Thread by @Stefanie2000

This is true.👇The pandemic has brought scientific conversations into the limelight. (Yay!) Our new media ecosystem puts these conversation in front of a broad public, often without the translation, context & nuance provided by journalists and comms experts. (Yikes!) 1/

https://twitter.com/echarlu/status/1408126135947386884

Talking about "vaccine hesitancy' among researchers is one thing -- people in the room know what the concept stands for. Using the term broadly all of a sudden puts a label on people who haven't been able to get the vaccine yet, or are unsure about the vaccine. 2/

First problem is, it puts hesitancy at the front of everyone's mind, instead of confidence. This is basic crisis communications! Don't say words you don't want people to be thinking about. If they measure hesitancy, should I be hesitant? 3/

More importantly, it focuses on the individual when so many barriers are structural. Continued lack of access to vaccines, esp for underrepresented communities, is a structural barrier. Historic distrust is a structural barrier. Low quality information is a structural barrier 4/

Currently, it's the CDC, HHS and other agencies that are driving the continued use of the term, even after many have called to abandon it. Here's the fearless @RheaBoydMD 's piece from March 5/

nytimes.com/2021/03/05/opi…

@RheaBoydMD Here's my piece from April. 6/

statnews.com/2021/04/27/vac…

@RheaBoydMD Scientists might be thinking:

Why change a term we've been using for a long time?
It's scientific concept, we need to be precise in our language!

Except: No scientist will misunderstand what you mean if you use words like uptake, intent, readiness, acceptance, confidence 7/

@RheaBoydMD This year, I've had the privilege to work with the magnificent @dsallentess a bit, and watch her affect change.

How does she do it? Well, one thing I observed is, she's not afraid to change words. Because words are concepts, ideas, descriptors. Words matter. 8/

@RheaBoydMD @dsallentess Don't take it from me, take it from the leader on a lot of this work, @ProfHeidiLarson There's a reason she named her efforts the Vaccine Confidence Project, known on twitter as @vaccine_trust 9/

@RheaBoydMD @dsallentess @ProfHeidiLarson @vaccine_trust What @ProfHeidiLarson teaches us in her book "Stuck" is that if we want to understand people's reluctance to getting vaccinated, we need to listen.

Collectively, right now, communities are speaking, but they are not being heard.

Here is what I worry about. 10/

@RheaBoydMD @dsallentess @ProfHeidiLarson @vaccine_trust Across the nation, many are moving on.

By choosing to take masks off early and pushing a "get vaccinated" narrative, the administration has made a risky bet.

The country is splitting. Not into dems vs. republicans. Or rural vs. urban. 11/

@RheaBoydMD @dsallentess @ProfHeidiLarson @vaccine_trust The country is splitting into those who live -- and have historically lived -- comfortably enough that vaccines are a question of a bit more education and a little nudging. Let's have a lottery! Let's do a shot for a shot! Let's have vaccines after church! 12/

@RheaBoydMD @dsallentess @ProfHeidiLarson @vaccine_trust On the other side, increasingly unseen (again) or only seen by those who bother to look, are millions and millions of people for whom a vaccine will only become possible when basic life needs are met. Food, jobs, physical safety. Access to high quality information. Education. 13/

@RheaBoydMD @dsallentess @ProfHeidiLarson @vaccine_trust It's like we're back to square 1. Great conversations about justice, equity, social determinants and health! Really insightful.
Now, let's tell everyone who is not getting vaccinated they'r 'hesitant', since it is so easy to get a vaccine anywhere, right? 14/

@RheaBoydMD @dsallentess @ProfHeidiLarson @vaccine_trust Let's finish with some insights from the last two weeks of conversation w/ community orgs, advocacy groups, and state vax coordinators.

"They say there's a vaccination site w/i 5 miles of everyone. In Huston, if you don't have a car, you can't walk even 1 mile in the heat" 15/

@RheaBoydMD @dsallentess @ProfHeidiLarson @vaccine_trust Transportation continues to be a big one in this rollout. Lack of public transportation. Lack of rides. Coordination of rides.

Also: getting the vaccine to homes of people with disabilities. Those who can't hatch a ride. Would love to see vaccination data for this group 16/

@RheaBoydMD @dsallentess @ProfHeidiLarson @vaccine_trust In Oakland, community orgs are wrapping vaccination conversations into layered services:
Come for the help with paperwork, basic supplies and other supports, stay to learn how you can keep yourself safe with a vaccine. 17/

@RheaBoydMD @dsallentess @ProfHeidiLarson @vaccine_trust In Newark, door-to-door efforts are registering people to vote, help them sign up for the new child tax credit, and get a vaccine appointment.

In short, brilliant community workers are doing brilliant work all across the country.

You know what they talk about? 18/

@RheaBoydMD @dsallentess @ProfHeidiLarson @vaccine_trust That none of this, really, is about vaccines.

It's about lack of resources and lack of safety. It's about living with risks much more threatening than Covid --every day.

It's about facing long-standing barriers and people being back to telling you "make better choices" 20/

@RheaBoydMD @dsallentess @ProfHeidiLarson @vaccine_trust So, here is what we need to do:

1) fix our words
2) listen
3) act.

Fin.