Commentary

Commentary: COVID-19 vaccine hesitancy requires out-of-silo thinking

March 26, 2021 4:00 am
Patient Annette Hanna-Campbell, 72, gets the vaccine from Medical Assistant Molly Flores. (Photo: John Partipilo)

Patient Annette Hanna-Campbell, 72, gets the vaccine from Medical Assistant Molly Flores. (Photo: John Partipilo)

Disappointing but not surprising that the muddled public health messaging from the Lee administration is now playing out in low rates of vaccination in many rural Tennessee counties.

Moreover, Tennessee Health Commissioner Dr. Lisa Piercey is warning of signs of another surge and saying the state is conducting market research to figure out a public service campaign to address the vaccination hesitancy.

To be fair to Gov. Bill Lee, Democratic and Republican governors and mayors alike have all been seduced during the pandemic into taking their star turn on ‘American Idol COVID-19’.  That’s one of the reasons we don’t elect state epidemiologists and infectious disease experts.  Scientific expertise, learning and training are not the stuff of ballot box choices. 

And to be honest, many of the public health experts seemingly forgot Risk Communication 101: The only certainty is uncertainty.

Every briefing in the past year should have begun with a caveat: What we know today is more than we knew yesterday and less than we will know tomorrow.  But we have to act even in the face of uncertainty if we are to confront this pandemic.

To overcome COVID-19 vaccine hesitancy in rural Tennessee, start old-fashioned grassroots organizing: If public health wants to have a trusted voice in rural Tennessee, enlist the dove and duck hunters, and don’t forget the bass and crappie anglers.

Would Tennessee have been better off if Lee hadn’t overlaid his “it’s your choice” political rhetoric on the public health messaging?  That will be the stuff of public health Ph.D dissertations for years to come.

It should be noted, however, that Dr. John Snow, often considered the father of modern public health epidemiology, didn’t give Londoners a choice in the 1850s when he convinced authorities to remove the pump handle from the Broad Street water pump and brought the cholera epidemic to a halt.

Maybe it’s time for Tennessee to stop treating mask-wearing like an off/on switch with county officials getting rid of mask requirements as soon as they see a dip in the numbers.  The virus does not have an off/on switch sadly.

As for the market research the commissioner is expecting to be completed by May, data are always good but figuring out trusted voices in rural Tennessee is not that complicated.

Any driving of the back roads will tell you quickly that the only thing more ubiquitous than Dollar General stores are cinder block churches where the parking lot is jammed to overflowing on Sunday.  And as long as we are talking religion and public health, it would be good penance this Easter season for the three Catholic bishops in Tennessee to have their network of rural pastors lead vaccination drives given the muddled bishops’ statement on the J&J vaccine.

September 1 every year, the hills of Tennessee are alive with the sounds of shotguns and dove season.  If public health wants to have a trusted voice in rural Tennessee, enlist the dove and duck hunters, and don’t forget the bass and crappie anglers.

Even the Biden Administration has figured out that NASCAR might be a way to reach Americans hesitant about the vaccines, according to a recent Wall Street Journal article.  Sullivan County is already using the Bristol Motor Speedway as a vaccination site.

Finally, back in the day, county extension agents were about the best political radar system a political reporter could have in Tennessee, and the local feed and mill store was another courthouse square, just with more gossip and fewer checkerboards.

None of this is as glitzy as an advertising campaign, but grassroots organizing and communication can also serve as a lasting foundation for after the pandemic.  Public health needs to get out of its silo, and the governor needs to let public health finally do its job.

 

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Jim O'Hara
Jim O'Hara

Jim O’Hara served as Associate Commissioner for Public Affairs at the Food and Drug Administration from 1993-1997 and Associate Administrator for External Affairs at the Environmental Protection Agency from 2012-2013.

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