Weekly coronavirus-related chat, questions, and minor updates - week of October 24

A better booster campaign (Your Local Epidemiologist)

Several years ago, Dr. Siegel was doing research on how to persuade people to become organ donors. This work resulted in something called the IIFF Model—a framework that maximizes the likelihood that people will act on their favorable attitudes—bridging the gap between feeling good about something and actually doing it.

Their work describes an orientation called passive positive. Drs. Rosenberg and Siegel thought that, given similarities, this model could be applied to better understand the low booster shot uptake.

In COVID-19, passive positives are people who are not motivated to find out if they are eligible for another booster, are actively trying not to think about COVID-19 or the booster, are not willing to exert energy to find out where they can get another booster shot, and are likely ambivalent about receiving the shot (e.g., may have positive attitudes about the protection it gives and negative attitudes about the immediate side effects).

All of this paints a relatively counterintuitive picture, as folks who have received two, three, or four COVID-19 shots are likely to hold relatively positive attitudes toward the vaccine—they were, after all, willing to get the primary series—but have yet to get the fall booster.

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Putting it all together, imagine a scene in a CVS pharmacy: Any time a medication is given to a customer, the pharmacist can ask about vaccination status (or check the patient’s records). If the patient is not boosted, the pharmacist can let them know they are eligible to receive a booster, that they can receive one right now, and describe the benefits. Ideally, the pharmacy could have posters advocating the benefits of booster shots so the topic is salient even before the pharmacist breaches the topic. This approach can work because all four elements of the model are simultaneously present. However, if even one aspect of the model is missing, the likelihood of success drops dramatically. Pharmacies are currently understaffed, overwhelmed, and burnt out. Getting vaccines into arms has to be an investment and public-private partnership, just like we did to get vaccines into vials.