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INTERVIEW: How to talk about COVID-19 vaccinations with EmblemHealth

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Published Apr 5, 2021 • by AHIP

Everyone is talking about COVID-19, and the words and phrases we use can affect whether people will get immunizations and vaccinations.

That’s according to a survey from New York health insurance provider EmblemHealth. These survey findings are crucial as vaccine supplies increase and become more available.

“When planning communications for the COVID-19 vaccines and other vaccinations, words matter,” said Kim Lauersdorf, Vice President of Marketing at EmblemHealth.

Lauersdorf answered some questions about the survey, the need for tailored communications strategies, and why we need to get rid of the word “shot” when communicating about COVID-19.

Tell us about the study and what it means for consumers and the health care industry?

Kim Lauersdorf: As one of the nation’s largest non-profit health insurers, EmblemHealth recently conducted a national survey on how language and health literacy affect people’s openness to receiving vaccinations and/or immunizations. Nearly 1,000 people were surveyed nationally, with a concentration in the New York tristate area, where EmblemHealth’s family of companies operate.

Results from our study showed us that in the health care industry, language matters, especially when it comes to a topic as deeply personal as what we put into our bodies like a vaccine.

Now more than ever, it is critical for the public to receive clear and timely information on vaccination safety and effectiveness—especially from trusted sources.

Of all the findings, what surprised you the most?

Lauersdorf: One of the hypotheses we wanted to test was if people associated different language with different types of vaccines. As an industry, we can use terms interchangeably, or associate a term with a type of immunization, like “immunizations” with childhood, or “vaccinations” with travel-based, and flu vaccine is often simply “shot”. We were curious if people had different associations with these various terms and if there would be clues to drive adoption.

What the study shows is people don’t have a strong association to language with types of vaccines or protection, yet their income, ethnicity, vaccination history, and health literacy correlate directly with the terminology that evokes positive association and openness to receive vaccines.

People now want to hear about how vaccines directly impact them and their families (as opposed to larger scale, total population benefit messaging).

What can health insurance providers do better when it comes to terminology and health literacy?

Lauersdorf: We, as health care experts, must move to a universal language—for all types of immunizations (e.g., MMR, Flu, DTap)—that consistently reinforces the need for people to get their immunizations through a vaccine.

Our study shows that people have a high level of understanding of the differences among terms like “vaccination,” “immunization,” “vaccine,” and “shot”. And “Vaccine” and “Immunization” are equally seen as “safe” and “effective”. However, each term has different audience appeal. For instance, Black and White populations slightly prefer “immunization”, while Latinx and Asian population slightly prefer “vaccine”, according to our study.

As health care professionals and communicators, “vaccine/vaccination” and “immunization” should be used together wherever possible to reinforce safety, prevention, and effectiveness. For example, “The COVID-19 vaccine can help immunize individuals against the coronavirus disease.”

And as health care professionals, be it providers, payers or communicators, we need to eliminate the term “shot” from our vocabulary, as it evokes negative associations that could drive hesitancy.

What should health care organizations take away from the study, what are some next steps to help drive vaccine adoption and acceptance?

Lauersdorf: As health care professionals, we need to accept responsibility when communicating to our base and know that if we are not intentional of the language we use, the voices we amplify, and the methodologies we use to get our messages out, we will perpetuate greater health disparity.

First, it’s clear that terminology matters. The widely used term “shot”, for example, evokes significant negative connotations across all populations, but specifically in low-income, younger, and Black communities. Clinically, it evokes needles, injection, and pain. Non-clinically, it evokes violence. Continued usage of the term will drive continued disparity in vaccine adoption.

Second, we must amplify trusted voices. People, across the board, trust their primary care providers above all other messengers. To take this even further, people have more trust in primary care providers who look like them or come from their same communities.

In addition, word of mouth—especially from trusted sources—is as important today as it ever was. Even more so, as we are each dealing with a worldwide crisis, coupled with a large scale, new, possible way out of it. We have to understand that this is all new territory that this generation has never experienced before. That too fosters hesitation.

Third, we must use multiple channels to get our messages out. While there has been an increase in digital health adoption, as seen through rising telehealth usage, we have to know that many of our communities still don’t have reliable Internet access or access to certain technology. We have to get our message to all of those we serve to ensure vaccine adoption doesn’t perpetuate existing health disparities.

Why is language so important when it comes to health care, during the COVID-19 crisis and beyond?

Lauersdorf: As an industry, we’ve talked about the commoditization of health care. However, health care isn’t something you can buy off the shelf. Health care is about active participation and driving behavioral motivation. The words we use are critical in igniting or fostering engagement in one’s health.

There is a strong link between self-reported health literacy and the likelihood of receiving a vaccine in the past and future.

Certain demographics, such as older, suburban, higher-income, and White groups, trend higher on these measures, while younger, lower-income, urban, and Black, Hispanic/Latinx, and Asian groups trend lower. What we can conclude from these trends is that our health care communications, outreach, and overall efforts are leaving certain groups behind.

We need to ensure that we are addressing the issue of health literacy by not employing a “one-size-fits-all” communication method. If we increase health literacy by adjusting our communications, we can in turn increase the likelihood of vaccination adoption.