The American Medical Association (AMA) strongly endorses COVID-19 vaccination and in an attempt to help improve vaccination rates, they are providing important information about the dangerous Delta variant. AMA Chief Health and Science Officer Mira Irons, MD, and AMA Board of Trustees Chair-elect and liaison to the CDC’s Advisory Committee on Immunization Practices Sandra Fryhofer, MD, wanted patients to know the following information about the current state of COVID-19:

• The Delta variant is spreading rapidly and will likely become the dominant strain soon
• The Delta variant is the most contagious and severe variant, but two doses of a mRNA vaccine protects individuals against it
• There are at least four variants of concern that may be more transmissible, cause more severe disease, and become more resistant to vaccines and antibody therapies
• Because variants are unpredictable, everyone will likely need a booster at some point
• The best protection again COVID-19 variants is vaccination

It is not just the AMA who is trying to increase understanding of the dangers of new variants through various communication channels.

An internal CDC document warns about the severity of the Delta variant and strongly urges new messaging to persuade people to be vaccinated. This article in the Washington Post summarizes that report, which highlights the dire need to focus public health messaging on vaccination being the best defense against the highly contagious variant because of its effectiveness. Additionally, stressing how this variant spreads more rapidly than even the common cold is key to encourage people, vaccinated or not, to still take the necessary precaution of wearing a mask indoors. Clearly discussing breakthrough cases to encourage this behavior is also needed to regain trust with public health officials so they will engage in recommended behaviors. Inconsistent or absent communication from public officials has created mistrust and confusion. It is important to shift the way people think about the virus; focusing on preventing serious disease and disability, instead of eradicating the virus, is a priority.

Clear and consistent messaging is vital for focusing how people think about COVID-19 and its vaccines. This letter published in the Journal of Communication in Healthcare summarizes recent research about the importance language choice for clear and effective messaging. The findings suggest the most effective messages do the following:

• State the benefits of taking the vaccine instead of the consequences of not taking it
• Address fear and anxiety by communicating the vaccine’s efficacy
• Build trust by precisely explaining the timeline for vaccine approval
• Use positive language
• Humanize, personalize, and individualize language about the pandemic
• Tailor messages for each audience

Because vaccination is the best protection against COVID-19, the AMA is implementing communication campaigns to encourage all eligible people to be vaccinated to reach herd immunity to protect the most vulnerable populations, even though the CDC has noted that reaching herd immunity is a more challenging target because of the Delta variant. Especially reaching those who are hesitant is key to increasing vaccine uptake. In this literature review, the researchers identified demographic determinants and individual difference factors that predicted vaccine hesitancy. Table 1 of the review provides particularly useful communicative implications for each of the predictors. Taken together, the findings clearly suggest well-planned public health messages using targeted dissemination strategies are required to reach those who need it most.

The AMA offers a guide with talking points to help physicians, in particular, communicate more effectively. It’s not just health care providers though who can help people recognize and address the threat. In this article in the Harvard Business Review, the authors provide several recommendations for employers to communicate including, but not limited to, encouraging vaccination (and deciding whether a vaccine mandate makes sense for each organization), recommending masks if not requiring them, communicating exposures, and supporting mental health. Communicating with employees about these areas is important for employees to recognize the severity of the virus. Beyond work relationships, creating partnerships between health care organizations and religious institutions has been shown to be a feasible and valuable approach to mitigating COVID-19-related disparities in some communities. In this paper, the authors detail their process of building medical-religious collaborations to address COVID-19, including working with self-identified, trusted leaders to tailor public health messaging for different congregations.

Regardless of target, the AMA suggests eight evidence-based communication strategies that can be used by anyone, interpersonally or publicly, to help build confidence in COVID-19 vaccines:

1. Meet people where they are
2. Avoid repeating false claims
3. Tailor messages to specific groups
4. Adapt messages as circumstances change
5. Respond to adverse events
6. Identify trusted messengers
7. Emphasize support for vaccines
8. Leverage trusted vaccine endorsers

Finally, it is important to note that most research and suggested targets focuses on vaccine hesitant groups. However, vaccine apathy may be a fruitful focus moving forward. Overlooking this population is problematic, and messaging should be tailored specifically to those who are not necessarily hesitant, just uninterested. As noted in this viewpoint published in JAMA, addressing apathy requires a completely different communication plan than addressing hesitancy. The focus needs to be on attitude to increase interest and less on emotion, which is what hesitant messages typically address. Using sound theoretical guidance, the authors provide important distinctions for messages between the different groups:

• Message source: vaccine-apathetic individuals rely heavily on the source, who is often not the top expert
• Message characteristics: must attract attention of the individual with novel elements and not require much cognitive effort to process the message