Testing Theory-Enhanced Messaging to Promote COVID-19 Vaccination: Results from a Randomized Controlled Trial.

Area of Science:

• Public Health
• Behavioral Science
• Vaccinology

Background:

• Low COVID-19 vaccine uptake persists in the US, despite public health recommendations.
• Factors contributing to low uptake include pandemic fatigue, reduced risk perception, misinformation, and mental health symptoms.
• Novel communication strategies are being explored to improve vaccine acceptance.

Purpose of the Study:

• To evaluate the effectiveness of two novel communication strategies compared to standard public health messaging on COVID-19 vaccine uptake.
• To assess the impact of attitudinal inoculation and CBT-kernels interventions on vaccine uptake and willingness.
• To investigate these strategies in a cohort of US adult residents, including those with and without anxiety and depression symptoms.

Main Methods:

• A 3-arm, parallel-group, assessor-blinded, stratified-randomized trial was conducted from April 15 to May 2, 2024.
• Participants (≥18 years) had received at least one COVID-19 vaccine dose but none since September 11, 2023, and no SARS-CoV-2 infection in the prior three months.
• Participants were randomized to attitudinal inoculation, CBT-kernels intervention, or standard public health messaging.

Main Results:

• No significant differences in COVID-19 vaccine uptake were observed at four-week follow-up across the three groups.
• Uptake rates were 1.6% for CBT-kernels, 0.9% for inoculation, and 1.3% for standard messaging.
• Vaccine willingness also showed no meaningful differences between the intervention and control groups.

Conclusions:

• Theory-enhanced communication strategies, including attitudinal inoculation and CBT-kernels, did not effectively increase COVID-19 vaccine uptake in this study population.
• Current messaging approaches may not be sufficient to overcome barriers to vaccination, such as pandemic fatigue and mental health concerns.
• Further research is needed to identify effective strategies for improving COVID-19 vaccine uptake.