Vaccine adherence as an information design challenge

Although healthcare professionals and economists are celebrating the development of COVID-19 vaccines, one of the greatest challenges — other than the logistics of vaccination delivery — will be convincing people to take it. The battle is still raging between the far sides of the vaccine argument; avid pro and anti vaxxers are deeply rooted in their perspectives. However, there are many more people who aren’t denying allopathic medicine or medical science, yet still feel somewhat nervous. They are crying out for information designed and delivered in a more empathetic way, another clear example of why great designers are an asset to any complex problem worth solving.

Great designers are deeply curious people who love turning complexity into simplicity. They seek out evidence and detail, balancing insights about irrational and rational human behaviours with system constraints. They find nothing more pleasing than being able to turn a mess of complex information into something comprehensible and engaging; the most elegant possible ‘interface’ to help people understand what to do to reach their desired goal. So, what could be more relevant for this skillset right now than the problem of vaccine adherence? We have some outstanding informational challenges to grapple with.

Firstly, differentiating between people who are reticent about the vaccine vs conspiracy theorists. It seems as though a battle line has been drawn between those who would willingly take the vaccine with complete trust and those who have concerns, with people who are concerned crudely disregarded as avid ‘anti-vaxxers’ or science deniers. This shows a lack of human empathy. In fact, reticence about the vaccine is based on reasonably justifiable fears:

• Distrust of government. Not everyone has been treated fairly by their local government, either recently or generationally, understandably questioning the motivations behind state guidance.
• Distrust of healthcare professionals. Many people have experienced disappointment when seeking medical treatment, with marginalised groups in particular regularly facing medical discrimination and ‘gaslighting’ when seeking support. It’s not a given that everyone has a reason to trust what their doctors have to say.
• Distrust of pharmaceutical organisations. Pharmas have been responsible for a number of ethical and safety breaches in the past and are assumed to be connected to the impoverishment of those trying to afford essential medications. Unless you have worked with or for these organisations, their beneficence is often obscured by a distrust of their motivations.

All of these fears need to be acknowledged and addressed before people are relegated into a conspiracy theory bucket, which is not a helpful response. It makes the issue binary when it is not. Simply saying ‘take the vaccine because these 3 entities say so’ will not cut it with millions of people.

Secondly, people need help balancing the information that is significant to them in order to perform their own risk assessment. To help people do this, there are three buckets of information that need to work together and be refined:

1. What are my chances of getting sick or making others sick?

It has been difficult for people to pinpoint the likelihood of them getting significantly ill and potentially having ‘long COVID’ if they are infected. There are particular demographic characteristics and afflictions that are assumed to make people more vulnerable, but this isn’t always the case and isn’t specific enough for humans who have a cognitive bias that makes them believe they can beat the odds. What is required is a smart triangulation of multiple sources of data; comorbidity, demographic, access to healthcare, infections by location and ‘stamina’ to help people to determine how likely they are to be afflicted AND how likely they are to infect others with those same underlying factors. This is a very difficult problem. Healthcare professionals are working with a mix of reliable data and complete guesstimates right now (how do you determine ‘stamina’ and what role do other complex medical histories play?), but this needs more work if reticent adopters are to be convinced. At the very least, being able to better show what we know so far and how that relates to individuals with a series of complex cisrcumstances.

2. What is the risk of being harmed by a vaccine?

One of the key concerns about the vaccines is the rapidity of their development and people not understanding the difference between the vaccines (Moderna, AstraZeneca, Pfizer and other emerging solutions). This is something that can be far more easily addressed. I have been fortunate enough to see inside of the medication development process as a designer and strategist and what I learned is that most trials take a tremendous amount of time because of limits to funding, information and expert review and having to grapple with complex regulation. I also learned that all medications come with a risks, but that those risks rarely outweigh the overarching benefits.

What is required from the clinical research community is to clarify how much of the shortened timeline is due to funding, regulation and information barriers being removed, as opposed to the lack of longitudinal evidence. It would also help to explain the risk of the vaccine in comparison to everyday medicines that people willingly take. Lastly, people need to easily understand what their body will and will not do after taking each of the vaccines and how those vaccines differ. Right now, none of this is truly comprehensible to people with a limited understanding of medicine and regulatory processes.

3. What impact will it have to me and my community if people don’t get vaccinated?

What many people are looking for, right now, is an understanding of whether they will be able to thrive or survive in 2021. This is dependent on communities beating COVID and being able to activate the economy again. So, if a certain percentage of people don’t get vaccinated, how will the recovery be impacted and, in particular, what will happen to employment and consumer confidence? This problem involves calculations from economists by industry, skillset, location and social strata, which is a guesstimate they are already making based on existing data. People need to know how their income and family may be impacted and how taking the vaccine may assist in their own recovery and that of their community.

HCPs and economists need designers

So, that’s a lot of complex information that most individuals don’t have the ability to fully comprehend, let alone assess side-by-side. This is where designers come in. I have been fortunate enough to work with HCPs on a number of key healthcare problems. It is a beautiful collaboration. People who work with extreme complexity need people who are in the job of making complex information simple. Sometimes there is a clash between the need to mitigate risk (HCPs) and the need to make things definitive and simple (designers) but it is entirely solvable when both are motivated by the benefit to the patient.

I’m certain designers will play a significant role in helping us all to thrive in 2021, part of which will be making the path to beating COVID a lot clearer for everyone.