RR:C19 Evidence Scale rating by reviewer:
Reliable. The main study claims are generally justified by its methods and data. The results and conclusions are likely to be similar to the hypothetical ideal study. There are some minor caveats or limitations, but they would/do not change the major claims of the study. The study provides sufficient strength of evidence on its own that its main claims should be considered actionable, with some room for future revision.
“The COVID States Project #36: Evaluation of COVID-19 vaccine communication strategies” is an extremely timely and relevant article. This publication pulls from a larger study with an impressive number of diverse respondents during a pivotal time period of vaccine uncertainty. This study has the advantage that most respondents did not have access to the vaccine yet and were not yet influenced by their peer networks to receive the vaccine.
Unfortunately, the specific demographics of the surveyed population was not included. The reviewer advises the authors to include these details, even if it is included elsewhere in the larger study. As this study demonstrates, different demographic groups have different responses, so this is extremely valuable for the reader to be aware of.
The study group did an excellent job dividing views by age, race, gender, and political party. In addition, this study made sure to integrate political and socially relevant figures, such as athletes. However, the types of categories should have been expanded to local community health leaders, since the study itself found that a recommendation from a physician can be highly impactful. Although they showed that a physician or scientist recommending the vaccine decreases resistance, they did not test whether viewing a non-partisan physician or scientist receiving the vaccine made a difference on the views of the respondents.
The reviewer’s biggest concern was the study’s lack of clarity with the distinction between vaccine hesitancy and vaccine resistance. Although the authors outlined their logic behind these distinctions, they assumed that these two categories were defined by different underlying causes and did not actually ask respondents for the reasons for their views. The underlying reason is important to consider because different respondents may react differently to the same intervention based on their underlying reason. The authors should include this as a limitation of their study