this,” he said Friday at an event in Wilmington, Delaware. “There is no political influence. These are first-rate scientists taking their time looking at all of the elements that need to be looked at. Scientific integrity led us to this point.”
Dr. David A. Kessler, a former commissioner of the Food and Drug Administration who advises the president-elect on the pandemic, said in an interview that the Biden team was working with medical organizations and other groups to come up with “the most creative, transparent and effective ways” to educate the public, including using a “range of respected voices — both local and national.”
Alongside that effort will be an equally important campaign aimed at doctors and professionals to whom patients will turn for advice. That was crucial, Kessler said, in ensuring that ordinary people were confident in the vaccine.
The Centers for Disease Control and Prevention says it will run its own effort to educate medical professionals; it is planning an online vaccine safety seminar for doctors and clinicians on Monday.
The Health and Human Services public education campaign — and its celebrity component — was conceived by Michael Caputo, the assistant secretary of health for public affairs and an ardent Trump loyalist, who went on extended medical leave in September after a bizarre and incendiary outburst on Facebook in which he accused federal government scientists working on the pandemic of “sedition” and warned of impending violence from left-wing “hit squads.”
The Health and Human Services campaign included a $15 million component aimed at bolstering the national mood. One theme included promoting the notion that “helping the president will help the country,” according to documents obtained by congressional Democrats.
The documents showed that the administration tracked the views of at least 274 entertainers under consideration but that all but 10 were ruled out. Christina Aguilera, for example, was deemed an “Obama-supporting Democrat,” while Jennifer Lopez was cast aside because she “made a political statement during her Super Bowl performance to address the president’s immigration policies.”
Caputo had even offered early access to a vaccine to a group of performers who play Santa Claus, Mrs. Claus and elves. In recordings obtained by The Wall Street Journal, Caputo described the Santas as “essential workers”; the plan was for them to appear at vaccine rollouts in up to 35 cities.
Weber, who oversees the new program, said he had pulled together officials from across the government — including the Food and Drug Administration and the Census Bureau — to work on the campaign.
Some early educational videos, produced in-house by the Department of Health and Human Services, are already appearing on social media platforms as part of a program the administration calls “Tell Me More.” In one, Fauci talks about vaccines as “one of the great triumphs” of science. Another video features Fauci; Dr. Stephen M. Hahn, the FDA commissioner, and Dr. Moncef Slaoui, the head of the government’s vaccine initiative, explaining the drug’s development process.
The first wave of the national advertising campaign will begin this week, Weber said. Once the campaign gains momentum, the government intends to use focus groups to help officials refine and target their digital advertising to communities that are disproportionally affected by the virus, Weber said. He added that the campaign would also be evaluated scientifically to determine whether it made a difference in vaccination rates.
But the road ahead is delicate. Because the vaccine is scarce, Weber said, the administration must be mindful of its timing; officials do not want to generate enthusiasm for a product people cannot get.
“This is exciting; the vaccines have been developed in record time,” he said. “But we have to be careful not to generate demand before they are available to the broader public.”