The research & marketing underpinning the push for vaccination in NZ

This post has the extensive surveying, research and focus groups that led to the marketing campaigns for vaccination in 2021 costing over $45 million

The first push to understand how Covid-19 vaccines would be accepted (or not) by the New Zealand population began in earnest in September 2020.

Directed by the Ministry of Health’s comms teams, Behavioural Insights team and their CERT alliance to combat disinformation - initial surveys were run twice in 2020 by Horizon research in conjunction with the School of Population Health University of Auckland. They reviewed people’s attitudes and behaviours and who was signalling they would be vaccinated, here the 2nd report in December showed:

69% of respondents overall (the same as in September 2020, an estimated 2,487,900 adults) would be prepared to have a “well-tested and approved” COVID-19 vaccine, while 24% (an estimated 852,100 adults, up from 19% in September 2020) were unlikely to.

The top issue on the vaccine was:

Proof of safety was foremost in respondents’ minds, with 60% choosing “Has been through extensive, properly conducted, clinical trials”, 55% choosing “sufficient information on any side effects” and 54% choosing “Approved by MedSafe in New Zealand”.

It went on to note vaccine messaging was better coming from WHO or the Ministry of Health or the then Director-General of Health Ashley Bloomfield than the Prime Minister or then Covid-19 Minister (who is now the Prime Minister).

It also gave a rationale that likely led to the incredible disinformation efforts in 2021:

Alongside the Ministry of Health, in February 2021 the Department of Prime Minister and Cabinet (DPMC) commissioned The Research Agency (TRA) to do further work on vaccine attitudes.

TRA had already been engaged in a wide range of behavioural sentiments and attitudes research on Covid-19 restrictions. They supported how DPMC’s lead marketing agency, Clemenger BBDO, could target vaccine messaging.

A briefing updating the Minister on TRA research noted:

This OIA shows some of TRA’s research with focus groups on types of vaccine messaging. Comments included:

“New Zealanders are past being told what to do, get us on board rather than being instructive.”

The focus groups confirmed ‘rational’ scripts were not as successful as ‘emotive’ scripts which emphasised the ‘in it together’ attitude that had been used in Covid-19 messaging to date.

Specific words were then tested. Protect performed well. Safe was a good word but raised alot of questions in the focus groups around how they knew it was safe. Social norming was proposed to get around skeptics and Medsafe didn’t rate as highly as people didn’t grasp it’s function quickly. The word free performed well if it included the word ‘to all who want them’ as it implied choice.

Supporting them was the DPMC Communications and Public Engagement team COVID-19 Group - which had a total of 81 people work within it running the Unite Against Covid brand.

In March 2021 the Ministry of Health and Unite Against Covid brand delivered a joint vaccine communications plan highlighting those key points again from Horizon research in 2020:

Safety safety safety hence safe and effective…..

The vaccine campaign agency brief also drew on the TRA focus groups and noted the campaign needed to focus on:

Immunity was a key concern to push and another message to focus on was:

No virus can take-on an immune system made-up of every single one of us.

Not to do another spoiler but that…didn’t age well. Remember there are (in early 2023) well over 2.2 million reported cases which is a large undercounting of total cases.

Okay I can’t help myself - the campaign strategy brand collateral also included reusable widgets like:

Notice purple was used for vaccine advertising? Purple was chosen to be a calming color in the same familiar patterning of the Unite Against Covid campaign but re-purposed for vaccination messaging.

The brief used the TRA research to focus the campaign around ‘possibilities’. Such as if you get vaccinated you get your freedom and human connection back through family and social gatherings and travel.

It also included pairing influencers and medical experts (a common theme that was used in Unite Against Covid messaging as well). This imagery was used as confirmed in the campaign brief:

It looks like they did short videos on questions with experts on how the vaccines could have been developed so quickly and how they were safe.

This particular marketing aspect matched advice from the many behavioural insights reports produced for the Joint Insights Group through out 2020 from Behavioural Science Aotearoa - Ministry of Justice.

1 of which evaluated the delivery of messaging Covid-19 restrictions and noted Fauci performed well in supporting messaging:

The Ministry of Health noted in their plan they would see the campaign as successful if 70% of people were vaccinated - alongside people knowing the vaccines were safe and they maintained a high level of trust in the government.

In June 2021 TRA tested the right names for a new animated vaccine safety series - spoiler - the name “vaccine facts” won and the videos described among other things comparing the pace of vaccine development to choosing whether you go on a direct or a scenic road trip.

Yes, vaccine development can be sped up or not and it really doesn’t matter either way.

At the same time even more vaccine research was supporting and tweaking the way vaccines were marketed as the vaccine rollout started.

Vaccine tracker surveys

The rollout was done in staged waves to border and health care workers, the vulnerable and then finally starting with the general population in July and August 2021. As it gathered pace from April 2021 the Ministry of Health commissioned research from Ipsos who conducted weekly surveys on vaccine sentiments.

Starting in the early waves in late April and early May it showed people’s key concern (hitting 36%) was knowing the vaccination was approved by Medsafe. Again safety.

(Slightly puzzling contrasting it with TRA’s earlier research that people didn’t have a grasp of who the regulatory agency in New Zealand was….but perhaps the greater numbers in the survey -around 1000 people were surveyed per week - versus smaller focus groups accounted for it.)

The top reason why people usually indicated they would get the vaccine?

To stop transmission of the virus.

Alongside the weekly surveys was the vaccination advertising hitting social media, online, radio, television, traditional media and influencers.

Later waves in the vaccine rollout had people showing increasing signalling that they would get vaccinated but there was still 30% showing they were hesitant or outright opposed to it.

As the months wore on vaccine uptake steadily increased and regional breakdowns started to be done to discover why there were differences in uptake by region. I guess it’s pretty clear that the most likely region to get vaccinated was Wellington and the least likely was Northland and Bay of Plenty.

Those later surveys also focused on vaccine hesitant and misinformation as there was a core group still showing safety and the risk of severe adverse reactions was a key driver in not getting vaccinated.

A July 2021 survey showed younger people and Māori were among the least likely to get vaccinated (and not to spoil it but I’ll be detailing how uptake was pushed in those groups in a later post) and again they found if they were to get vaccinated - those groups too had stopping the spread as the key reason:

If you think those surveys seemed comprehensive - wait. I have more!

Alongside the Ipsos weekly vaccine tracker surveys, there was also monthly Horizon surveys to survey New Zealanders’ attitudes and sentiment towards vaccinations.

And alongside that TRA had been doing regular behaviour and sentiment surveys for DPMC remember - which also started to have questions on vaccine attitudes.

Yet further surveys were commissioned by the Ministry of Health - Colmar Brunton did 1 on Attitudes towards vaccination of Pacific People. I also saw mention Horizon specifically researched Māori attitudes to vaccination but if they did I couldn’t find the report.

In January 2022 TRA followed it up with focus groups and surveys on parents on barriers to getting their 5 to 11 years olds vaccinated and focus groups on vaccine barriers for disabled children and young people.

Horizon Research conducted 2 further surveys in 2022 on Reconnecting New Zealand to the World which contained work on vaccination intention for boosters and travel.

When the second booster was rolled out the Ministry commissioned another Horizon survey into the second booster in 2022 - and found the biggest issue was - safety concerns.

And none of this covers any work done by other places say the University of Auckland’s surveys that includes vaccine attitudes, or Massey University’s or Victoria University’s.

If there was a stone left unturned in Covid-19 vaccine uptake research- have faith that the Ministry of Health is funding more research into it.

Vaccine advertising costs

This September 2022 OIA when DPMC managed the marketing spend as specifically $45 million between March 2021 to end of June 2022:

I don’t know if these prices include items like booster questions being added to television game show The Chase to increase uptake which cost:

“…were NZD $45,501, which comprised production costs of NZD $20,501 and paid media costs on TVNZ’s channels of NZD $25,000….”

After the end of June 2022 - the Ministry of Health held the vaccine advertising costs (the 2nd booster, bivalent vaccine and 6 month to 5 year old vaccine was rolled out during that time).

The Ministry of Health costs towards the vaccine strategy was refused in an OIA request as it was in the most recent annual report (to the end of June 2022). The best i could find where it clearly notes they incurred:

additional costs ($30.993 million) required for COVID-19 vaccine strategies including advertising and awareness campaigns, and the development of a national immunisation solution.

It’s unsure to me how much were just advertising and awareness campaigns (what is the difference?) and work on the national immunisation solution (which appears to be turning the Covid Immunisation Register into a new all of vaccination register for everyone in New Zealand).

And just to finish this off - alongside this core vaccination message was campaigns done by Te Puni Kokiri, Ministry for Pacific Peoples and District Health Boards (DHBs) who did their own regional messaging as well.