Vaccinating 12-15 years of age against COVID-19 – Key success factors

Ido Hadari, Dragoslav Popovic 

Every parent knows, that making a teenager to do something, requires a lot of discussions, negotiations - sometimes with ‘’carrots and sticks’’ - until you find the right motivator that would help them to adapt their behavior. How can we motivate 12-15 years old to get vaccinated against COVID-19?

Spoiler – please help us find the right answer by filling the questions below. Your response is important to us.  

The starting point:

Every vaccination campaign lays on 3 main legs: (1) Uninterrupted Vaccine Supply, (2) Wide access to services and trained health workforce, (3) Public response.

It works like a braid with 3 groups of hair. Each must be in accordance with the length and thickness like the other 2. The hands making the braid must be firm but gentle, planned but agile.

In practice, it is a bit different. The most efforts and resources are by default, allocated to the first 2 – as this is traditional health systems response. It may work, but without public response, you may end up with the party with no guests attending.

Change the Executives’ usual way of thinking:

Public health crises are first and foremost – public, and it can be resolved only in close collaboration of concerned population and health personnel. This should be the case in our latest challenge – vaccinating the 12-15 young adults in Israel.    

What will be the difference between the 16+ response to vaccination comparing to the 12-15 age group? There are many questions out there: How will this group accept the fact that vaccine is now registered as safe and effective to them? Would they be motivated to joint others and get the vaccine, or they will be skeptical to joint vaccination now, “when the party is almost over” and after majority of others got their shots? Would they see benefits of vaccination, considering that burden of COVID-19 disease was lower in this group consideration to those previously vaccinated? Do they care for vaccines? Do they feel vaccination fatigue?

Like in many similar cases in the past, the key of success could in effective communication based on so called 'Laswell’s model' by using it’s five essential questions:

1.     WHO

2.     SAYS WHAT

3.     IN WHICH CHANNEL

4.     TO WHOM

5.     WITH WHAT EFFECT?

 Models vs. Reality:

A typical 13th years old boy/girl is exposed to so many information channels, influencers and messages, so addressing these 5 questions is not simple, but let's try.  

·       TO WHOM – the target audience should not be limited to 12-15 years, but should also cover their siblings, teachers, parents, and grand-parents.

·       WHO – the lead in communication lies with the government and its proxies like the HMO's or other Health providers, being the most trustful source of health information.

·       SAYS WHAT – Health professionals are best positioned to communicate about health, but the message "The COVID-19 is dangerous virus – and the vaccine is safe" may resonate with parents and grandparents, but it may not be sufficient to motivate youngsters. The message for the 12-15 must be adapted to their language and ways of communicating to get to their minds and hearts. If you can amplify the message with some other incentive, you may get better effect. "Only vaccinated teens are allowed to enter this party / concert", may work very well.   

Other message that may work is "congrats, finally it’s your turn". It targets teens’ need to be part of the (vaccinated rest of the family) or a wider society. It will be good if teens can be invited to vaccination at the same time with some other family members (getting the vaccine is like hunt for a treasure).

·       IN WHICH CHANNEL – what is the most relevant channel for the generation of 12-15? GP, the parent, other siblings, other peers, the grandparents or the Tik-Tok celebs? Our answer is: no-one. Or better – all the above. Carefully listening and then addressing their real concern is the best way to get closer to this group. Do not forget that they may have same concerns as other groups when it comes to technical issues related to vaccines, vaccine safety, COVID-19 disease. Such messages need to be adopted and available to them along with other motivational messages.

·       WITH WHAT EFFECT – The answer is clear: the message was heard, accepted, and teens getting vaccinated in high numbers.

These principles must be agile and adaptable to the changing reality of the campaign. When it comes to WHEN, we advise to kick start of the communication short before the vaccination campaign starting date.   

Regarding the question of – IN WHICH CHANNEL? The answer is all. A 360 degrees' circle of messengers and messages. Parents, Teachers, Friends, Tik-Tok, Instagram, TV, Grandparents. Everywhere, all the time.

A normal media consumer is exposed to hundreds of messages per day. It is critical to be the loudest voice with the most accurate and targeted message to create an effect.

When the Israeli Ministry of Health announced that the age group of 16-18 is eligible for the vaccination, it took 2 weeks to achieve 50 percent acceptance. By now the Maccabi HMO is already on 87% coverage (including those who had COVID-19 daises in the past). Achieving this numbers with the 12-15 will certainly be outstanding challenge.

Take home message:

Based on our experience, vaccinating 12-15 is more complex than other age groups. It's like the lock of a safe: it requires perfect fit for the safe to open.

Success depend more on achieving high acceptance than on logistics – so allocate proper and sufficient resources for the social marketing, communication and engagement (e.g. including considering organization of local level events, small tokens or presents for vaccinated teens). Think like a 13th teen - the campaign must "meet" them in as many platforms as possible.  

Ido D. Hadari, M.A, M.B.A, Director of Communications & Government Affairs at Maccabi Healthcare Service, and a Venture Partner at ALIVE – Israel Health-Tech Fund. For over 20 years he leads large scale and high volume processes. Serves at key positions in the Israeli Health System. Consults to governments and health professionals around the world, also consulted UNICEF regarding generating demand to Polio vaccinations.     

Dragoslav Popovic, M.D, M.P.H, is an International Public Health Consultant, with three decades of experience in health systems reforms, vaccines and immunizations, private and public partnerships, management, and communication/social marketing. His recent collaborations include UNICEF, WB, UNDP, WHO, GAVI Alliance and IPSOS.