Finding the right message — and right messengers — to persuade skeptical conservatives to get the COVID-19 vaccine has become an urgent concern for public health experts pushing to contain the coronavirus.
Polls show nearly half of people who voted for former President Donald Trump in November say that if they are offered a vaccine for COVID-19, they won't get it. That hesitancy could be a major barrier to reaching herd immunity.
A recent focus group conducted by longtime Republican pollster Frank Luntz shows it will be tough to break through. But there are ways to do it.
For those developing campaigns to get enough people vaccinated that the virus runs out of room to spread, this challenge is commanding a lot of attention. Breaking through with this population could be key to a return to some semblance of normal.
"We found, and the White House is very aware, that the largest correlation to vaccine hesitancy is actually being a conservative," said John Bridgeland from the COVID Collaborative, which is working on this issue with the Biden administration. "We actually need to get a lot of that population engaged in getting a vaccine to reach herd immunity."
Take Jen from Iowa, one of 19 participants in Luntz's focus group, which was sponsored by the de Beaumont Foundation, a nonpartisan group with a public health focus.
She and her husband both recently had the virus, and he spent three weeks in an intensive care unit. "For us personally, I don't know, I really am highly doubtful we'll ever get vaccinated for this, even though it almost killed him," Jen said in the early minutes of the Zoom session, which used first names only.
Luntz said the focus group members had two things in common. "You all voted for Donald Trump in 2020 and you all expressed at least some hesitation of getting the COVID vaccine," Luntz said. "So you represent about 30 million people."
In fact, the NPR/PBS Newshour/Marist poll last week found 47% of Trump voters said they would turn down a vaccine. By way of comparison, among Biden voters, only 10% said they wouldn't get vaccinated.
New data from a poll Luntz conducted found younger Republicans will be more of a challenge to reach than those who are older. He says it's not about the grandparents. It is about the parents and their adult children, those aged 18-49, who are less afraid of the virus and more skeptical of the vaccine.
Early on, Luntz asked participants to briefly share their thoughts on the vaccines and it was a cascade of doubt. "Rushed." "Unsure." "Experimental." "Scary not knowing long-term side effects."
Jen from Iowa went last, describing the vaccines as "untrustworthy."
"Oh my God," Luntz responded, acknowledging he and the others he invited to the focus group to test persuasion messaging had their work cut out for them.
Distrust was a running theme: a lack of faith in institutions, the government, and the media. "It's sad because I don't know who to trust and that's not the America I grew up in," said Chad from Minnesota.
They talked about valuing freedom and said the pandemic has been used to manipulate and control people. Patrick from Tennessee, who like several in the group has had COVID-19 himself, said people are panicking for no reason.
"It's amazing how many people who should know better have fallen into the trap of being afraid to go in a restaurant, to be around their family, 'I've got to wear a mask. Now I've got to wear two masks.' Logical people that you thought were intelligent people have just bought the hype," Patrick said.
As for the vaccine, David from Texas hit on a core concern among the group. "My fear of the vaccine is more than my fear of getting the illness," he said.
Luntz asked for a show of hands on who agreed with David's statement. Almost everyone raised their hands.
Over the course of the more than two-hour session, Luntz brought in various doctors and politicians to try different arguments on the group.
Dr. Tom Frieden, the former CDC director, said he wasn't there to convince them, just to share facts. He explained how vaccines like the ones from Pfizer and Moderna work, saying it was like an email delivering a "most-wanted poster" to your immune system so it knows how to combat the coronavirus.
"And then poof, like a disappearing message it disappears," Frieden said, gently dispelling a conspiracy theory making the rounds online. "It's not in your body. It's gone."
He admitted what he didn't know, acknowledging where there is scientific uncertainty, and presented a set of five facts about COVID-19 and the vaccines.
Frieden described the potential long-term effects that the virus could have on people, arguing that although not everything is known, he is confident the virus is a greater long-term risk than the vaccine.
"More than 95% of the doctors who have been offered this vaccine have gotten it as soon as they can," said Frieden, in a point that seemed to particularly resonate with the group.
At one point, Luntz asked the participants about who they thought would be a better messenger about getting a vaccine. "You've got to choose: Donald Trump or your own doctor — who's going to have a greater impact on whether or not you get the vaccine?" Luntz asked.
All 19 said their own doctor would be more influential. That surprised Luntz, who expected Trump would be more influential. In the end, though, the focus group confirmed for him that when it comes to vaccines, it is such a personal decision that people don't want politicians anywhere near it.
The focus group took place before Trump delivered a pro-vaccine message in an interview with Fox News. This came less than a week after the Ad Council released an ad featuring all the living ex-presidents other than Trump talking about getting their shots and encouraging others to do so. Luntz played it for the group.
But they panned it. "It was kind of like propaganda, actually," said Brian from Florida.
"It actually kind of annoyed me," said Debbie from Georgia.
When asked if having Trump in the ad would have helped, the response was swift. "Not a bit," said one participant whose voice rose over the cacophony.
"A lot of us don't trust this because it's been politicized from the very beginning and now they're trying to get a lot of politicians to tell us what to do," said David from Texas.
Bridgeland, who was involved in making the ad, said he was proud of it and argued it was more about setting a tone of bipartisanship in the nation around the vaccines. His fear is that vaccines could become politicized like masks did last spring. But he's thrilled Trump, who received his vaccine in private, has now offered a full-throated endorsement.
His organization is working with the Biden administration and people and groups from an incredibly broad spectrum of perspectives to push out other more-tailored messaging to persuade people to get vaccines. That includes partnering with health care providers, religious leaders and people who are trusted in their communities.
Luntz's focus group confirms much of what the White House and Bridgeland have found as well. People's doctors are far better messengers than politicians, celebrities or the media, especially when it comes to Trump voters. The White House is expected to launch an expansive public persuasion campaign soon, but it's not clear how many of the details they will get into, in part because they know there are a lot of people who don't want to hear a message that they know is coming from the Biden administration.
During the focus group session, more overt political appeals fell flat. Science and personal stories hit a chord.
Former New Jersey Gov. Chris Christie talked about his personal experience with the coronavirus.
"You all know how I got it," Christie said. "I went into what was supposed to be the safest place in America. The White House."
Christie caught COVID-19 during debate preparation sessions at the White House in late September. All but one person in the room ended up coming down with the virus, including President Trump. Trump was hospitalized for a few days. Christie, who is obese and asthmatic, was in intensive care for a week. But, he also said a much younger aide got very sick.
The message he tried to drive was about the randomness of it all. It's not always easy to predict who gets really sick and who doesn't. He talked about his cousin and her husband, in their early 60s. She was a smoker, but he was active and physically fit.
"They both ended up getting hospitalized and two weeks ago they both passed away," Christie said. One of the participants audibly gasped, explaining she wasn't expecting him to say they had died.
At the end, Luntz asked the participants to reflect on what they had learned. Most had moved closer to getting the vaccine, including Jen from Iowa, who said she was now "a 7 out of 10" for getting it.
House Minority Leader Kevin McCarthy and two doctors who are in Congress — Rep. Brad Wenstrup from Ohio and Sen. Bill Cassidy from Louisiana — also spoke to the group.
But in the end, most participants said they were most persuaded by Frieden, who served as CDC director in the Obama administration; and Christie, who kept his pitch personal and told them "politicians screw up almost everything we touch."
"We want to be informed we don't want to be emoted to," said Adam from New York. "We want to be educated, not indoctrinated."
Luntz says he thinks there is a message that can reach Trump supporters, but those making the pitch have to keep politics out of it. He imagines a 60-second spot with a doctor and a patient talking about their experiences, with facts about the safety of the vaccines up on the screen.