'Vaxfluencers' Getting Residents to Get the Shot

On June 18, Cassie Bustamante, a home decor and lifestyle influencer based in Greensboro, North Carolina, uploaded a series of photos to her Instagram page. The first two shots featured potted plants, arranged artfully on a table next to a bottle of wine and a letterboard reading “plant one on me finally,” followed by a picture of Bustamante with friends at a wine bar. 

In the caption, Bustamante told her followers that she loves to entertain. “I need my people and thrive on getting together with my friends,” she wrote. And so, she continued, the widespread availability of Covid-19 vaccines was a blessing that would hopefully allow her to welcome friends back into her home for happy hour.

The post was a paid partnership with the Guilford County Division of Public Health, one of a host of government agencies working with influencers to promote vaccines to targeted local audiences. Similar campaigns have launched in San Jose, California; Columbia, South Carolina; Oklahoma County and the states of New Jersey and Colorado. 

Details differ, but the basic plan is the same: using trusted community messengers to spread the word about the safety and availability of vaccines. 

“Our goal was to increase vaccinations,” said Kenya Smith, communications coordinator for the Guilford County Division of Public Health in North Carolina. “This was back in June, and we were starting to get information that some of our lowest numbers of vaccinated populations were in that 25 to 43 age group. We knew we were reaching the 65 and up group in the newspapers and local groups, and a different population in our own Facebook posts, but we wanted to move to something a little bit more fun and catchy on Instagram.”

Dr. Iulia Vann, the county’s public health director, had read about a similar campaign in San Jose, where spikes in vaccination rates correlated strongly with the dates of targeted social media posts from local influencers. That project was coordinated by Xomad, a digital marketing agency that uses technology to identify and vet influencers in specific geographic regions who excel at connecting with their audience and have interests that align with the needs of various clients. The county reached out to Xomad, which contracted with the health department to craft its own campaign.

Prior to the pandemic, most of the agency’s work had been for private-sector clients, including Burt’s Bees and L’Oreal, said Rob Perry, Xomad’s founder and CEO. But the technology, he thought, could also work well for public-sector clients, so in early 2020, the agency reached out to several government entities, offering to craft campaigns that urged people to wear masks or stay home to slow the spread of the virus. 

From those initiatives, Xomad compiled data showing that virus cases dipped after influencers posted, which led to more interest from government agencies across the country once vaccines became available, and again when variants of the virus began to spread.

“We’ve got real-life stats and charts, and they show these striking parallels that when influencers all post in the same time period, you see vaccination rates go up one to three days later,” he said. “If influencers are silent, the rates come back down. Initially we had to be proactive going out to them, but then a lot of it became organic. In the past few weeks, especially, we have been crazed.”

The details of each campaign vary based on the client’s budget, goals and location, but the basics are the same, Perry said—using the agency’s technology to identify a group of local creators, then tapping them to deliver pre-approved content in their voices. Instagram photo posts go live on scheduled dates, though influencers may also be asked to disseminate emerging information in more immediate formats, including Instagram stories, which disappear after 24 hours and can be updated throughout the day. (Bustamante, for example, received a lump sum in exchange for one post on her main Instagram feed, plus three posts in her stories.)

Content creators in each geographical area are given access to a chat platform where they can discuss their posts and the feedback they receive, with government officials on hand to help craft responses to negative comments or questions. The priority, Perry said, is to empower influencers to relay information in their voices by telling their stories.

“The key to this whole thing working is authenticity,” he said. “If we’re telling the influencers what to say it’s not going to work. We just give them the platform to talk to the government and health officials, to report back to them on myths and misinformation they see from their follower base, and get up-to-date information from officials to disseminate in their voice.”

The campaign was a departure from Bustamante’s social media comfort zone, where she usually highlights stylish snapshots of home decor. When Xomad contacted her, Bustamante took a day to consider the offer, ultimately deciding that participating in the project aligned with her general approach to paid content.

“Vaccination is definitely something I felt strongly about, but I knew that because I’m in the home decor and lifestyle influencing world, I definitely have folks who follow me who are on the other side,” she said. “I knew I would probably lose followers, and anger some, for working on this. But I decided that every time I promote something, it’s because it’s a company or a cause that I believe in. And this is something I believe in.”

‘Meeting People Where They’re At’

The idea of using influencers to promote public health may seem edgy, but it’s not that different from the role of local health ambassadors, who have been used for years to promote healthy behaviors and distribute information within their communities, said Tara Trujillo, Covid-19 vaccine campaign manager for the state of Colorado. (Depending on the state and locality, health ambassadors may be paid or volunteers.)

“The effectiveness of those ambassadors, and of influencers in promoting public health, has really been long established,” she said. “You have to meet people where they’re at, whether that’s a community event, or on social media.”

The Colorado Department of Public Health and Environment launched its influencer outreach this spring as part of a larger “Power the Comeback” initiative, a $16.4 million informational campaign funded via a combination of state and federal dollars. 

The influencer initiative, designed by Denver-based Idea Marketing, distributes vaccine and other Covid-19 information via 126 local creators, a diverse group that all have followers from harder-to-reach communities, including immigrants and people of color. The initiative focuses primarily on Instagram, TikTok and Facebook and pays creators between $400 and $1,000 per month, depending on the reach of their posts. The six-month campaign launched in early April, roughly when the state’s health experts expected Colorado’s vaccine supply to begin outpacing demand.

Much like Guilford County’s outreach, Colorado’s campaign encourages influencers to tell their stories in their words, using pre-approved information, Trujillo said. (State officials have final say on the posts before they go live.) Thus far, the campaign has exceeded its goals for impressions and engagements per post, particularly among younger demographics, she said.

“This is a really large state, and there are a lot of people that can be hard to reach because it’s so rural,” she said. “And it’s such a diverse state that you really have to use all means possible. When you’re trying to reach 12-to-17-year-olds, that absolutely includes social media, and I think you can see the effectiveness of that in the responses to the influencers.”

In Guilford County, the two-month, $100,000 campaign included 36 Instagram posts, 15 Facebook posts and seven tweets, garnering more than 959,000 views and 15,100 engagements, according to data from Xomad. Influencers were paid between $50 and $1,000 to promote the vaccine, depending on their follower count. A summary of the campaign's results shows vaccination rates in the county regularly spiking in the days after influencers posted information, most notably in early July. 

As of Aug. 2, 51.5% of Guilford County residents had received at least one dose of the vaccine, up 5.5% from the beginning of the campaign and more than 4% higher than the statewide average, Smith said. The campaign, funded via federal Covid-19 relief funding, concluded on Aug. 7, and the county is considering another contract. 

“Even in periods where the statewide vaccine rate went down, ours went up, consistent with the impressions,” Smith said. “It was impressive. If you had that kind of consistent growth all year, that would be remarkable.”

Connecting government agencies to local influencers makes sense, Perry said. It’s simply a more innovative way of disseminating information that might traditionally be found in a print ad or public service announcement, with little downside for government agencies, who spend money that largely gets reinvested into their local communities.

“I think there’s a tremendous need for these kinds of strategies to connect the government to the public on the channels the public is using,” he said. “This is tremendously effective in reaching people, especially younger generations, because the highest level of trust exists in these genuinely authentic relationships between citizens in a community who are seen as leaders, and their follower base.”

Bustamante agreed. She lost followers as a result of the campaign, but far fewer than she’d feared. In hindsight, she said, her participation in the project seems like a natural fit for her role as an influencer.

“People listen to people they trust, and I’ve worked really hard over the past few years to build trust with my audience,” she said. “My belief is that if it’s something you genuinely believe in, it’s OK to say what you’re thinking, and I definitely think there is potential for governments to tap into that.”