Emergent Advocacy Coalitions and SARS-CoV-2 Vaccine Hesitancy: The influence of beliefs and narratives on individual decision-making

The 2021 COVID-19 vaccine campaign is likely to be among the most important public health initiatives in recent history. Its success in dampening the coronavirus pandemic rests on its ability to persuade large portions of the population to be vaccinated quickly. Unfortunately, individuals often act in ways inconsistent with their best interests, whether in terms of voting behaviors, financial decision making, or in this case, vaccination decisions. Most communication strategies to persuade people to make better decisions involve one or more of the following: providing information that supports evidence-based decision making; employing influential spokespeople; utilizing an expanded range of formal and informal media channels; introducing fear-based messaging to promote action; and enhancing people's capacity to make evidence-based decisions. Rarely do such communication strategies consider the strength and influence of underlying belief systems. This may be particularly relevant in those situations in which national advocacy groups have introduced counter-narratives to sway public opinion or actions. The COVID vaccination campaign offers an opportunity for examining how belief systems influence the adoption or rejection of a protective behavior. This study focuses on three aspects of belief and attitude formation: (1) the evolution of newly-formed advocacy groups and coalitions endorsing pro- or anti-vaccine stances, (2) the deployment of narratives and stories by these advocacy groups to advance their mission, and (3) the power of these narratives, stories, and beliefs to persuade individuals to accept, delay, or reject a COVID vaccine. This research identifies distinctive advocacy coalitions operating at elite levels to influence local stakeholder beliefs and policies, and develops a matrix of policy and core beliefs based on content analyses of public documents. The team also identifies and characterizes the policy narratives emanating from these advocacy coalitions. Subsequently, the research samples and surveys 3,000 US residents at two points in time to capture public opinion and decision making at two moments in the vaccine development timeline. The team tests the influence of policy narratives among individuals, and analyzes the contribution of aligned policy beliefs with the vaccine behaviors of the study participants.