A Dollar Store Solution?

Ever since the United States missed its July 4 goal of getting 70% of adults their first shot of the COVID-19 vaccine, hesitancy has become one of the nation’s most concerning topics. But who exactly are the ones who have not received a shot, and what is preventing it? The New York Times analyzed a large-scale survey that explored the potential root causes keeping people from getting vaccinated and classified them into four categories: COVID-19 Skeptics, Cost-Anxious, System Distrusters and the Watchful.

Misinformation was the key that led to vaccine hesitancy across these groups. People who fall into one of the four groups seemed to be misled by false claims on the virus and vaccines from the news media or elsewhere. Confirmation bias also exists, as people tend to stick to their prior conclusions and listen to or follow only certain politicians and influencers. Thus, people with different socioeconomic backgrounds, from different communities in terms of race, ethnicity or political leanings, could share tendencies toward certain pieces of misinformation.

According to one of our published studies on early responses to COVID-19 on Twitter, people from high-income areas and those in less-resourced areas reacted differently when the pandemic first hit the United States in 2020. Our study highlighted the need to address specific fears and concerns of these communities through public health messaging at a granular level. We further demonstrated the potential of people, especially those from less-resourced areas, being disproportionately affected by misinformation. Instant and personalized public health messaging campaigns should take place as soon as possible to achieve better reach and spread.

Even more essential is understanding the major concerns and turning them into actionable insights. The analysis from The New York Times reveals detailed concerns from public beliefs and hints at potential solutions. For instance, the Cost-Anxious and System Distrusters likely have poor proximity to vaccines and other resources based on their historical experiences. That is, time and cost constraints and resource accessibility have been holding them back from vaccination.

That raised the issue of how to best bring vaccines to their neighborhoods.

From another study on retail vaccine availability, we assessed providing vaccines at the ubiquitous Dollar General stores in addition to the current Federal Retail Pharmacy Program partners. Store locations are chosen in part based on proximity to target customers, and evidence showed that Dollar General has done better reaching vulnerable communities than current partnered pharmacies. Our study further showed that using Dollar General stores as vaccination sites would offer considerable proximity benefits, particularly for low-income households, people living in rural counties, Black Americans and Hispanic Americans in several regions of the United States.

In summary, misinformation and confirmation bias, whether caused by fake news, false claims or political allegiance, can lead to vaccine hesitancy. Public messaging at a granular level, together with actionable policies, is essential to reversing this trend. Enhancing proximity to vaccination sites could be our next step as it ensures access, equity and high rates of vaccination among low-income and minority communities that are more likely than others to experience vaccine hesitancy.

President Joe Biden’s push to bring the vaccine conversation directly to the front doors of Americans faced criticism. Perhaps it would be worth trying to offer their Dollar General neighbors as a convenient vaccine choice.