In the past few years, flu vaccination rates have decreased by 16 percentage points for pregnant people and seven percentage points for children.
It’s a worrying public health trend. Pregnant people and children younger than five are among those at elevated risk for severe flu cases, hospitalization and death.
To combat the pervasive misperception, amplified online, that the flu vaccine doesn’t work, and to reach these high-risk populations in areas with historically higher caseloads and low flu vaccination coverage, the Centers for Disease Control and Prevention (CDC) launched a digital flu vaccine campaign in early September.
The “Wild to Mild” campaign aims to “reframe the discussion and expectations” around what the flu vaccine can and can’t do, said Erin Burns, associate director for communications for the CDC’s Influenza Division.
The messaging emphasizes how a flu shot can “tame” flu’s symptoms, taking them “from wild to mild.” The visual assets juxtapose wild animals against nonthreatening counterparts, like a shark and a goldfish, a tiger and a kitten or a grizzly bear and a stuffed teddy.
The medium is the message
In the CDC’s focus groups, people talked about how they still got sick after going in for a flu shot.
“People become discouraged and subsequently don’t get vaccinated again,” Burns said. But while the flu vaccine can prevent infection, its main strength is reducing the severity of an infection.
The campaign, which will run through the end of January, targets pregnant people and parents with paid placements in the digital environments where they’re spending time and seeking out health information, according to Burns.
While the federal agency is primarily running ads on Facebook and Instagram, it’s also producing a series of digital radio spots for Pandora, running search ads and looking to collaborate with Peanut, an app for pregnant women. The CDC doesn’t have a TikTok presence, but it’s working with a vetted group of microinfluencers to share the campaign message on their channels.
To allay any concerns about vaccines, the CDC found influencers to speak candidly about their personal experiences with the flu vaccine and why they chose to vaccinate themselves and their kids. The agency also addressed some of the main concerns “upfront in our messaging,” Burns said.
For instance, many expectant parents are apprehensive about their baby’s safety, so the CDC focused on the message that flu vaccines, safely administered to millions of pregnant women for more than 50 years, have “a very good safety record,” Burns said.
The messaging also stresses that a flu vaccine during pregnancy grants babies immunity to the flu for the first few months after birth, when they’re too young to receive their own vaccines. This information came as a surprise to many focus group participants.
“It was eye-opening for them,” Burns said. “They’re like, wow, if this is something that’s going to protect and help my baby, I would reconsider my decision not to get vaccinated.”
Calling the shots
The CDC tested four concepts with supporting text in its focus groups before settling on the “Wild to Mild” concept.
Scare tactics and “wording that comes off as shaming or judgmental” didn’t land with focus group participants, Burns said. Early on, the agency ruled out one ad option because it evoked a “visceral reaction” from parents, she said, who “felt like they were being told that if they hadn’t vaccinated their children, then they weren’t good parents.”
The remaining three concepts all tested fairly well, but the winning concept presented new information that felt “motivating” and “truthful” to focus group participants, Burns said. Also, the CDC came across as “forthright and transparent” in this creative option, making the participants feel better about the agency as a whole.
The CDC could use the brand lift – and the goodwill.
The past three years have seen a “tarnishing of public perception” of the institution, Burns said. Increasingly, people have reacted to the CDC and other government organizations with cynicism and lack of trust.
The CDC plans to measure not only performance metrics for its flu campaign, like reach, click-through rate and time spent on the designated CDC landing page, but also the quality of the engagement.
Often when the CDC engages on social media, “professional anti-vaxxers who spend their time trying to torpedo vaccines” take over the discussion, and it turns negative very quickly, Burns said.
But the tone tends to be markedly more positive in response to content from microinfluencers, who are “already trusted spokespeople,” she said. The CDC was so struck by the success of its microinfluencer pilot last year that it expanded the program.
“We’re continually looking at where we’re getting the most bang for our buck in terms of paid placements and refining that to find the greatest efficiencies,” Burns said.
In addition, the CDC is translating the campaign into Spanish and considering A/B testing different versions of the creative to ensure it resonates with Spanish-speaking audiences. For instance, how much does the rhyme in the “Wild to Mild” campaign slogan really matter? “You want it to be colloquial, but you also want it to be accurate,” Burns said.
Accuracy is everything for this campaign. Getting it right – finessing the information, the tone, the wording and the presentation to draw people in, not alienate them – is a matter of life and death.
Since flu deaths in kids are “nationally notifiable,” the CDC receives a report every time a pediatric death occurs.
“As a mom myself, to see those is heartbreaking,” Burns said. “And as much as possible, the hope is that this campaign will help people make a decision that prevents those kinds of tragic events.”