As childhood vaccination rates drop, local health officials battle misinformation

OKLAHOMA CITY — By the summer of 2021, Phil Maytubby, deputy executive director of the OKLAHOMA City Health Department, was concerned to see the number of people getting the covid vaccine dwindle after a strong initial response.

With doubt, fear, and misinformation rampant across the country, both online and offline, I knew the agency needed to rethink its messaging strategy.

So the Department of Health ran something called “opinion research” online, which assesses how certain words are perceived on social media. The tool found that many people in Oklahoma City did not like the word “vaccinate,” a word that was featured prominently in the health department’s marketing campaign.

“If you don’t know how your message is resonating with the public,” Maytubby said, “you’re shooting in the dark.”

Oklahoma City County Health Department Assistant Director General Phil Maytubby.Nick Oxford for KHN

Across the country, health officials have been trying to combat misinformation and restore trust within their communities in recent years, a period when many people have not fully trusted their state and local health departments. Agencies are using Twitter, for example, to engage specific audiences, like NFL fans in Kansas City Y “Star Wars” Enthusiasts in Alabama. They are collaborating with influencers and celebrities like Stephen Colbert Y Akbar Gbajabiamila to broaden your reach.

Some of the efforts have paid off. For now, more than 80% of US residents have received at least one shot of a covid vaccine.

But the data suggests that skepticism and misinformation around Covid vaccines are now threatening other public health priorities. According to him Centers for Disease Control and Prevention. The decline in flu vaccination coverage among pregnant women is even more dramatic in the past two years: 18 percentage points.

Other common childhood vaccination rates are also down, compared to pre-pandemic levels. Nationwide, 35% of all American parents oppose requiring children to be vaccinated against measles, mumps and rubella before entering school, up from 23% in 2019, according to a KFF survey released on December 16. Suspicion revolving around once-reliable vaccines, as well as fatigue from so many injections, is likely to blame.

Maytubby, center, meets with staff members from the Oklahoma City County Health Department to review data on the number of Covid cases and hospitalizations.
Maytubby, center, meets with staff members from the Oklahoma City County Health Department to review data on the number of Covid cases and hospitalizations. Nick Oxford for KHN

Part of the problem is the lack of investment that eroded the public health system before the pandemic began. A analysis by KHN and The Associated Press found that local health department spending fell by 18% per capita between 2010 and 2020. State and local health agencies also lost nearly 40,000 jobs from the 2008 recession until the outbreak of the pandemic.

That made his response to a once-in-a-century public health crisis challenging and often inadequate. For example, during the early days of Covid, many local health departments used fax machines to report case counts.

“We weren’t as flexible as we are now,” he said. Dr Brannon Traxlerdirector of public health for the South Carolina Department of Health and Environmental Control.

At the start of the pandemic, Traxler said, only two people worked on the media relations and public outreach team at the South Carolina department of health. Now, the team has eight.

The agency has also changed its communication strategies in other ways. This is the first year, for example, that South Carolina has released data on flu vaccines every two weeks, with the goal of raising awareness about the effectiveness of the shots. In South Carolina, not even a room of adults and children who are eligible for flu shots got vaccinated in early December, even as flu cases and hospitalizations increased. The flu vaccination rate across all age groups in the US was 51.4% last season.

Those who have opted out of the covid and flu vaccines appear to be correlated, Traxler said.

“We’re really just trying to dispel the misinformation that’s out there,” Traxler said. To that end, the health department has partnered with local leaders and groups to encourage vaccinations. Agency staff have also grown more comfortable speaking with the media, she said, to better communicate with the public.

but some public health experts argue that agencies continue to fail in messaging. Scientific terms such as “mRNA technology”, “bivalent vaccine” and “monoclonal antibodies” are widely used in public health, although many people find them difficult to understand.

A study published by NEVER found that the Covid-related language used by state agencies was often more complex than an eighth grade reading level and more difficult to understand than language commonly used by the CDC.

“We have to communicate complex ideas to the public, and that is where we failed,” he said. Brian Castrucci, CEO of the Beaumont Foundation, a charitable group focused on strengthening public health. “We have to acknowledge the fact that our miscommunications created the environment in which misinformation flourished.”

Most Americans support public health, Castrucci said. At the same time, a small but vocal minority pushes an anti-science agenda, and it has been effective in sowing seeds of mistrust, he said.

Misinformation has changed everything.

Phil Maytubby, Oklahoma City County Health Department

The more than 3,000 public health departments across the country will benefit from a unified message, he said. In late 2020, the foundation, in collaboration with other public health groups, established the Public Health Communications Collaborative for more easy-to-understand information about immunizations.

“The good ones must be as well organized as those who seek to harm the nation,” he said. “You’d think we’d learn from this.”

In the meantime, a report published in October by the Pew Research Center found that 57% of American adults believe that “false and misleading information about the coronavirus and vaccines has contributed a lot of to the problems that the country has faced in the midst of the pandemic.

“I was suspicious like everyone else,” said Davie Baker, 61, an Oklahoma City woman who owns a business that sells draperies. When the injections became widely available in 2021, she thought they had developed too quickly and was concerned about some of the things she had read online about side effects. A Sam’s Club pharmacist changed her mind.

“She just educated me on what the shot was really about,” Baker said. “She clarified a few things for me.”

Davie Baker, an Oklahoma City resident.
Davie Baker, an Oklahoma City resident.Nick Oxford for KHN

Baker signed up to get her first Covid shot in May 2021, around the same time the Oklahoma City Health Department noticed the number of vaccines given daily was starting to drop.

The department updated its marketing campaign in early 2022. Instead of using the word “vaccinate” to encourage more people to get vaccinated against Covid (the word that the agency’s social media analysis revealed people were not liked), the new campaign urged people to “Choose Today!”

“People don’t trust like they used to,” Maytubby said. “They want to make their own decisions and make their own decisions.”

The word “choose” acknowledges that preference, he said.

Maytubby thinks the “Choose Today!” campaign worked. A survey of 502 adults in Oklahoma City conducted during the first half of 2022 found that less than 20% of respondents reacted negatively or very negatively to a sample of “Choose Today!” announcements and an estimate 86.5% of adults in Oklahoma City have received at least one dose of a Covid vaccine, a rate higher than the state average of about 73%.

There are most likely other factors at play that have helped bolster Oklahoma City’s vaccination numbers. In the same survey of Oklahoma City adults, some people who had recently been vaccinated said they were urged to get vaccinated by family members or church leaders or that they knew someone who had died from covid. One person said that money was the motivation, as he received $900 from work to receive the vaccine.

Meanwhile, the war on misinformation and disinformation continues. Childhood immunization rates for the vaccines students normally need to enter kindergarten are down 4.5% in Oklahoma County since the 2017-18 academic year as parents increasingly seek exemptions to the requirements.

That worries Maytubby. He said the main tactic among those trying to sow mistrust about vaccines has been to question everything from the science to their safety.

“In that regard, they’ve been quite successful,” Maytubby said. “Disinformation has changed everything.”

Kaiser Health News and NBC News teamed up to produce this story.