Biden won’t reach his vaccine goal. Here’s why

President Biden recently conceded that he will not reach his July 4th COVID19 vaccination goal to get at least one shot in the arms of 70% of Americans. The frenzy to push to the front of the vaccine line has since given way to vaccine disinterest.

In response to this plummeting vaccine acceptance, the Biden administration launched its “We can do this” campaign, part of a $10 billion effort to increase vaccine confidence and access. In addition to an inperson concert showcasing Jennifer Lopez, this push will include vaccination tours by President Biden, VicePresident Harris, the First Lady and other key political figures.

The data, however, show these efforts are likely bound to fail.

In December 2020, our team at the Clinical Excellence Research Center at the Stanford University School of Medicine collaborated with YouGov on national surveys about the COVID19 pandemic. We asked a demographically representative sample of the American population to rank whose endorsement would most affect their decision to be vaccinated. The options included former President Donald Trump, President Biden, public health leaders like Dr. Anthony Fauci, personal doctors and religious leaders (i.e., priest, pastor, rabbi, or imam).

To our surprise, political affinity was not a dominant factor in deciding to get the vaccine. When asked which endorsement would most influence them, 40% of respondents ranked public health leaders first and 20% picked their own doctors. Trump was selected by 15% and Biden by 10%.

Only 6% of Biden voters reported they would look to their candidate for vaccine advice. Instead, 63% of Biden backers ranked public health leaders first, while 12% favored their doctors. Similarly, 27% of Trump voters ranked their doctors first and 20% ranked public health leaders.

Other polls have shown men get vaccinated much less often than women. Perhaps not surprisingly, men were more likely to say they were not scared of contracting COVID19 and less likely to take preventative measures.

Could it be that men are listening to different trusted leaders?

In this case no. We analyzed whether gender impacted vaccine trust and found that men, like women, were more likely listen to doctors and public health leaders.

We also examined the results by race, income, political ideology, religion, and a variety of variables. None of these factors influenced the conclusions. Most Americans from different backgrounds would depend on their doctors and public health leaders when deciding whether to receive the COVID19 vaccine. The only exception was Native Americans, 50% of whom selected their religious leaders. No subgroup placed political icons at the top of the list for vaccine advice.

Americans crave scientific information about vaccines. But there are often competing views in the media and an everchanging evidence base. Not only do we need to hear about the science, but we need people to build trusting relationships with credible experts. That doesn’t include musicians. (No offense, Sir Elton John.)

It’s likely that efforts to encourage vaccination are failing because they ignore the real reasons for vaccine hesitancy, including barriers to access, fear of needles, likelihood of unpleasant side effects and unknown long term effects. Confronting these issues will almost certainly require honest conversations with people who know medical science as well as an individual’s personal health circumstances.

Despite their immense talent, J.Lo and Elton John can’t help.

So, how should we convince the 25% Americans who will refuse the vaccines, or the 40% of U.S. Marines who turned them down to change their minds?

Like all health decisions, vaccination is personal. Discussions about the benefits and potential costs of vaccination need to be twoway streets.

Good health care providers listen, not just lecture, ultimately reaching decisions that take a patients’ personal fears and unique circumstances into consideration. Thoughtful and personalized conversations will produce better results than encouragements from your mayor, a lottery ticket, or a free beer.

Aimee J. Lansdale is a graduate student at Stanford University’s Community Health and Prevention Research Program and a research associate at Mathematica, a policy research organization. Robert M. Kaplan is a faculty member at Stanford University's Clinical Excellence Research Center, a former associate director of the National Institutes of Health, and former chief science officer for the U.S. Agency for Health care Research and Quality.