Promoting COVID-19 vaccine acceptance: recommendations from the Lancet Commission on Vaccine Refusal, Acceptance, and Demand in the USA

Saad B Omer; Regina M Benjamin; Noel T Brewer; Alison M Buttenheim; Timothy Callaghan; Arthur Caplan; Richard M Carpiano; Chelsea Clinton; Renee DiResta; Jad A Elharake; Lisa C Flowers; Alison P Galvani; Rekha Lakshmanan; Yvonne A Maldonado; SarahAnn M McFadden; Michelle M Mello; Douglas J Opel; Dorit R Reiss; Daniel A Salmon; Jason L Schwartz; Joshua M Sharfstein; Peter J Hotez

doi:10.1016/S0140-6736(21)02507-1

Promoting COVID-19 vaccine acceptance: recommendations from the Lancet Commission on Vaccine Refusal, Acceptance, and Demand in the USA

Lancet. 2021 Dec 11;398(10317):2186-2192. doi: 10.1016/S0140-6736(21)02507-1. Epub 2021 Nov 15.

Authors

Saad B Omer¹, Regina M Benjamin², Noel T Brewer³, Alison M Buttenheim⁴, Timothy Callaghan⁵, Arthur Caplan⁶, Richard M Carpiano⁷, Chelsea Clinton⁸, Renee DiResta⁹, Jad A Elharake¹⁰, Lisa C Flowers¹¹, Alison P Galvani¹², Rekha Lakshmanan¹³, Yvonne A Maldonado¹⁴, SarahAnn M McFadden¹⁰, Michelle M Mello¹⁵, Douglas J Opel¹⁶, Dorit R Reiss¹⁷, Daniel A Salmon¹⁸, Jason L Schwartz¹⁹, Joshua M Sharfstein²⁰, Peter J Hotez²¹

Affiliations

¹ Yale Institute for Global Health, Yale University, New Haven, CT, USA; Infectious Diseases Section, Department of Internal Medicine, Yale School of Medicine, Yale University, New Haven, CT, USA; Department of Epidemiology of Microbial Diseases, Yale University, New Haven, CT, USA; Yale School of Nursing, Yale University, Orange, CT, USA. Electronic address: saad.omer@yale.edu.
² Gulf States Health Policy Center, Bayou La Batre, AL, USA.
³ Department of Health Behavior, Gillings School of Global Public Health, and Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA.
⁴ Department of Family and Community Health, University of Pennsylvania School of Nursing, and Center for Health Incentives and Behavioral Economics, University of Pennsylvania, Philadelphia, PA, USA.
⁵ Department of Health Policy and Management, School of Public Health, A&M University, College Station, TX, USA.
⁶ Langone School of Medicine, New York University, New York, NY, USA.
⁷ School of Public Policy, University of California, Riverside, CA, USA.
⁸ Clinton Foundation, New York, NY, USA; Mailman School of Public Health, Columbia University, New York, NY, USA.
⁹ Stanford Internet Observatory, Stanford University, Stanford, CA, USA.
¹⁰ Yale Institute for Global Health, Yale University, New Haven, CT, USA; Infectious Diseases Section, Department of Internal Medicine, Yale School of Medicine, Yale University, New Haven, CT, USA.
¹¹ Department of Obstetrics & Gynecology, Emory University, Atlanta, GA, USA.
¹² Center for Infectious Disease Modeling and Analysis, Yale University, New Haven, CT, USA.
¹³ The Immunization Partnership, Houston, TX, USA.
¹⁴ School of Medicine, Stanford University, Stanford, CA, USA.
¹⁵ School of Medicine, Stanford University, Stanford, CA, USA; Stanford Law School, Stanford University, Stanford, CA, USA; Freeman Spogli Institute for International Studies, Stanford University, Stanford, CA, USA.
¹⁶ Department of Pediatrics, University of Washington School of Medicine, Seattle, WA, USA; Seattle Children's Research Institute, Seattle, WA, USA; UC Hastings College of Law, University of California, San Francisco, CA, USA.
¹⁷ UC Hastings College of Law, University of California, San Francisco, CA, USA.
¹⁸ Institute for Vaccine Safety, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
¹⁹ Department of Health Policy and Management, Yale School of Public Health, Yale University, New Haven, CT, USA.
²⁰ Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
²¹ Hagler Institute for Advanced Study at Texas A&M University, A&M University, College Station, TX, USA; Scowcroft Institute of International Affairs, Bush School of Government and Public Service Texas, A&M University, College Station, TX, USA; Texas Children's Center for Vaccine Development, Departments of Pediatrics and Molecular Virology & Microbiology, National School of Tropical Medicine, Baylor College of Medicine, Houston, TX, USA; Department of Biology, Baylor University, Waco, TX, USA; James A Baker III Institute for Public Policy, Rice University, Houston, TX, USA.

Abstract

Since the first case of COVID-19 was identified in the USA in January, 2020, over 46 million people in the country have tested positive for SARS-CoV-2 infection. Several COVID-19 vaccines have received emergency use authorisations from the US Food and Drug Administration, with the Pfizer-BioNTech vaccine receiving full approval on Aug 23, 2021. When paired with masking, physical distancing, and ventilation, COVID-19 vaccines are the best intervention to sustainably control the pandemic. However, surveys have consistently found that a sizeable minority of US residents do not plan to get a COVID-19 vaccine. The most severe consequence of an inadequate uptake of COVID-19 vaccines has been sustained community transmission (including of the delta [B.1.617.2] variant, a surge of which began in July, 2021). Exacerbating the direct impact of the virus, a low uptake of COVID-19 vaccines will prolong the social and economic repercussions of the pandemic on families and communities, especially low-income and minority ethnic groups, into 2022, or even longer. The scale and challenges of the COVID-19 vaccination campaign are unprecedented. Therefore, through a series of recommendations, we present a coordinated, evidence-based education, communication, and behavioural intervention strategy that is likely to improve the success of COVID-19 vaccine programmes across the USA.

Publication types

Review

MeSH terms

Behavior Therapy*
COVID-19 / transmission*
COVID-19 Vaccines*
Communication*
Humans
Immunization Programs*
Politics
SARS-CoV-2*
United States
Vaccination Refusal / psychology

Substances

COVID-19 Vaccines

Supplementary concepts

SARS-CoV-2 variants

Grants and funding

UL1 TR001863/TR/NCATS NIH HHS/United States