Home Visitors and Community Health Workers COVID-19 Vaccination Messaging Guide

"The more people that I know and trust that are doing something, the more likely I am to consider doing it as well."

From the Christian relief, development, and advocacy organisation World Vision, this guide is designed to help home visitors, community health workers, and others understand how to counsel families to increase COVID-19 vaccine uptake, and what questions and answers (messages) to use to be most effective. Grounded in barrier analysis, the guide includes behavioural science that may be useful when promoting demand for other vaccinations and uptake of childhood services.

The half of the guide outlines considerations to keep in mind when counseling people on vaccination. For example, the reader learns the importance of:

• Affirming the person - e.g., "It sounds like you have done a great job of thinking through how to protect your family so far from COVID-19."
• Using reflective listening - e.g., "So you think the vaccines would help you to avoid getting COVID-19 but some of your family members disapprove?"
• Avoiding arguing with people - e.g., "I understand why you have some concerns since this is all very new."
• Using close-to-home stories - e.g., by reminding them of all the people in their community who are planning to get a vaccine and who are supportive of vaccines, such as specific faith leaders, doctors, community leaders, or other people they trust.

Some of the other evidence-based techniques explored include:

• Increase perceived social acceptability.
• Connect with people's values.
• Use social proof.
• Use cues for action.
• Use social and value-driven responsibility.
• Use loss aversion and anticipated regret.

Also stressed: what one should not do when counseling a person: (i) Don't lecture the person; (ii) don't make character judgments or criticise the person; (iii) don't do most of the talking; (iv) don't blame the person; (v) don't label the person; (vi) don't argue or debate with the person or confront them; and (vii) don't be dismissive or give up on the person.

The second half of the guide explores six specific barriers, providing some messages the home visitor or community health worker can use, depending on the questions posed or reasons given by the people or groups who are hesitant about or choosing not to get a COVID-19 vaccine. The barriers include:

1. Concerns about safety and side effects;
2. Efficacy doubts;
3. Social norms;
4. Skepticism and mistrust;
5. Lack of awareness of positive consequences (advantages); and
6. Low perceived susceptibility to and severity of COVID-19.

The guide's annex features key facts about COVID-19 variants.

World Vision indicates that anyone is free to reproduce and use this booklet or a portion of it, adding their own logo, under the conditions mentioned on page 2 of the booklet. World Vision asks that those who use it contact them at health@wvi.org to explain where they are using it, the results they are seeing, and any suggestions they have for improvement of this resource.