The Initial Relationship Between the United States Department of Health and Human Services’ Digital COVID-19 Public Education Campaign and Vaccine Uptake: Campaign Effectiveness Evaluation

Abstract

Background Over 1 million people in the United States have died of COVID-19. In response to this public health crisis, the US Department of Health and Human Services launched the We Can Do This public education campaign in April 2021 to increase vaccine confidence. The campaign uses a mix of digital, television, print, radio, and out-of-home channels to reach target audiences. However, the impact of this campaign on vaccine uptake has not yet been assessed. Objective We aimed to address this gap by assessing the association between the We Can Do This COVID-19 public education campaign’s digital impressions and the likelihood of first-dose COVID-19 vaccination among US adults. Methods A nationally representative sample of 3642 adults recruited from a US probability panel was surveyed over 3 waves (wave 1: January to February 2021; wave 2: May to June 2021; and wave 3: September to November 2021) regarding COVID-19 vaccination, vaccine confidence, and sociodemographics. Survey data were merged with weekly paid digital campaign impressions delivered to each respondent’s media market (designated market area [DMA]) during that period. The unit of analysis was the survey respondent–broadcast week, with respondents nested by DMA. Data were analyzed using a multilevel logit model with varying intercepts by DMA and time-fixed effects. Results The We Can Do This digital campaign was successful in encouraging first-dose COVID-19 vaccination. The findings were robust to multiple modeling specifications, with the independent effect of the change in the campaign’s digital dose remaining practically unchanged across all models. Increases in DMA-level paid digital campaign impressions in a given week from –30,000 to 30,000 increased the likelihood of first-dose COVID-19 vaccination by 125%. Conclusions Results from this study provide initial evidence of the We Can Do This campaign’s digital impact on vaccine uptake. The size and length of the Department of Health and Human Services We Can Do This public education campaign make it uniquely situated to examine the impact of a digital campaign on COVID-19 vaccination, which may help inform future vaccine communication efforts and broader public education efforts. These findings suggest that campaign digital dose is positively associated with COVID-19 vaccination uptake among US adults; future research assessing campaign impact on reduced COVID-19–attributed morbidity and mortality and other benefits is recommended. This study indicates that digital channels have played an important role in the COVID-19 pandemic response. Digital outreach may be integral in addressing future pandemics and could even play a role in addressing nonpandemic public health crises.

Association Between the “We Can Do This” Campaign and COVID-19 Booster Uptake, U.S., 2021–2022

“…This study builds upon prior evaluations in which campaign exposure was associated with increased first-dose vaccination uptake, 24 , 25 demonstrating a positive association between HHS’s We Can Do This Booster Campaign and COVID-19 booster uptake as well as the speed at which individuals received their booster dose, relative to the timing of their first dose. In both the multilevel logistic regression and Cox proportional hazard models, results were consistent with multiple operationalizations of booster campaign exposure, indicating the campaign may have encouraged individuals with later first-dose vaccination dates to remain up-to-date with their COVID-19 vaccinations.…”

“…Booster campaign delivery data were operationalized in 2 ways: (1) cumulative media delivery, conceptualized as aggregate advertising with influence decaying over time; and (2) weekly media delivery. Consistent with existing research on the impact of digital and TV paid media on COVID-19 vaccination, 24 , 25 , vii the cumulative media delivery measures account for current and past exposure to paid media using a 3-week half-life decay function. All measures were lagged by 1 week to account for the expected temporal ordering of media delivery prior to respondents’ decisions to receive a booster.…”

“…In evaluations that included campaign TV dose, the association between short-term campaign digital dose and the likelihood of vaccine uptake was larger in magnitude than the association between cumulative campaign local TV dose and vaccine uptake likelihood. 24 , 25 For the booster campaign, although there was an association between cumulative campaign digital dose and booster uptake among those with later first-dose vaccine dates, there was no association between short-term changes in campaign digital impressions and booster uptake, and the effect of cumulative local TV dose on booster uptake was larger in magnitude than the effect of cumulative digital dose on booster uptake. Higher, more entrenched booster hesitancy than first-dose vaccine hesitancy may be a factor, as booster hesitant people who remained so in December—3 months after boosters were authorized—may be less open to uptake than they were for their first-dose vaccination.…”

“… 25 , xix Similarly, the larger TV effect for the booster campaign suggests increased TV GRPs move individuals with later first-dose vaccine dates toward booster confidence, when taking the lower initial vaccine confidence into account. Building upon first-dose uptake research, 24 , 25 digital impressions contribute by moving initially vaccine-hesitant individuals toward receiving a booster dose, proxied by later first-dose vaccine dates, but the effect is not as strong as that of TV GRPs.…”

“…Two types of models were estimated to show the different but complementary associations between booster campaign media delivery and booster uptake. Similar to other campaign studies, 24 , 25 a multilevel logistic regression model with random DMA-level intercepts and time-fixed effects was estimated to evaluate the association between cumulative booster campaign media delivery and the week-over-week probability of receiving a booster dose. xi Next, a Cox proportional hazard model was estimated to evaluate the association between weekly booster campaign media delivery and changes in the length of time to receiving a booster.…”