The Five Flavors of Vaccine Interest
Health systems and public health departments across the country are all currently experiencing the same issue: thousands of unfilled COVID-19 vaccine appointments. Recently, I’ve started seeing an increasingly dichotomous view of vaccination: individuals are either very eager to be vaccinated or are considered vaccine hesitant without anything in between. I’d like to propose an alternate model:
ECIHD (“E-KID”)
Vaccine Enthusiastic: Individuals cannot wait to get the vaccine and are willing to do whatever it takes.
Vaccine Convenient: Individuals are open to receiving a vaccine, but want it to be in a comfortable location, time, language, or setting that matches what is convenient for them.
Vaccine Indifferent: Individuals could go either way on the vaccine and are looking to those around them (friends, family, and community members) to help guide their decision.
Vaccine Hesitant: Individuals are worried or hesitant to receive the vaccine. They may be worried about receiving the vaccine too early, may feel like a test subject, may feel like they do not need it, or may be concerned about the vaccine’s side effects.
Vaccine Declining: Individuals are not interested in receiving the vaccine at all.
At this point, I believe we’ve begun exhausting the “vaccine enthusiastic” segment of the US population and need to quickly engage the “vaccine convenient” and “vaccine indifferent” group. It is now time to focus on community-led vaccination efforts, which are best suited to meet the needs of these groups. By entrusting community leaders, we can meet others where they are, whether that means hosting vaccination events at a Gurdwara, outside a school, or at a local community center.
I encourage everyone to try approaching vaccination efforts using the model above. Think about how you might engage each group differently and how your outreach might change.
I’d love to hear your thoughts and feedback! Please share with others if you find this model helpful.
UPDATES:
Some additional thoughts on the ECHID framework after receiving feedback from some excellent colleagues:
1. Vaccine hesitancy should not be conflated with not trusting the health care system. Many communities, especially BIPOC communities, have seen structural racism and unethical medical practices deeply affect them — this cannot be discounted and “hesitancy” as a descriptor does not do this justice.
2. The term “indifferent” can come with the connotation that someone does not care, but some may just be undecided or unsure. We should be careful not to negatively stereotype or put others in a box. Many may just not have thought about the vaccine in detail, especially if their daily life is less impacted by COVID and others around them have not gotten sick.
3. The categories are not hard and fixed but just a framework to consider. Even those who are “vaccine declining” will have opportunities for engagement, but the conversation would need to be different.
