Communication Strategy for COVID-19 Vaccines: The Essential Checklist

A guide to support public health communicators in preparing and executing a vaccine communications strategy, including planning for each phase of roll out and for specific audiences.

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Checklist action
Phase 1: Targeting prioritized groups
Phase 2: Engaging general public
Phase 3: Ensuring high coverage

General preparedness activities

Establish vaccine communications working group Recruit a multidisciplinary team of scientific subject matter experts, media liaisons,
spokespeople, community engagement specialists, content creators and monitoring specialists to meet frequently, particularly during the weeks immediately following new COVID-19 vaccine introduction. Agree on communication objectives for each phase of roll out. Create relevant contact lists of group members, key stakeholders, influencers and media.
Designate roles and responsibilities Identify lines of responsibility per working group member.

Designate clear authority around sign-off and information clearances.

Nominate spokespeople Identify spokespeople trusted by the general community. It may be helpful for health authorities to team up with civil society, academic or scientific spokesperson outside government.

Meet any training needs for spokespeople in advance, e.g., media training.

Identify and secure resources to implement communications plan Outline resources: financial (include budget for new trainings and message testing) and human (number of people and skills required).

Consider engaging people dedicated to managing specific channels, e.g., social media, and specific areas of work such as social data collection, racial equity, and social listening regarding confidence.

Develop decision tool to determine response to vaccine-related event Response must be context-specific, based on scientific data (when possible) and informed by an assessment of the potential impact of a real or perceived vaccine safety. The assessment should include measures of trust and vaccine confidence (low, medium, high) in order to help choose the appropriate, rapid communications response.

Prepare template statements on topics such as safety, adverse events and prevalence of misinformation in advance. A brief, simple statement that acknowledges an event, such as a safety signal, helps avoid ‘no comment’ responses.

Establish rumor-monitoring system Carefully monitor negative messaging, e.g., misinformation on news or social media and the actions of anti-vaccine activists.

Create a rapid response mechanism for misinformation. Develop messages and media responses in anticipation of identified threats.

Define target audience: prioritized groups recommended for vaccination (US federal level example) Phase 1 allocations (CDC Advisory Committee on Immunization Practices)

  • Phase 1a: Health care workers and long-term care facility residents
  • Phase 1b: Phase 1b: Persons aged ≥75 years and frontline essential workers (e.g., first responders, teachers, grocery store and
    public transit workers, etc.)
  • Phase 1c: Phase 1c: Persons aged 65–74 years, persons aged 16–64 years with high-risk medical conditions, and other essential
Remaining population from phase 1 and general public with emphasis on historically marginalized communities General public, particularly communities with continued barriers to accessing vaccination, and vaccine hesitant groups
Identify potential threats to confidence in vaccine safety Review emergency use authorization (EUA) and patient factsheets for each vaccine.

Collect information on background rates of possible adverse events following immunization (AEFIs).

Prepare for events such as a temporary suspension of a vaccine, vaccine recall, change in vaccine or introduction of a new COVID-19 vaccines.

As phase 1 roll out continues, ensure the availability of disaggregated coverage data regarding vaccine uptake and vaccine hesitance in specific groups. Use this data to target and tailor communication.

As vaccination coverage increases, continue to monitor AEFIs and adverse events of special interest that are either connected or perceived to be connected with vaccination.

Monitor how acceptance of COVID-19 vaccines may affect confidence in other vaccines, especially when rolled out in children.

Review and understand new scientific data on COVID-19 vaccine benefits and risks.

Update potential threats as confidence in and demand for existing vaccines may increase or decrease as new vaccines are authorized.

Specifically monitor and address attitudes and beliefs of communities with pre-existing and continued vaccine hesitance months after vaccine introduction.

Activities targeting health care workers

Identify and respond to specific vaccine confidence needs of health care workers Recognize health care workers as a target group themselves.

Consult health care workers and their relevant associations to understand and address concerns and potential knowledge gaps.

Encourage health and long-term care facilities to hold routine small (8-10 people), routine staff meetings to answer COVID-19 vaccine questions and discuss strategies to make vaccine confidence visible, such as capturing personal narratives.

Clearly communicate relevant sub-prioritization within phases (e.g., categories of health care workers within phase 1a).

Recommend staggering vaccination within departments to reduce potential staff shortages due to side effect-related absenteeism.

Ensure the rationale for continual introduction of new vaccines is clearly communicated, as are clinical considerations and recommended populations for each vaccine.

Facilitate dialogues with providers who may have continued vaccine hesitance.

Encourage and equip relevant associations to include COVID-19 vaccine confidence in routine continuing medical education and health care worker capacity-building efforts.
Prepare specific key messages, materials and trainings for health care workers Create clear channels for rapid and effective information dissemination to all health care workers, to support their own vaccine confidence.Use identified channels to share existing toolkits for health care workers providing the COVID-19 vaccine (e.g., presentations, videos, messages, job aides, posters, tip sheets).

Equip health care workers with tangible strategies and necessary materials for effective conversations with their patients, even in advance of wider vaccine allocation.

Create additional tailored materials in multiple languages as needed per local context.

Recognize health care workers as one of the most important primary channels to reach the general public.

Routinely update materials as new data emerges and vaccines become more widely allocated and available.

Adapt communication channels as additional health providers are onboarded and COVID-19 mass vaccine implementation plan is revised, with vaccination becoming part of routine services.

Anticipate messaging, material and training needs for health care workers to adapt push and pull vaccination distribution strategies to better reach communities with access barriers, as well as vaccine hesitant groups.

Activities targeting influencers, particularly for marginalized and/or vaccine hesitant communities

Identify key influencers and ambassadors Consider, in advance of roll out, who may have an influence on how COVID-19 vaccines are received by media and each distinct phase 1 allocation group at local levels, as well as who may be approached by media for an expert opinion, or in case of a vaccine safety event.

Reassure their vaccine confidence and prepare them to respond to public concern and media queries.

Consider preparing materials influencers can use in their communications, e.g., a one-pager summarizing strategy and key messages.

  • Phase 1a: For health care workers and long-term care facility residents, identify champions and leaders in hospitals and long-term care settings and encourage them to be vaccinated in public.
  • Phase 1b: Identify key influencers for the elderly in written and visual media; if they are eligible, request them to vaccinate publicly. Identify leaders within essential workers’ places of work, as well as essential worker associations and unions.
  • Phase: 1c. Recognize ambassadors to best represent persons aged 65-74 years, those aged 16-64 years with high-risk medical conditions and other essential workers who may influence vaccine uptake.
Continue to expand influencers and ambassadors to include those most relevant to historically marginalized populations. Engage community and religious leaders, high-profile health experts, educators, and other people with a large audience. Partner with community influencers and organizers to disseminate information.

Establish partnerships with trusted community groups that serve the Black, Indigenous, People of Color (BIPOC) population, as well as those vulnerable groups disproportionately impacted by COVID-19, like individuals who are uninsured, undocumented, experiencing homelessness, substance use, incarceration or detention.

Before vaccination begins for adolescents, include younger digital or social media influencers with many followers among the communities of interest.

Empower health care workers who are participating in vaccination efforts to act as vaccine advocates and disseminate fact-based safety information. They may need training on both content and interpersonal communication and advocacy.

A strong and dynamic presence on digital and social media is one of the most effective ways to have influencers (popular bloggers, Instagram profiles, etc.) spread vetted vaccine communications messages. This is particularly the case for in vaccine hesitant communities. Consider partnering with formerly vaccine hesitant individuals with large followings that have decided to take the vaccine.

Partner with experts who have been addressing vaccine confidence in certain groups for years as they may have a level of pre-established trust.

Assess whether messages from current influencers and ambassadors are reaching communities with lower vaccine uptake, which may be due to vaccination access barriers.
Identify additional influencers as needed and push messages around improved distribution strategies aimed at addressing access barriers.

Seek input from key stakeholders, particularly those representing historically marginalized communities Proactively reach out to stakeholders—particularly those representing communities with specific information needs or concerns—for guidance as a COVID-19 vaccine introduction plan is being developed, keeping them engaged and informed.

Work with members of phase 1a groups such as health care workers, long-term care facility residents, who may also represent marginalized communities, to document their own vaccination experience.

Expand engagement to include stakeholders from additional culturally and linguistically diverse communities and those committed to vaccine advocacy and uptake.

As vaccine supply increases, use stakeholder insight on community access barriers as well as community listening session feedback to inform vaccine implementation teams as they consider alternative, more convenient, vaccination locations. Consider barriers to online engagement (e.g., the digital divide in underserved communities).

As COVID-19 vaccination becomes routine, include additional strategic, unique, stakeholders per the local context. For example, it may be the case that vaccine hesitancy is high in communities that tend to seek out alternative medicine. Consider engaging with or collecting testimonials from trusted naturopaths or osteopaths who have been vaccinated to boost community uptake.

Before pediatric populations begin to receive vaccines, have dialogues with local mothers’ groups or parent networks to understand and better address potential vaccine concerns.

Choose most effective and equitable communication channels Identify key channels where each target allocation group seeks out health information and/or is talking about vaccine safety. At minimum, ensure that health authority and partner organization websites, and social media efforts, include key messages around safety, efficacy, vaccine availability, allocation and benefits.

  • Phase 1a: Posters and videos in health care settings and long-term care facilities; health care organization and association websites; mass emails and/or letters to health care workers and long-term care facility personnel from leaders in their organizations; specific social media channels favored by these populations. For long-term care facility residents, consider both the resident and closest family/kin; expect challenges around the issue of informed content.
  • Phase 1b: Posters and videos in frontline essential workers’ places of work; in large companies, mass emails and/or letters to essential workers from company or union leadership; for younger frontline essential workers, consider specific social media channels (e.g. Tiktok, Instagram, FB Live, dating applications, etc.); media channels favored by people aged over 75 in your locality (e.g., local or national TV, radio, newspapers, etc.); consider using targeted snail-mailed invitations for vaccination.
  • Phase 1c: Provide ready-made fact sheets and social media content to health providers, patient networks or registries and organizations for those with high-risk conditions (American Heart Association, American Diabetes Association etc.); posters and videos in other essential workers’ places of work; in large companies, mass emails to workers from company or union leadership; consider sharing guidance on prioritized groups via Medicare and Medicaid newsletters.
Use mass media to reach the general public, coupled with strategies to access any target groups who are not easily reached through traditional channels. Strategies may include access through immunization providers and community health workers, partnerships with faith leaders, health equity advisory boards, community organizers and civil society organizations.

Communicate transparently with marginalized communities by highlighting stories of individuals from those demographics who were successfully vaccinated in previous phases to build confidence.

Map out websites and social media channels as well as any traditional media outlets (e.g., TV, radio, newspapers) preferred by historically marginalized populations.

Consider using targeted brochures and posters in community settings that target populations visit frequently.

Communicate transparently racial/ethnic demographics of those who were successfully vaccinated in previous phases to build confidence.Continue engagement with wide-reach mass media channels, coupled with websites, forums and social media channels and groups where vaccine hesitant individuals gather and discuss online.

To help ensure high coverage as vaccines become more widely available for children and adolescents recommended pediatric populations, consider social media campaigns, brochures or handouts at pediatric practices as well as public forums on vaccine benefits and safety at municipalities, schools and other educational institutions.

Continue to publicize narratives/testimonials of racially and ethnically diverse people who were successfully vaccinated in previous phases help address any remaining concerns.

Activities targeting the general public

Engage with media Ensure that the phased plan for COVID-19 vaccine introduction is available, widely shared by media and revised as needed.

Based on the media channels, influencers and ambassadors identified for each phase subgroup, develop a plan for routine media engagement.

Create a list of external (third party) experts and spokespeople who would be effective information sources for the media and who represent different communities, including those marginalized and most affected by COVID-19.

Build social media presence Develop a plan, that is resourced accordingly, to post on social media targeting particular subgroups based on the pre-identified best social media channels to reach them. Ensure it includes one-way posts as well as more interactive features.

Schedule pre-prepared posts as well as live opportunities for posts and streams that address hot or trending topics as these arise.

Create clear procedures for approval and dissemination of information Agree on who releases what, when, and how, well in advance of any communication activity.
Clarify approval processes, especially if information needs to be disseminated quickly in event of a crisis.
Create key messages and communications materials and pre-test as needed Review behavioral insights on vaccine acceptance and uptake
as well as existing communication resources, including talking points for spokespeople, media release templates, FAQ banks, key messages (on
safety and efficacy of the vaccine, possible adverse events and how to report them, prioritized allocation of vaccine doses), and tools
for individuals to easily figure out whether (or when) they are candidates for vaccination in phase 1.Health providers will need more detailed materials, including the clinical considerations for vaccine administration.Tailor based on local context and pretest communication materials in target populations.Partner with local community-based organizations to provide culturally competent translations. Address specific concerns around how clinical trials have included diverse age/race/ethnicity groups.
Revise messages for the general public, FAQS, and tools necessary to determine if and when can they access vaccine (e.g., CDC’s Vaccine Finder).

In advance of expanded vaccine roll out, tailor and pretest messages specifically addressing concerns of historically marginalized communities around the safety, efficacy and benefits of the vaccine as well as access to vaccination.

Use simple, plain language when conveying messages, focusing on personal narratives that build trust through relatable messengers, beyond statistics from government institutions.

Disseminate through the pre-identified, most effective, communication channels.

Develop or tailor messages that specifically address concerns of low-uptake and/or vaccine hesitant communities. This may require acknowledgement and in-depth explanation of safety risks and concerns, as well as clear messages around possible side effects, what they mean and what to do in case of presentation of a mild, moderate or severe adverse event. Include guidance on how to distinguish vaccine side effects from incidental illnesses. 

Include recommendations on where to find additional trusted sources of information for vaccine-hesitant individuals and trusted forums for discussion.

Implement routine information dissemination Across all phases, consider routine public press briefings from trusted sources to inform public about new vaccine information, decisions around allocation and distribution plans.

  • Phase 1a: Encourage regular meetings in hospitals, clinics and long-term care facilities to discuss and address vaccine safety concerns.
  • Phase 1b: Encourage regular meetings with associations and organizations or companies of frontline essential workers, in particular those from historically marginalized communities to discuss and address vaccine safety concerns. Encourage regular briefings and discussions on preferred and effective media channels for elderly people 75 and older.
  • Phase 1c: Proactively share vaccine fact sheets, tailored for elderly patients with high-risk conditions, with providers. Routinely promote vaccine uptake on message boards and social media channels frequented by other categories of essential workers.
Continue to provide key messages, fact sheets and presentation materials for, and encourage, regular meetings with stakeholders, community and religious or cultural leaders, health workers and others, especially those representing marginalized communities, to provide a forum for discussing and addressing vaccine safety concerns. Proactively seek engagement opportunities (meetings, panels, discussions etc.) with vaccine hesitant communities (but not ardent anti-vaccine activists) to address remaining concerns around safety and efficacy, as new information becomes available and new vaccine are introduced.

Consider having experts in vaccine hesitancy review messages and materials before disseminating information.

Revise messages on vaccine distribution as additional push and pull distribution strategies are introduced to better serve communities with identified barrier to access.

Create mechanisms for responding to questions Establish two-way communication channels and multiple ways for the public to directly ask questions or raise concerns (e.g., public forums, website feedback forms, email, hotlines, online chat, social media, radio events simultaneously livestreamed online).

Ensure these channels are easily accessible to the targeted communities/subgroups in each phase, e.g., health care workers may prefer an anonymous question box within the health care facility, while essential workers may prefer social media. Elderly people may be more comfortable with hotlines and calling in to TV discussions or town hall style events. Ensure that special consideration is given to the needs (language, connectivity, etc.) of specific communities, including the most marginalized.

Two-way communication systems need to be very careful of their communication with vaccine hesitancy groups. People managing these need to be specifically trained not to engage with ardent anti-vaccine activists, not to repeat misinformation, and to instead show empathy to those who have remaining questions or concerns leading to hesitancy.

Monitoring activities

Review new information and continually update materials as additional vaccines and recommendations are introduced Establish a team or dedicated focal point responsible for continually updating materials as additional vaccines and recommendations are introduced.

Regular trainings, centered on values of fairness and equity, may also be needed for people leading communication efforts, influencers and ambassadors.

Develop strategies to monitor and evaluate communications Consider various methods of regularly assessing COVID-19 vaccine confidence across different population groups, including knowledge, attitudes and practices surveys, social media listening, media monitoring and establishing a toll-free vaccine Q&A hotline. For example, in phase 1a, create mechanisms to receive routine feedback from health care workers related to receiving, administering and discussing COVID-19 vaccines with patients, including those in long-term care facilities. Solicit feedback specifically from influencers, community and faith leaders, and civil society organizations.Formalize process of documenting challenges and lessons learned, identifying gaps in skills and resources and identifying actions to improve and inform ongoing vaccine communications. Review disaggregated vaccination coverage data to identify and map lower uptake communities. Use vaccine-confidence listening sessions and feedback from strategic stakeholders to craft revised key messages targeting lower uptake communities. Consider tailoring communications to target groups based on trends related to health equity metrics, comparing case positivity and case rate across demographic groups.
Monitor reactions from media and public, particularly around safety events Review CDC guidelines and systems for vaccine safety monitoring, e.g., V-Safe, VAERS, Vaccine Safety datalink.

During vaccination, publicize and encourage uptake in post-vaccination safety monitoring tools e.g., V-Safe.

Remember that vaccine safety data may evolve as monitoring continues, larger numbers of people are vaccinated, and new vaccines are introduced; related key messages will need to be updated and promoted.

Establish daily monitoring mechanism for media (especially social media as well as newspaper, TV, radio). Respond immediately in case of media questions or public concern. Maintain daily monitoring for 3 months post-introduction of each COVID-19 vaccine.

Collect feedback from third party experts and local key stakeholders, as well as feedback from a toll-free Q&A telephone line (if this has been established).

Besides safety, be prepared for questions around vaccine supply and availability, especially as allocation criteria opens to general public.