Outlook: Newsletter of the Society of Behavorial Medicine

Fall 2020

We Need to Start Talking About the SARS-CoV-2 Vaccine NOW

Monica L. Kasting, PhD and Katharine J. Head, PhD; Health Decision Making SIG

The COVID-19 pandemic, caused by the SARS-CoV-2 virus, has dominated our lives for most of 2020. It is the lead story in the news and has affected nearly every aspect of daily life. While the current pandemic is unprecedented, controlling infectious disease through messaging is exactly what we as social and behavioral researchers have been studying for decades, making our research uniquely relevant for the times. Perhaps the greatest challenge is how to simultaneously communicate risk of infection, promote preventive behaviors, and discuss vaccine development. Even though a SARS-CoV-2 vaccine is not yet available, we believe we should begin communicating with the public about a SARS-CoV-2 vaccine now, to ensure optimal uptake once it becomes available.

SARS-CoV-2 Vaccine Intent

In May 2020, we conducted a survey of adults living in the U.S. and assessed, among other variables, their SARS-CoV-2 vaccine intentions.1 We found that intentions were high (M=5.23/7 point scale), and increased when we included a strong healthcare provider recommendation (M=5.47). However, these intentions varied significantly based on several important demographic and health belief variables. Modifiable health belief variables like perceived threat, worry, and altruism were positively associated with higher vaccination intent. Notably, less education and conservative ideology were significantly associated with lower vaccination intent. These differences suggest that some sub-groups may forego vaccination, and therefore leave some communities at higher risk. Social and behavioral scientists have the tools to address these differences through evidence-based communication strategies.

Vaccine Communication

Vaccination promotion is challenging even when there is not a global pandemic. Given there are already attacks on the SARS-CoV-2 vaccine from the anti-vaccine industry,2 along with the decision by the U.S. federal government to name the SARS-CoV-2 vaccine development process “Operation Warp Speed,”3 social and behavioral scientists may already be behind in their need to address vaccine promotion.  The findings from our survey – specifically, the association of vaccine intent with perceived threat, worry, and altruism – give us important starting points for campaign and intervention development. While this is certainly not an exhaustive list, several important health behavior concepts and models are useful to reference:

  1. Inoculation Theory posits that exposing people to potential counterarguments about the new vaccine will help them generate resistance to these negative messages that they may encounter in the future (e.g., the belief that the SARS-CoV-2 vaccine was developed quickly and is therefore unsafe).4 It will be helpful in anticipation of the SARS-CoV-2 vaccines to begin implementing aspects of Inoculation Theory now, before people have encountered too much more misinformation. Furthermore, implementing aspects of Inoculation Theory now, and acknowledging the negative messages, may help avoid a “boomerang effect,” which describes the effect of only giving people positive messages, without acknowledging risks or limitations.5 By developing messages that expose people to potential counterarguments and acknowledge possible risks, we can effectively communicate that the benefits far outweigh the risks and improve vaccine uptake.
  2. Diffusion of Innovation posits that preventive innovations are particularly hard to promote.6  Consistent with diffusion of innovation work, we will need to rely on media for spreading accurate and timely information about the SARS-CoV-2 vaccine, but it will be incumbent on opinion leaders within our interpersonal networks to promote vaccine uptake.7  As noted in our survey findings, healthcare providers will be a particularly important opinion leader in this context, but other important opinion leaders may include politicians, religious leaders, and business owners.
  3. Extended Parallel Process Model can enable us to capitalize on the natural perceived threat that many people feel right now, and pair it with an effective and safe “response” in the form of a vaccine that will hopefully be easy for people to obtain.8


There are close to 200 vaccines in various stages of production, and some have moved to Stage III clinical trials.9 A safe and effective vaccine that is widely available and acceptable to the public will be essential to ending the COVID-19 pandemic. As social and behavioral scientists, we have the tools to ensure high acceptance and uptake of this vaccine.  Never has our research and expertise been more important.  Let’s get to work.



  1. Head KJ, Kasting ML, Sturm L, Hartsock JA, Zimet GD. A national survey assessing SARS-CoV-2 vaccination intentions: Implications for future public health communication efforts. Under Review. 2020.
  2. Ball P. Anti-vaccine movement could undermine efforts to end coronavirus pandemic, researchers warn. Nature. 2020;581(7808):251.
  3. U.S. Department of Health and Human Services. Fact Sheet: Explaining Operation Warp Speed. https://www.hhs.gov/about/news/2020/06/16/fact-sheet-explaining-operation-warp-speed.html. Published 2020. Updated 16 June 2020. Accessed 20 August 2020.
  4. Compton J, Jackson B, Dimmock JA. Persuading Others to Avoid Persuasion: Inoculation Theory and Resistant Health Attitudes. Frontiers in Psychology. 2016;7(122).
  5. Kasting ML, Cox AD, Cox D, Fife KH, Katz BP, Zimet GD. The effects of HIV testing advocacy messages on test acceptance: a randomized clinical trial. BMC medicine. 2014;12:204.
  6. Rogers EM. Diffusion of preventive innovations. Addictive behaviors. 2002;27(6):989-993.
  7. Rogers EM. Diffusion of innovations. 4th edition. Simon and Schuster; 2010.
  8. Witte K. Putting the fear back into fear appeals: The extended parallel process model. Communication Monographs. 1992;59(4):329-349.
  9. Corum J, Grady D, Wee S, Zimmer C. Coronavirus Vaccine Tracker. The New York Times. 2020. Accessed: https://www.nytimes.com/interactive/2020/science/coronavirus-vaccine-tracker.html