Since the first rumblings of a vaccine for COVID-19 at the pandemic’s outset, the issue of vaccine uptake and how to increase it has been ubiquitous in American public and political discourse. From ongoing debates, particularly around childhood vaccination, we know that vaccine uptake is shaped not only by individuals’ level of confidence in vaccines and their willingness to get the shot, but also by systemic barriers that only policy and structural changes can address. However, the media, government, and some in the medical community consistently make the issue of vaccination about confidence and safety first and foremost.

People who work in the field of vaccination share the same goal: to increase vaccine uptake. This project was designed to explore whether placing individual behavior change and the safety of vaccines at the center of communication is the most effective way to reach that goal. It builds on the premise that scientific information, access to health care, and structural discrimination and racism in and beyond the health care system shape attitudes and behaviors around vaccines. Through interviews with researchers, practitioners, advocates, and the general public, we identified both helpful and challenging beliefs about vaccines and vaccination in the United States. It provides preliminary insights on expert and public thinking and guidance on how to talk about the importance of vaccines in general—and childhood vaccination specifically.

This report represents the first stage of a larger research project that seeks to contribute to building public understanding of vaccines and to increasing support for structural and policy changes that will improve vaccination access and uptake.