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On Monday morning, the first person in the United States received a dose of the Pfizer/BioNTech Covid-19 vaccine. Now images of Sandra Lindsay, a nurse at Long Island Jewish Medical Center in Queens, are going viral. But over the coming weeks and months, shell be far from the only person showing up in social media feeds getting inoculated.

At the dawn of the pandemic, celebrities and influencers flooded our feeds with content urging us to take preventive measures, like hand-washing, social distancing, and mask-wearing. That wasnt a coincidence: Public health leaders and campaigns strategically encouraged and recruited those with large online followings to use their platforms for good.

Now the groundwork is being laid for the same thing to happen again except this time, the mission is to convince as many people as possible to get a Covid-19 vaccine.

Recent polling shows that the number of Americans willing to get the vaccine, and to do so as soon as it becomes available, oscillates. An ABC News/Ipsos poll found that more than 80 percent are willing to get the vaccine, but just 40 percent will do so as soon as they can. Pew Research Center found about 60 percent of people would probably or definitely get the vaccine in an early December survey.

Thats a significant jump from the 50 percent who said they would be willing to take a vaccine in September but it still means millions are hesitant about getting vaccinated. For the vaccine to have a large-scale impact, people dont just need to be willing to be inoculated; they have to be enthusiastic enough to seek it out (and possibly twice, if theyre getting the Pfizer vaccine, which requires a booster shot).

The global campaign to encourage Covid-19 vaccination will be unprecedented, and many institutions will have a role, including government and public health authorities. But some, including the World Health Organization, the Ad Council, and the United Kingdoms National Health Service, are already laying the groundwork for influencers and celebrities to have a hand in the process.

They say influencers could help promote positive, accurate vaccine content to a wide audience, as well as target content to individual communities. But theres also concern the campaign could backfire: One persons trusted celebrity is anothers red herring. And influencers and celebrities that encourage their fans to get inoculated will inevitably be jumping into frequently tense online discourse surrounding vaccines and exposing themselves to misinformation and online attacks from the anti-vaccine movement.

Still, these campaigns are already in the works. In the United Kingdom, where the Pfizer vaccine was rolled out in early December, the National Health Service is planning to get celebrities to encourage people to take the vaccine, with soccer player Marcus Rashford and members of the British royal family identified as optimal candidates, the Guardian reported.

Influencers can be very helpful in spreading awareness about benefits of vaccines and advocating for vaccine acceptance, Tarik Jaarevi, a spokesperson for the WHO, told Recode, in an email. WHO is working on a comprehensive campaign on immunization and Covid-19 vaccines for 2021. The organization added that the value of recruiting influencers depends on the audience, and that its not always influencers with a huge online following that have the most value.

In the US, there are many efforts meant to involve celebrities and influencers in rolling out Covid-19 vaccination. The Ad Council which famously created the wildfire prevention campaign of Smokey Bear and the 1990s AIDS prevention campaign encouraging safe sex is putting together a $50 million campaign that will rely in part on influencers to encourage people to take the vaccine. Some have even floated the idea of offering athletes and a subset of rich and famous people the vaccine early in a bid to boost confidence. Some politicians, including former Presidents Barack Obama, George W. Bush, and Bill Clinton, and New York Mayor Bill de Blasio, have already said theyll take the vaccine publicly. Even Dr. Anthony Fauci has volunteered to do so on camera.

In fact, the Trump administration had planned a Covid-19 public awareness campaign on celebrities earlier this year. The federal government planned to spend hundreds of millions of dollars on a broad marketing effort that would enlist celebrities like Dennis Quaid and Billy Ray Cyrus to counter sadness triggered by the pandemic and boost excitement for the vaccine. The plan fell apart amid Democrats concern that the ploy was actually designed to boost Trumps reelection chances. Now the Department of Health and Human Services is moving quickly to develop a new outreach campaign focused on the vaccine on a somewhat rushed schedule. A spokesperson for HHS told Recode the original plan to use celebrities has been put aside, making the influencer- and celebrity-based campaigns being developed outside the government perhaps even more important.

The virtue of recruiting influencers for this marketing effort is that not everyone cares or is even paying attention to what Fauci or other US public health authorities have to say about the vaccine. And even for those who are, repetition of that message can make getting a Covid-19 vaccine become a social norm more quickly, especially in an environment where peoples faith in official public health sources is strained, according to Sherry Pagoto, a professor who directs the University of Connecticut's Center for Health and Social Media.

To the extent that we can leverage other trusted and influential sources to get the word out, I think well have better luck at getting people to feel comfortable and have confidence in the vaccine, Pagoto told Recode.

That celebrities and influencers would have a role in promoting a Covid-19 vaccine isnt surprising. Elvis Presley famously took the polio vaccine on The Ed Sullivan Show in order to encourage other young people to do the same. And celebrities have made a significant impact on public health communications in the past. Some researchers have found, for instance, that Angelina Jolies 2013 op-ed about getting a preventive double mastectomy might have boosted genetic testing that could indicate future breast cancer.

Throughout the pandemic, a number of influencers have stepped up to encourage coronavirus safety measures. TikTok star Charlie DAmelio made a social distancing-inspired dance go viral. Kim Kardashian West arranged a private Zoom call with dozens of celebrities and Fauci to ask questions that could inform how they spoke to their own followers. Some social media influencers have even been brought on to promote flu vaccines.

US Surgeon General Jerome Adams directly called on celebrities like Kylie Jenner to encourage people to take the pandemic guidelines from health professionals seriously (the reality television and cosmetics industry entrepreneur obliged in an Instagram Story sent to her 166 million followers). Actor Harrison Ford also encouraged Americans to participate in Covid-19 vaccine trials in a public service announcement.

The next phase of the Covid-19 outbreak will require sharing accurate information about vaccinations, a task that will need to be tailored to different communities. The distribution for the vaccine will be in phases based on who is most at risk, meaning that young people without preexisting conditions are likely last in line.

We know for sure that a one-size-fits-all message will not be the solution to such a complex challenge, said Michelle Hillman, the Ad Councils chief campaign development officer. We also know that a patchwork approach wont work.

Influencers will be part of the Ad Councils effort. Over the coming weeks and months, the nonprofit is laying the groundwork for a $50 million campaign to encourage Covid-19 vaccination, which the organization thinks could be one of the largest public education efforts ever run in the US. The idea is to use trusted people with large online followings to discuss vaccine safety and address misinformation.

Even though it will likely be some time before a vaccine is widely available, Hillman said the work for finding the right voices and messaging to counteract vaccine hesitancy needs to begin now.

The Ad Council is taking an approach that involves influencers, in part because it wants to tailor messaging to particular communities. The organization will even use artificial intelligence from IBM Watson to study and predict what kind of content does best with different audiences. The campaign will pay particular attention to Latinx and Black communities, in which reluctance toward taking a Covid-19 vaccine can be higher due to distrust in the government, existing health inequities, and a history of systemic racism in the US health care system.

This approach is similar to the Ad Councils #MaskUpAmerica campaign, which encouraged mask-wearing in the pandemic. So far, the nonprofits Covid-19 efforts have involved more than 120 influencers and celebrities who have pushed pro-mask content on a variety of platforms, including Twitch and TikTok.

But the Ad Council isnt alone in its focus on influencers. When a vaccine becomes widely available, Qianna Smith Bruneteau, the founder and executive director of the American Influencer Council, is planning to encourage influencers to share information about getting vaccinated. The council, which operates as a nonprofit trade organization, has already created an online resource center. In addition, Bruneteau and Patrick Janelle, the councils chair and an Instagram influencer with more than 400,000 followers on Instagram, both plan to livestream their vaccinations on the platform.

That lots of influencers will play a role in promoting getting vaccinated against Covid-19 seems inevitable, according to Tyler Farnsworth, the chief growth officer and founder of the influencer marketing agency August United. In some sense, the effort will build on influencer marketing campaigns that Farnsworths company has already worked on during the pandemic, like hand-washing content produced with a soap company.

The groundwork has already been laid for it, Farnsworth said. There is at least one state that we are actively working together with [...] on putting together a plan to activate influencers across their state to encourage the use of the vaccine. I believe many more will follow. He added that, in the past year, influencers have become more open to potentially contentious content, like political advocacy, which could make them more willing to speak about the Covid-19 vaccine.

Vaccine misinformation is showing up on platforms like Instagram, Facebook, and YouTube, so anti-vaccination content, and even Covid-19 conspiracy theories, will certainly impact the work that influencers can do to promote a vaccine. Earlier in the pandemic, some celebrities and political activists, including actor Woody Harrelson and the commentator duo Diamond and Silk, spread conspiracy theories about Covid-19, and theres no sign that trend will stop when a vaccine candidate is authorized in the US. Now some see a role for influencers in counteracting such messaging.

Recently, conservative commentator Candace Owens posted a video on Instagram raising skepticism about the need for a Covid-19 vaccine, and implied that people who take the vaccine are sheep. The video was flagged by Facebooks fact-checking system but was still viewed nearly 2 million times. Other longstanding anti-vaccine voices, such as Robert F. Kennedy Jr., have remained active on social media, and theyre increasingly focusing on sowing skepticism in Covid-19 vaccine candidates.

Before the emergency use authorization arrived, Facebook and YouTube started to adjust their policies on Covid-19 vaccine misinformation, such as banning vaccine conspiracy theories and content that contradicts the recommendation of public health authorities. But these changes dont mean content thats skeptical toward such vaccines is always removed.

Public health experts have also emphasized that people are going to have worries about a new vaccine, and should have space online to ask questions and share their concerns. Those fears could be exacerbated by blatantly wrong misinformation.

We are dealing with so many people having doubts about the vaccine, said Bruneteau of the American Influencer Council. Creators can 100 percent help combat Covid-19 vaccination misinformation.

Influencers smaller, more focused accounts than celebrities with tens of millions of followers rely on clients to pay them to promote certain products. That means some influencers dont always want to post content they fear could be controversial, like politics, or even information about vaccines.

Every time I post about vaccines in general, I get just in droves people coming and attacking my page, Danielle Jones, an OB-GYN who has more than half a million subscribers on her YouTube page, told Recode. At one point in the past couple of years, I actually had to make my Instagram private, because people had gone over and just started commenting that my kids were vaccine-injured.

She added that attacks from anti-vax accounts will discourage some people from posting about Covid-19 vaccines. Still, she says she feels a duty to share the right information.

Theres no single entity responsible for encouraging vaccination. As a result, it seems like many groups including social media companies, the White House, public health experts, and even influencers need to be involved.

The hard part [is] that theres so many players who need to be at the table, and theyre all so critical that any one of them missing would possibly lead this to not work, said Carly Goldstein, a Brown University psychiatry and human behavior professor who has written about potential Covid-19 vaccine influencers.

Careful calibration is important, experts told Recode, because missteps could lead to a campaign backfiring. A government agency bringing along celebrities could actually decrease peoples trust in the governments abilities, notes Alessia Grassi, a lecturer at the University of Huddersfield. Even if a particular celebrity did manage to convince their audience, their endorsement could potentially turn off another audience.

A guide to Covid-19 vaccine communication produced at the University of Florida, in partnership with the United Nations anti-misinformation campaign, has urged public health leaders to choose the right messengers. That initiative found that celebrities on their own are not trusted sources of Covid-19 information.

That might indicate that influencers themselves shouldnt get too into the scientific weeds, and should instead play a role in diverting people toward public health sources. It might also mean looking more toward influencers with a health care background. In fact, the public could likely benefit from the surge in the number of nurse and doctor influencers seen in 2019 and 2020, according to Joe Gagliese, the CEO of the influencer agency Viral Nation, which worked with the WHO to provide accurate information to influencers earlier in the pandemic.

What youll see is theres a ton of influencers that are in the health care space, and theyll generally lean toward whatever the consensus is in the medical field, Gagliese told Recode.

In fact, some of these influencers are already starting. Some physicians have posted TikToks explaining how mRNA works, which is foundational to the Pfizer/BioNTech and Moderna Covid-19 vaccines. Others, like Jones, the OB-GYN, have offered guidance on what the vaccine might mean for pregnant people. And then there are the physicians who are just sharing their excitement about the prospect of inoculation.

I cannot wait to get the vaccine, because I know it can protect me, and it can protect those around me that I care about, Jennifer Arnold, a doctor with preexisting conditions who stars in the TLC show The Little Couple and has nearly a million followers on Instagram, said.

I get excited when I am able to have any type of influence, she added. If I can help one other person to decide to get the vaccine and ultimately save a life through social media, that is phenomenal.

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Why Covid-19 vaccine ad campaigns will include celebrities and influencers - Vox.com