Does Framing Coronavirus in Terms of Disparities Reduce or Increase Vaccine Hesitancy?

RESEARCH OBJECTIVE: Studies on health communication have suggested that acknowledging past injustice is an important step in reducing hesitancy towards vaccination among African‐Americans. However, few studies have tested this messaging through experimental approaches. Furthermore, research on racial priming suggests that framing messages in terms of prioritization of one racial group over another could trigger resentment in the out‐group. As the vaccine roll‐out continues in the US, policymakers are looking for ways to increase vaccine confidence and uptake, particularly in more hesitant populations. Through a survey experiment, this study asks how popular representations of race‐ethnic disparities in Coronavirus cases and deaths impacts vaccine hesitancy in a racially diverse sample of New Yorkers. STUDY DESIGN: Using a survey experiment, respondents were randomized to receive a newspaper prime recommending minority prioritization for vaccination acknowledging historical racism versus a control article without a minority prioritization focus. Respondents were then asked a series of questions about their attitudes towards vaccines, racial justice and socio‐demographics. We compared responses of the experimental versus control condition overall and stratified by race‐ethnicity. POPULATION STUDIED: 1,353 New York State residents recruited through the survey firm Qualtrics between November 23‐December 8. Black and Hispanic respondents were oversampled producing a sample of 429 NH Whites; 443 NH Blacks and 481 Hispanics. Respondents were drawn from both Downstate (43%) from Upstate (57%). PRINCIPAL FINDINGS: We find no effects of the prime on respondents' intention to vaccinate against Coronavirus altogether and interacted with race‐ethnicity. We explore correlates of vaccine hesitancy and find that while African‐Americans are more vaccine hesitant than other race‐ethnic groups, identifying politically as an independent, being female and watching alternative news media are each stronger predictors of hesitancy. Qualitatively examining reasons for hesitancy or confidence, we find that conspiracy beliefs do not figure prominently in people's vaccine hesitancy, but rather more quotidian (and legitimate) concerns about the speed of the development process and generalized lack of trust in the political and scientific institutions producing the vaccine contributing to a desire to “wait and see.” These themes cut across race‐ethnic groups. CONCLUSIONS: We conclude that strong hesitancy views may be relatively fixed and difficult to change at least with simple messaging campaigns among a segment of the population that holds longstanding deep‐seated skepticism towards established institutions (justified or not). Nor, do simple messaging campaigns animate racial resentment in out‐groups in a way that will influence their behavior. Rather, weaker hesitancy views may give way to willingness relative quickly as more people take the vaccine. IMPLICATIONS FOR POLICY OR PRACTICE: While vaccine hesitancy is considered to be a major barrier to widespread uptake of the Coronavirus vaccine, especially among African‐Americans, our results suggest that it is a relatively small portion of the population that is hesitant, but that “more than messaging” will be required to influence behavioral intentions to vaccinate. PRIMARY FUNDING SOURCE: State of New York