国际战略研究中心-为什么疫苗信心事关国家安全（英文）-2021.5-45正式版

MAY2021

WhyVaccineConfidenceMatterstoNationalSecurity

areportofthecsis-lshtmhigh-levelpanelonvaccineconfidenceandmisinformation

CO-CHAIRS PROJECTDIRECTOR

HeidiJ.Larson KatherineE.Bliss

J.StephenMorrison

MAY2021

WhyVaccineConfidenceMatterstoNationalSecurity

areportofthecsis-lshtmhigh-levelpanelonvaccineconfidenceandmisinformation

CO-CHAIRS PROJECTDIRECTOR

HeidiJ.Larson KatherineE.Bliss

J.StephenMorrison

AboutCSIS

TheCenterforStrategicandInternationalStudies(CSIS)isabipartisan,nonprofitpolicyresearchorganizationdedicatedtoadvancingpracticalideastoaddresstheworld’sgreatestchallenges.

ThomasJ.PritzkerwasnamedchairmanoftheCSISBoardofTrusteesin2015,succeedingformerU.S.senatorSamNunn(D-GA).Foundedin1962,CSISisledbyJohnJ.Hamre,whohasservedaspresidentandchiefexecutiveofficersince2000.

CSIS’spurposeistodefinethefutureofnationalsecurity.Weareguidedbyadistinctsetofvalues—nonpartisanship,independentthought,innovativethinking,cross-disciplinaryscholarship,integrityandprofessionalism,andtalentdevelopment.CSIS’svaluesworkinconcerttowardthegoalofmakingreal-worldimpact.

CSISscholarsbringtheirpolicyexpertise,judgment,androbustnetworkstotheirresearch,analysis,andrecommendations.Weorganizeconferences,publish,lecture,andmakemediaappearancesthataimtoincreasetheknowledge,awareness,andsalienceofpolicyissueswithrelevantstakeholdersandtheinterestedpublic.

CSIShasimpactwhenourresearchhelpstoinformthedecisionmakingofkeypolicymakersandthethinkingofkeyinfluencers.Weworktowardavisionofasaferandmoreprosperousworld.

CSISdoesnottakespecificpolicypositions;accordingly,allviewsexpressedhereinshouldbeunderstoodtobesolelythoseoftheauthor(s).

©2021bytheCenterforStrategicandInternationalStudies.Allrightsreserved.

AbouttheCSISGlobalHealthPolicyCenter

Since2008,theGlobalHealthPolicyCenter’sgoalhasbeentogenerateindependent,forward-thinking,andmultifacetedanalysesthatreachabipartisanaudienceandshapeU.S.policyapproachesonglobalhealth.Wedothisbyundertakingpolicy-relevantresearchandbringingtogetherdiversestakeholders—U.S.policymakersfromacrosstheaisle,globalhealthexperts,andglobalhealthandforeignpolicypractitioners—todiscusscriticalissuesanddeveloprecommendationsregardingU.S.globalhealthleadership,policies,andprograms.Todothis,wecapitalizeonourexpertiseinhealthsecurity,infectiousdisease,andwomen’sandfamilyhealth,aswellastheexpertiseofthebroaderCSISexpertcommunityonregionalpolitics,nationalsecurity,anddevelopmentchallenges,toexaminethegeopoliticalissuesaffectingcurrentandfutureglobalhealthactivities.

CenterforStrategic&InternationalStudies

1616RhodeIslandAvenue,NW

Washington,DC20036

202-887-0200|

II

whyvaccineconfidencematterstonationalsecurity

AbouttheLSHTM

VaccineConfidenceProject™

TheVaccineConfidenceProject™(VCP)wasestablishedin2010tomonitorpublicconfidenceinimmunizationprogramsbybuildinganinformationsurveillancesystemforearlydetectionofpublicconcernsaroundvaccines;byapplyingadiagnostictooltodatacollectedtodeterminetherisklevelofpublicconcernsintermsoftheirpotentialtodisruptvaccineprograms;and,finally,toprovideanalysisandguidanceforearlyresponseandengagementwiththepublictoensuresustainedconfidenceinvaccinesandimmunization.TheVCP™alsodevelopedaVaccineConfidenceIndex™asatoolformappingandmonitoringconfidenceglobally.

LedbyProf.HeidiJ.Larson,theVCP™teamisaninterdisciplinaryandinternationalgroupofresearcherswithexpertiseinanthropology,digitalanalytics,epidemiology,policy,psychology,riskcommunications,andmathematicalmodelling.Vaccineconfidenceisnotaone-dimensionalissue,andsotheVCP™cutsacrossdisciplinestoproduceinnovativeresearchandpolicyrecommendations.

WhiletheVCP™isaglobalnetworkofresearchersandanalysts,thecoreteamisbasedattheLondonSchoolofHygiene&TropicalMedicine(LSHTM).Foundedin1899,theSchoolisrenownedforitsresearch,postgraduatestudies,andcontinuingeducationinpublicandglobalhealth.TheSchoolhasaninternationalpresenceandcollaborativeethos,andisuniquelyplacedtohelpshapehealthpolicyandtranslateresearchfindingsintotangibleimpact.

III

whyvaccineconfidencematterstonationalsecurity

AbouttheHigh-LevelPanelonVaccineConfidenceandMisinformation

InJuly2020,theCenterforStrategicandInternationalStudies’(CSIS)GlobalHealthPolicyCenterandtheLondonSchoolofHygiene&TropicalMedicine’s(LSHTM)VaccineConfidenceProject™convenedahigh-levelpanelofexpertstoconsidertheurgentchallengesofvaccinehesitancy,misinformation,andU.S.nationalsecurity.InOctober2020,thepanelissuedacalltoactiontoaddresstheseissuesinthecontextoftheCovid-19crisis.

Thepanelisco-chairedbyJ.StephenMorrison,seniorvicepresidentanddirectoroftheCSISGlobalHealthPolicyCenter,andHeidiJ.Larson,professorofanthropology,risk,anddecisionscienceanddirectoroftheVaccineConfidenceProject™attheLondonSchoolofHygiene&TropicalMedicine.Thepanel’ssecretariatisbasedattheCSISGlobalHealthPolicyCenterandisheadedbyKatherineE.Bliss,projectdirectorandseniorfellow,andsupportedbyMichaelaSimoneau,programmanager.

Acknowledgments

ThepanelisgratefultoMichaelaSimoneau,forcoordinatingtheworkofthehigh-levelpanel’ssecretariatandforheranalyticalcontributionstothegraphicelementsinthereport;SamanthaChivers,forsupportingcommunicationsassociatedwiththepanel’seventsandpublications;MotiHeda,MaggieHicks,NoelleHuhn,LaurenMann,andMichaelRendelmanforresearchassistance;andtheCSISGlobalHealthPolicyCenterstafffortheirsupportofthisproject.SpecialthanksalsototheentireteamfromtheCSISDracopoulosiDeasLabfortheirprodigiouseffortsproducingthisreportandtheassociatedmultimediaproducts.

Thepanel’sworkissupportedbyagrantfromtheRobertWoodJohnsonFoundation.

Theviewsexpressedheredonotnecessarilyreflecttheviewsofthefoundation.

IV

whyvaccineconfidencematterstonationalsecurity

LetterfromtheCo-Chairs

AsthesecondyearoftheCovid-19pandemicunfolds,theUnitedStateshasenteredanewphaseofheightenedhopeintheracetocontrolthepandemicandgetaheadofevolvingvariants,withanimperativetomovewithacceleratedspeedtovaccinateatscaleandtoaddressdisparitiesathomeandabroad.

WheredoestheUnitedStatesremainmostvulnerable?Publictrustandconfidenceinvaccines,inscience,andinpublichealthauthoritiesremainfragilebutabsolutelypivotaldimensionsofvaccineacceptance.Awearyandoftenskepticalpublicsearchesforanswersinaconfusinginformationenvironment,besetbymisinformation,falsehoods,andconspiracies.HistoricallegaciesandpartisandivisionsintheUnitedStatesshapeattitudesinprofoundways.Solutionsarenotimmediatelyevident,simple,oreasytoimplement.IntheUnitedStatesandelsewhere,widespreadvaccinehesitancyandrefusal,ifnotaddressedstrategicallyandsensitively,canbesignificantbarrierstoachievingherdimmunity,reopeningeconomiesandsociety,andeasingracialandsocialstrife.Thesearematters,atbase,ofU.S.nationalsecurity.

LaunchedinJuly2020,theHigh-LevelPanelonVaccineConfidenceandMisinformation,jointlyorganizedbytheCSISGlobalHealthPolicyCenterandtheLondonSchoolofHygiene&TropicalMedicine’sVaccineConfidenceProject™,hasbroughttogetherexpertsinpublichealth,cybersecurity,nationalsecurity,andthesocialsciences.Itsmandateistounravelthetangledweboffactorsshapingvaccinebehaviorsandchoicesandtoidentifyconcretemeasuresthatwillstrengthentrustandconfidence.Muchcanbegained,inourview,throughenhancedandinnovativeengagementandpartnershipsthatimprovecommunityperceptionandunderstandingofpublichealthpoliciesandthescienceandvaluesthatinformthem.Ifsuccessful,theseactionscanbetterprotectAmericans’health,promoteU.S.nationalsecurity,andinformU.S.internationalengagementtosupportsimilargainsglobally.

Weinviteyoutoreadthepanel’sreportandrecommendations,hopeyoufindthemtimelyanduseful,andwelcomeyourthoughts.

HEIDIJ.LARSON J.STEPHENMORRISON

ProfessorofAnthropology,Risk,andDecisionScience SeniorVicePresident

Director,VaccineConfidenceProject™ Director,GlobalHealthPolicyCenter

LondonSchoolofHygiene&TropicalMedicine CenterforStrategicandInternationalStudies

V

whyvaccineconfidencematterstonationalsecurity

MembersoftheCSIS-LSHTMHigh-LevelPanelonVaccineConfidenceandMisinformation

VI

whyvaccineconfidencematters

CONGRESSMANAMIBERA(D-CA-07)

U.S.HouseofRepresentatives

MOLLYANNBRODIE

ExecutiveVicePresident,COO,andExecutiveDirector,

PublicOpinionandSurveyResearch

KaiserFamilyFoundation

DAVIDA.BRONIATOWSKI

AssociateProfessorofEngineeringManagementandSystemsEngineeringandAssociateDirector,InstituteforData,Democracy,andPoliticsTheGeorgeWashingtonUniversity

SUSANW.BROOKS

FormerCongresswoman(R-IN-05)

U.S.HouseofRepresentatives

FREDERICKR.CHANG

Chair,ComputerScienceDepartment,

LyleSchoolofEngineering

SouthernMethodistUniversity

RENÉEDIRESTA

TechnicalResearchManager,

StanfordInternetObservatory

StanfordUniversity

CARYFUNK

Director,ScienceandSocietyResearch

PewResearchCenter

BRUCEGELLIN

President,GlobalImmunization

SabinVaccineInstitute

DENISEA.GRAY-FELDER

FoundingPresidentandCEO

CommunicationforSocialChangeConsortium

MARGARET“PEGGY”HAMBURG

InterimVicePresident,GlobalBiologicalPolicy

andPrograms,NuclearThreatInitiative

andFormerCommissioner

U.S.FoodandDrugAdministration

JOHNNYHEALD

ChiefExecutiveOfficer

ORBInternational

REBECCAHERSMAN

SeniorAdvisorandDirector,ProjectonNuclearIssuesCSISInternationalSecurityProgram

KATEJOHNSON

FormerProgramDirector,CenterforBestPractices,NationalGovernorsAssociation

DeputyDirector,MedicaidPolicy&ProgramsAurreraHealthGroup

JULIETTEKAYYEM

SeniorBelferLecturerinInternationalSecurityHarvardKennedySchool

JAMESA.LEWIS

SeniorVicePresidentandDirector

CSISStrategicTechnologiesProgram

LAQUANDRAS.NESBITT

Director

DistrictofColumbiaDepartmentofHealth

JOEROSPARS

Founder&CEO

BlueState

UMAIRA.SHAH

SecretaryofHealth

WashingtonStateDepartmentofHealth

tonationalsecurity

SARAHSHIRAZYAN

LecturerinLaw,StanfordLawSchool

andContentPolicyManager

Facebook,Inc.

JULIASPENCER

AssociateVicePresident,GlobalVaccinesPublicPolicy,

Partnerships,andGovernmentAffairs

Merck&Co.,Inc.

CLAIREWARDLE

Co-FounderandU.S.Director

FirstDraft

ELIZABETHWEHR

StrategyandPolicyAdvisor

ParsonsCorporation

JUANZARATE

GlobalCo-ManagingPartner&ChiefStrategyOfficerK2Integrity

Disclaimer

Thepanelistsparticipatedintheirindividualcapacities,notasrepresentativesoftheirrespectiveorganizations.Thisreportrepresentsamajorityconsensus;nopanelistisexpectedtoendorseeverysinglepointcontainedinthedocument.Inbecomingasignatorytothereport,panelistsaffirmtheirbroadagreementwithitsfindingsandrecommendations.Languageincludedinthisreportdoesnotimplyinstitutionalendorsementbytheorganizationsthatpanelistsrepresent,andtheopinionsexpressedherein,includinganyimplicationsforpolicy,shouldnotbeattributedtothoseorganizations.

VII

whyvaccineconfidencematterstonationalsecurity

Contents

LetterfromtheCo-Chairs

V

MembersoftheCSIS-LSHTMHigh-LevelPanelonVaccineConfidenceandMisinformation

VI

Introduction

1

ACrisisDecadesintheMaking:VaccineHesitancyfromSmallpoxtoCovid-19

6

HealthandCommunitywithintheInformationRevolution

12

VaccinesforHealthandNationalSecurity

17

Recommendations:BolsteringConfidenceNowandPreparingfortheFuture

21

Endnotes

27

VIII

whyvaccineconfidencematterstonationalsecurity

CHAPTER01

Introduction

photosource:patrickt.fallon/afp/gettyimages

SINCEJANUARY2020,THEOUTBREAKOFNOVELCORONAVIRUSINTHEUNITEDSTATESHASLEDTOMORETHAN32MILLIONCONFIRMEDCASES,ANDMORETHAN577,000DEATHS,WITHSEVERALSTATESREPORTINGHOSPITALSYSTEMSANDINTENSIVECAREUNITSAT,OROVER,CAPACITY.

TheUnitedStatesleadstheworldwithmorethanone-fifthofthemorethan153millionreportedcasesandnearly20percentofallreporteddeaths.1

ConfirmedCovid-19casesintheUnitedStateshavevariedbystateandcounty,withminoritygroupsbeinghitespeciallyhard.2Ofthe15.9millioncasesforwhichraceorethnicitydatawasavailableonMay3,2021,29.1percentwereHispanic/Latino,yetHispanicsaccountforanestimated18.5percentofthepopulation.3AndBlacks,anestimated12.5percentoftheU.S.population,accountfornearly14percentofdeaths.

UndertheadministrationofDonaldJ.Trump,thefederalgovernmentinvestedbillionsoftaxpayerdollarsintoOperationWarpSpeed(OWS),apublic-privatepartnershipledbytheDepartmentsofDefenseandHealthandHumanServicesandinvolvingmultiplefederalagenciesandpharmaceuticalcompanies,withtheintentofdeliveringmorethan300millionvaccinestopeoplelivingintheUnitedStatesbytheendof2021.

InDecemberof2020,theFoodandDrugAdministration(FDA)grantedemergencyuseauthorizationfortwovaccines,andonFebruary26itsVaccinesandRelatedBiological

ProductsAdvisoryCommittee(VRBPAC)approvedtheapplicationofJanssenBiotechInc.(Johnson&Johnson)foremergencyuseauthorizationforitsonedosevaccine.4FollowingthecompletionofitsownphaseIIIclinicaltrials,AstraZenecaalsoindicatedonMarch22thatitwillpreparetoseekFDAemergencyuseauthorizationintheUnitedStates.5TheDepartmentofHealthandHumanServices(HHS)hasallocatedshipmentsofvaccinestostates,territories,tribalareas,andmajorurbancenters,leavingdistributionplanninglargelyuptolocalgoverningbodiesinthoseentities.6

Incommunitiesacrossthecountry,thepercentageofpositivetestsinminoritycommunitieshasbeenroutinelyhigherthanmajoritywhiteneighborhoodsinthesameareas,andyetearlyvaccinedistributiondatashowsthatwhiteswithineligiblerecipientgroupshavesecuredadisproportionatelyhighpercentageofavailablevaccines.7

“TherehavebeenalotofopportunitiestotalkaboutthereasonswhywehavedisparitiesinCovid-relatedoutcomesintheUnitedStates.Thesedisparitiesarenotduetotheacutenatureoftheemerginginfectiousdisease,butarerootedinthesystemicnatureofwhatcausesdisparitiesinhealthoutcomesandhealthcaredisparitiesoverall.InordertoeliminatethesedisparitiesinCovid-19-relatedoutcomes,whetheritbetreatmentdisparitiesorthevaccinedisparitiesthatwehavethepotentialtosee,weneedtoengagemultiplesectorsofgovernmentbeyondgovernmentalpublichealthintheCovid-19response.”

LaQuandraS.Nesbitt,

DistrictofColumbiaDepartmentofHealth

DifferentialaccesstoonlineregistrationservicesoravailabilitytowaitatmassvaccinationsitesduringworkdayhoursmayaccountforsomeoftheracialdisparitiesinaccesstotheCovid-19vaccines.Atthesametime,historicexperienceofdiscriminationwithinthehealthsystemiscontributingtovaccinehesitancyonthepartofmanyBlackandLatinopopulations.8

InsufficientattentionhasbeenpaidtohesitancyandvaccinerefusalamongRepublicans,includingruralRepublicanvoters.RecentsurveysshowthatalmosthalfofRepublicanmendonotintendtogetaCovid-19vaccine.9And44percentofRepublicansindicatetheywillprobablynot,ordefinitelynot,bevaccinated.10AmongDemocrats,thenumberismuch

2

whyvaccineconfidencematterstonationalsecurity

lower,at18percent.Asvaccinesupplyshiftsfromrelativescarcitytoabundance,therehavebeenincreasedcallsforformerpresidentTrumpandothertrustedRepublicanleaderstobecomemoreactiveincommunicatingthesafetyandvalueofvaccinestotheirsupporters.InhisFebruary28addresstotheConservativePoliticalActionConference(CPAC),formerpresidentTrumpstated,“Everybody,gogetyourshot.”11OnMarch16hefurtherurgedhisfollowerstobevaccinated,sayingherecommendstheshots“toalotofpeoplewhodon’twanttogetit,andalotofthosepeoplevotedforme.”12

“Thispandemichasprovidedthedeeplyunfortunateanswertothequestion:‘Willsomeleadersreallyseekadvantageforthemselvesbydeliberatelypoliticizingotherwiseuncontroversialpublichealthstepsthatpreventmassdeath?’Inacrisislikethis,responsibleleadershaveadutyofpeerpressure:topersuadecolleagueswhopossessinfluentialplatformstobevocalvaccineproponents,andtoconfrontandholdaccountabledisingenuouscolleagueswhoseektoprofitpoliticallybyperpetuatingdangertousall.”

JoeRospars,BlueState

Thespreadofmisinformationthroughface-to-faceconversationsaswellasthroughmainstreamanddigitalmediaisalsounderminingconfidenceinvaccines.Extremistgroups,includinganti-vaccinationgroups,haveusedsocialmediatospreadmisinformationandtoorganizeprotestsorotherwisedisruptvaccinationprograms.13Andforeignactors,notablyRussiaandChina,usemisinformationaboutCovid-19vaccinestoraisequestionsaboutthemotivesoftheU.S.governmentindistributingthemtounderminetheinfluenceoftheUnitedStatesabroad.

Withvaccinesofferinghopeofslowingtheoutbreak,reachingCovid-19herdimmunity,restoringeconomicgrowth,andavertingmajornationalsecuritychallenges,itisimportanttounderstandbothwhatmakespeopleconfidentorhesitantaboutvaccineswithintheCovid-19contextandtheextenttowhichmisinformationisunderminingvaccineconfidence,aswellaspoliticalstability.

InJuly2020,theCSISGlobalHealthPolicyCenterjoinedwiththeLondonSchoolofHygiene&TropicalMedicine’sVaccineConfidenceProject™toconveneabipartisanandinternationalgroupofexpertsfrompublichealth,cybersecurity,publicopinionresearch,andcommunications,

withthegoalofassessingtheimplicationsofmisinformationandvaccineconfidenceforU.S.nationalsecuritywithintheCovid-19context.Theexpertsfocusedontwokeyquestions:Inwhatwaysdovaccinehesitancyandmisinformationimpactnationalsecurity?Andwhataretheconcrete,feasiblestepsthattheU.S.government,Congress,socialmedia,industry,advocates,andcommunityleadersshouldstandbehindtoimproveAmericans’healthandsecurity?

TheHigh-LevelPanelonVaccineConfidenceandMisinformationisco-chairedbyJ.StephenMorrison,seniorvicepresidentatCSISanddirectoroftheGlobalHealthPolicyCenter,andHeidiJ.Larson,professorofanthropology,risk,anddecisionscienceattheLondonSchoolandfoundingdirectorofitsVaccineConfidenceProject™.KatherineE.Bliss,seniorfellowwiththeCSISGlobalHealthPolicyCenter,istheprojectdirector.

Asthepanelmet(virtually)overthesummerandfall,memberswereemphaticaboutthreethings:

ThedangerouslylowlevelsofpublicconfidenceinCovid-19vaccinesbeingreportedrepresentaclearthreattothepotentialoftheUnitedStatestoeffectivelycontrolandrecoverfromthepandemic.

Makingsafeandhighlyeffectivevaccinesaccessiblequicklyandequitablyiskeytoescapingtheburdenofanuncontrolledpandemicandreopeningtheeconomyandsociety.Atthesametime,thevaccinesmustbedeliveredtothepublicinacoordinatedandequitableprocessbuiltonreliabledata,activeoutreach,andsensitivitytohistorytoensurepublicconfidenceinthem.

AddressingthechallengesofmisinformationanddisinformationaboutCovid-19vaccinesrequiresamultidisciplinary,multiprongedapproach.

InOctober,thepanelissuedacalltoaction,definingthechallengeofwaningvaccineconfidenceandmisinformationaboutvaccinesasanationalsecuritythreat.14

ThisreportbuildsonthatcalltoactionandrecommendsfivestepstoaddressthechallengesofvaccineconfidenceandmisinformationwithintheCovid-19context:

Innovationsinreachingdiverseandunderservedpopulationswithvaccinesdeliveredinthecontextofhealthandsocialservices.

Pledgesandactionsbymainstreamanddigitalmediaplatformstostopthespreadofmisinformationandtocollaboratewithhealthprovidersandthe

3

whyvaccineconfidencematterstonationalsecurity

scientificcommunitytoincreasetheavailabilityofaccuratecontent.

IncreasedengagementbykeysocialandeconomicsectorstoempowerpeopletomakeinformedchoicesaboutCovid-19vaccines.

Greaterexecutivebranchcoordinationandactionbeyondtheemergency.

IncreasedU.S.supportforglobalimmunizationpartners.

SinceOctober,thepanelhashostedaseriesofpublicdiscussionstofacilitateinteractionwithabroadsetofactorsonwaystobolstervaccineconfidencewithintheU.S.pandemiccontext.TheseonlineconversationshaveofferedanopportunitytorefinetheoriginalrecommendationsandreflectontheimplicationsofthepoliticaltransitionandneweffortsonthepartoftheBidenadministrationtostrengthenpublicconfidenceinCovid-19vaccines.

Anumberofeducationalprogramshavebegunreachingouttokeypopulationstohelpthosewhoarehesitant

makeinformeddecisionsaboutCovid-19vaccines.TheAdCouncilandCOVIDCollaborativehavelauncheda$50millioncampaign—theCOVID-19VaccineEducationInitiative—toreachthecommunitieshardesthitbythepandemicwiththemessagethat“It’sUptoYou.”15Itisalsoencouragingsocialmedia“influencers”tosharephotographsandmessagespromotingthevaccines.16

“Weneedtolookfortrustedleadersincommunities,trainthemup,andallowthemtodeliverthemessage.Thatreallyhasbeenshown,inmanysettings,tobeaneffectivewaytogetapublichealthmessageout.Itisnotanexternalpersoncomingintoacommunitytotellyouwhatyouneedtodo.Itissomeonewhoalreadyhasaleveloftrust,armingthemwiththeinformationanddataandlettingthemdeliverthatinformationanddatainthelanguageandthemethodsthatworkwithinthosecommunities.”

CongressmanAmiBera(D-CA-07)

4

whyvaccineconfidencematterstonationalsecurity

PeoplelineupearlyattheJacobJavitsConventionCenterCovid-19vaccinationhubonMarch4,2021,inNewYorkCity.

timothya.clary/afp/gettyimages

TheBlackCoalitionAgainstCOVID-19hasmobilizedhealthcarepersonnelandotherfrontlineworkerstoaddressthe“reluctanceonthepartofmanyAmericans,butparticularlyAmericansofcolor,tofollowtheguidancethathasbeenofferedand,also,averygreatreluctancetobewillingtoparticipateintheclinicaltrialsforthevaccineandforacceptingavaccineoncesafeandproven.”17AndtheCONVINCEprojectisa“globalinitiativetopromotevaccineliteracygenerallyandconfidenceinCOVID-19vaccinesinparticular.”18

“Thereisalotmoreawarenesstodayofthewaysinwhichhealthmisinformationcanbedeeplysociallyharmful:theorganizationsthathavetocounterthesenarrativesaretakingsocialmediacontentmoreseriously,andtheplatformsarefinallythinkingaboutimprovingcurationinwhattheysurface.Counteringhealthmisinformationreallyrequiresawholeofsocietyapproach.Myhopeisthat,particularlygiventheimpactfulexperienceofthepandemic,wewillseesustainedfocusondevelopingsolutionsthatwillallowustodevelopabetterinformationecosystemoverall.”

RenéeDiResta,StanfordInternetObservatory

Socialmediacompanieshavetakendeliberatestepstocollaboratewithpublichealthauthorities,includingsteppingupfact-checkingefforts,banningadsthatmakefalseclaimsaboutCovid-19vaccines,directingreadersawayfromwhatisdeterminedtobemisinformationandtowardpublichealthsites,andalteringalgorithmicmethodstoreducetheamplificationoffalseorinaccurateinformationaboutvaccines.19Facebookhasannouncedtheformationofanindependentoversightboardtoadviseonthecorrectbalancebetweenfreedomofexpressionandfreedomfromdangerousmisinformation,andthecompanyhastakenmeasurestoconnectuserswithonlinetoolsthatcanhelpthemlearnwhenandwheretheycangetaCovid-19vaccine.20

SincethepresidentialtransitioninJanuary,theBidenadministrationhasmadebolsteringvaccineconfidenceapriority,issuinganexecutiveordercreatingaCovid-19EquityTaskForceandsituatingfederalvaccinationcentersinminoritycommunitieshardesthitbythepandemic.21Withambitiousgoalstoacceleratethedistributionofvaccines,

theadministrationannouncedanagreementonFebruary11withPfizer/BioNTechandModernaforthepurchaseofanadditional200milliondoses,ensuringenoughsupplytovaccinateeveryadultintheUnitedStatesbyJuly2021.22InearlyMarch,theBidenadministrationannouncedaplantopurchaseadditionaldosesoftherecentlyauthorizedJohnson

Johnsonvaccine,madepossiblethroughaWhiteHouse-brokeredproductionarrangementwithMerck&Co.23Andduringhistelevisedspeechontheone-yearanniversaryoftheWorldHealthOrganization’s(WHO)declarationthatCovid-19wasapandemic,PresidentBidendirectedallstatesandterritoriestomakeallpeopleage18andoldereligibleforvaccinesbyMay1,2020.24

TherecentpassageoftheAmericanRescuePlanActof2021,a$1.9trillionbill,isavitallyimportantstepandincludesupto$1billiontosupporttheU.S.CentersforDiseaseControlandPrevention(CDC)inconductingeducationdedicatedtobuildingconfidenceinvaccines,includingCovid-19vaccines.25AndaWhiteHouseannouncementonMarch25promisestocommitadditionalresourcestobringfederalinvestmentsforvaccineconfidence-boostingactivitiesupto$3billion,witha“focusonreachingcommunitieshardesthitbythepandemic.”26

“Restoringvaccineconfidenceiscriticaltorestoringthepublichealth,economy,andsocialcohesionofourcountry—aswellasstrengtheningournationalsecurityandpreparedness.Unfortunately,vaccinationshavealsobecomeadomainofcompetitionanddisinformationstokedbythosesee