Back in August 2020 in the middle of the 110+ days lockdown in Melbourne, Australia I blogged about a practical application of authentic co-design that was hypothetical at that point: how to rollout COVID vaccines?
At the time people were asking about current issues in their work and wondering if co-design could work to solve a gnarly problem or help deliver a difficult outcome. Since launching Authentic Co-design Max Hardy, Susan Carter and myself have been involved in several practical applications of Authentic Co-design, including for local COVID vaccine rollout.
From back in August 2020 when articles were starting to appear about the need to build a sense of trust in the COVID vaccine to now (February 2021) when articles are appearing about reluctance to get the vaccine or how to convince (not my word!) people to take the COVID vaccine, we believe there is a place for co-design in the vaccine roll-out.
Getting a large uptake of COVID vaccines is a great example of the need to build trust in a very broad community of people (the broadest possible) when there are real and genuine issues that some people have with the vaccines and the scale of the roll-out. Just because the science shows that for any vaccine to work there needs to be a high % uptake across the community, does not mean that everyone will be onboard for a jab in the arm.
How does Co-design help?
Co-design is about building trust.
Trust is fundamental to building a high vaccine uptake across the community.
This challenge is fundamentally complex! It involves technical issues, ethical issues, science/medical communication issues, moral issues, logistical (including -70C freezer) issues, jurisdictional issues (e.g., Federal, State, and local roll-out) and social issues, amongst other things. This is a complex project.
There are some real concerns about the vaccines and how they will roll-out. I’m not talking about the anti-vaxxers (to be frank, they can sit with the climate change deniers, flat-earthers and Elvis watchers while the rest of the adults talk about evidence). It is important to avoid letting the loudest voice in the room drown out the a range of diverse voices. I’m talking about the genuine and heart-felt concerns that many have about what a vaccine is, what side-effects it might have, how a vaccine might roll out, how the different ones work, who gets vaccines first and why, questions of equity and even morality (e.g., see this report from the Vatican in August 2020).
Each of these concerns (and likely many more that I have not listed) are important questions and challenges that anyone rolling the vaccines will need to address.
Co-design is about delivering complex projects in a way that builds trust.
If we revisit the five Principles of Authentic Co-design, each gives us an insight into the practical application of Authentic Co-design to building widespread trust in a COVID vaccine.
Be Substantial – Involving community in the design of a local roll-out strategy is a substantial action. It is an act of leadership and will undoubtedly build trust in the outcome. While the boundaries and rules (we call them “not-negotiables” in Authentic Co-design) must be set Nationally so that everyone gets the same vaccines in the same way, there are many options for involving communities (especially vulnerable or more wary ones) in how the local roll-out will occur. Give people a real problem to solve about the roll-out together.
Be Collaborative, inclusive, and safe – Involving the broadest possible community voices will build a diverse understanding and coalition for the roll-out strategy. There are communities with little trust I health authorities, or a different language to the dominant, or completely different cultural practices. All these communities need to take up the vaccines in a way that is safe for them.
Foster mutual learning – this is so important when there is such embedded technical detail as there in to understand how a vaccine works. It is complicated by the media fixation on the ranking of some of the performance measures of the different vaccines (there are 3 likely to be used in my country, Australia, and I noted up to 6 in some other countries. There are real data gaps about comparing each vaccine to each other on a level playing field, but that has not stopped people ranking the “effectiveness” of A over B and B over C. All vaccines work slightly differently and so there is a job in just explaining to those who want to know.
On the flipside, the medical authorities can learn a great deal from hearing the concerns and fears of recipients. Sometimes there are clear and simple responses to fears. Sometimes there is more work to do.
Be open and transparent – trust will come from the broadest coalition of as many different parts of the community seeing the openness of a co-designed local roll-out strategy.
Be jurisdictionally aware – As we have learnt so well from the pandemic response in my country (Australia, and I’m sure this is visible in many other countries s as well), there are different, important, and intersecting layers and levels of Government (and corporations and organisations) that need to act in a cooperative or coordinated way for the response to work. A vaccine rollout will be no different. Jurisdictional awareness is crucial.
How would you use co-design to help promote trust in vaccines?
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