With the Congress in Barcelona firmly behind us we are able to reflect on the key themes and discussions that took place. Such a theme was undoubtedly sparked by Dr Angus Thomson who led our Vaccine Hesitancy and Misinformation workshop on the pre-Congress workshop day. We were lucky to catch him the day after this to hear about what went on and what he is taking away from the event. Thank you to Dr Thomson for his time and insight, and we hope that you enjoy the conversation!

Introducing Dr Thomson

Dr Thomson is “trained as a molecular geneticist” but is now working in behavioural and social sciences, particularly as pertaining to “vaccine behaviours”. During the pandemic he served as a senior technical advisor to UNICEF, and has since established a behaviour design consultancy, called Irimi. Irimi’s approach is “listen to understand people’s lives”, and we’ll explore this in greater detail later on.


What did the workshop cover?

If you weren’t able to join the workshop, Dr Thomson explores some of the key ideas that were covered in this next segment. He reflects that the session was full of insights and attendees engaged with the key theme of the panel: getting on the “front foot”. For Dr Thomson, this means institutionalising the work that has been done to encourage public trust in vaccines.

“We’re always on the back foot; we’re always playing catch up, whether it’s in a pandemic or in our routine programmes.”

What the workshop highlighted were a “serious of mechanisms” with “strong science” behind them. Therefore, we can design “human-centred” and more effective interventions. When he speaks of effectiveness, Dr Thomson refers both to “public trust” and getting people vaccinated.

“The theme that emerged from yesterday’s discussion was: we know what works now. We invest billions of dollars in solid cold chain and vaccine delivery mechanisms, in discovery and clinical development, in bringing vaccines to market. But this last mile, or in many ways it’s like the last millimetre in people’s heads, of vaccine delivery, is the forgotten child of vaccination.”

During the pandemic, we saw the consequences of “failure to secure public trust” before vaccine introduction; Dr Thomson describes this as “disastrous” in many settings.


Listening, listening, listening

If you’ve encountered Irimi before, or perhaps you’ve checked out their website today, you’ll notice an emphasis on listening. We asked Dr Thomson to explain the significance of this.

“So, social listening is fundamental.”

With an understanding of “what’s driving people’s decisions” we can “design programmes that respond to those barriers or levers”, whether they are psychological, social, or even logistical. Dr Thomson refers to Dr Joe Smyser, from Public Good Projects, as an example of social listening to inform practices.

“Social listening is often confused with social media listening, and it’s not.”

Dr Thomson highlights that much of the world is “digitally disenfranchised” so social listening must be flexible to all avenues of social communication. For example, television or radio, are examples of offline communication that many people access. Social listening is “fundamental” to vaccine demand strategies.

“Any strategy should be underpinned by a solid social listening programme. That programme allows you to… not just detect mis- and disinformation but to be able to tune into people’s questions and concerns, understand the information they’re looking for, and therefore provide that to them.”


Offline communities and a call to action

After Dr Thomson mentioned “digitally disenfranchised” communities we were curious about how easy it is to engage in, or implement, social listening programmes in these communities. Interestingly, he suggests that, despite the “standard thinking”, many countries already have “very strong networks” within communities already.

“The challenge is, countries need to build a strategy for this, a strategy that fits within the current programme…it actually needs to become institutionalised.”

Dr Thomson emphasises that “we will never stop having crises of confidence or just key questions that arise”. For him, the “only” response is rooted in understanding, to which a national social listening programme is “fundamental”. Then, the next steps are using the behavioural insights to inform behavioural interventions and “wrapping all of that into a broader strategy”.

Looking back to the workshop, Dr Thomson identifies some key themes. The first is “dialogue”.

“It must be dialogue; it can’t be one way communications”.

Another theme is “empirical” data, the social and behavioural insights that are revealed. Finally, collaboration is key.

“No single vaccination programme can be expected to be doing everything that is needed to sustain high coverage, high immunisation rates in all of their programmes.”

For Dr Thomson, some of the “best examples” are partnerships or coalitions involving academics, the private sector, or civil society. These come together and “coordinate” a strategy.

“There was almost a call to action yesterday to many of the attendees, to be thinking about what their organisation can be contributing to this. It’s not something you can leave in the lap of a programme, which is usually overworked and understaffed.”

Partnerships bring resources and “mobilise and align actions”, and have an effect on both trust and uptake.


The media

With varying levels of engagement and trust in the media during the pandemic, we asked Dr Thomson about how the vaccine community can effectively support media outlets and ensure that vaccine information is effectively and accurately reported. He defers to Apoorva Mandavilli, who spoke during the workshop, making a “very clear request” for “more information, more data, and the provision of that in a transparent way”.

Dr Thomson emphasises that “journalist are fundamental”. Although some media outlets have lost trust, there are still “key” outlets that provide essential information. Journalists working at these outlets “consistently” ask for more information, both during pandemics and not. However, some health authorities were “opaque” in sharing data.

“Risk communication is a science and we know what works, and it is underpinned by the principle of transparency; you say what you know; you say what you don’t know, and you say it very, very regularly.”

This principle was applied “differently” during the pandemic, with “dramatic” results. A study that Dr Thomson refers to highlights this, demonstrating that “public trust” in institutions correlated with vaccine uptake. Therefore, the national health response of different countries had a “differentially positive or negative” effect, and we are now catching up.


Why WVC?

As with all of our speakers, we asked Dr Thomson what his hopes for, or highlights of, the Congress are. He suggests that everyone has “our own agenda”. For him, that involves several things, including understanding the “great and very exciting work” that is taking place across the vaccine environment.

“As a biological scientist it’s the most exciting period in my whole career!”

However, “we can’t continue to forget” the last stage of vaccine delivery: building public trust. For him, the “reality is” that technology is “unlikely to transform public trust”.

“It takes strategy; it takes investment; it takes a programme at a national and subnational level in every country. We know what works…I guess we’re here trying to mobilise people to be thinking through what is the role they can play, at an individual or an organisational level, to be supporting this crucial part of vaccination programmes across the world.”

If you encountered Dr Thomson we are confident that he mobilised you in this way, and we hope that he had a productive time with us in Barcelona. Thank you to Dr Thomson for his contribution to the Congress Conversations series, and we hope that you enjoyed his insights. For more conversations like this one, don’t forget to subscribe to our newsletter.