The image flashes on the computer screen. It’s a flyer showing a woman getting a flu shot, accompanied by this admonition: “Flu and COVID-19 can be a tragic combination – with the flu leaving you more at risk for a severe case of COVID-19 that may result in long-term damage or death.”
A dozen or so men and women over age 65, here on a recent Zoom call to give their opinions on the makings of a flu vaccination campaign, pull no punches.
“You don’t want to think about death when you’re going in for a flu shot,” says one woman. Off-screen, her husband chimes in: “It’s already scary to get the flu shot. Don’t bring up the thing about COVID. Take that off.”
The pretesting session was one of several involved in developing the new flu vaccine campaign being designed by the Johns Hopkins Center for Communication Programs with the Baltimore City Health Department. By sharing drafts of flyers with the target audience, facilitators are able to see if the messages work or if they need some tweaking.
The Baltimore City Health Department has an ambitious goal this year. They want 70 percent of city residents to get a flu vaccine. Last year, just 34 percent of those 66 and older were vaccinated and other groups didn’t fare much better.
The flu vaccine must be administered annually because influenza rapidly mutates and the vaccine does not offer protection from year to year.
And with the COVID-19 pandemic continuing unabated across the United States, health officials are now more concerned than ever with ensuring people are protected from the flu. Not only can the symptoms be similar, people who get the flu could find themselves more vulnerable to COVID-19 for which there is currently no cure or vaccine.
The U.S. Centers for Disease Control and Prevention estimates that, during the 2019–2020 season, 22,000 Americans died from the flu. According to Johns Hopkins University, more than 215,000 Americans have died from COVID-19 this year.
Amber Summers, PhD, who leads CCP’s Baltimore programs, helped facilitate the recent pretesting session with the older adults in Baltimore. Then it was her job to meet with her team and the health department’s Director of Communications, Adam Abadir, and figure out how to incorporate their comments.
“We can’t just go out and say, ‘go to your doctor and get a flu shot,’” she says. “There are reasons why just one-third of older adults got their vaccines last year. We need to empathize with their current concerns, but reiterate the positive things that can happen if they get their flu shot.”
It’s asking older people to change their behavior yet again. Health professionals have been telling them to stay home as much as possible, to wear masks and be socially distant. They’re having their doctor’s appointments via video chat and many haven’t been able to visit in person with their children and grandchildren.
“How confusing is it to all of a sudden be asked to leave their homes when the conditions haven’t changed?” Summers says.
The health department has been doing its part to make it easier for people to get their shots. They have brought flu vaccine clinics to senior housing facilities, for example. There’s a hotline (410-396-CARE) that older residents can call for assistance getting vaccinated.
The final version of the new campaign flyer shows a man wearing a mask with the headline, “The FLU VACCINE is Worth it.” The upbeat message is about how people can protect themselves and others, containing this quote: “I’m getting my flu shot now, because when this pandemic is over, I want to be able to play with my grandkids again.”
This message and others will appear throughout the city and across social media in the coming days and weeks and will be shared by groups that have long worked with older people in the city.
“The message is that getting a flu shot is a positive thing I can do for myself and my family,” Summers says. “We think it’s a message that will resonate with a lot of people.”