[Senate Hearing 117-712]
[From the U.S. Government Publishing Office]




                                                        S. Hrg. 117-712

        SHOT OF TRUTH: COMMUNICATING TRUSTED VACCINE INFORMATION

=======================================================================

                                HEARING

                               before the

                 SUBCOMMITTEE ON COMMUNICATIONS, MEDIA,
                             AND BROADBAND

                                 of the

                         COMMITTEE ON COMMERCE,
                      SCIENCE, AND TRANSPORTATION
                          UNITED STATES SENATE

                    ONE HUNDRED SEVENTEENTH CONGRESS

                             FIRST SESSION

                               __________


                             APRIL 15, 2021

                               __________

    Printed for the use of the Committee on Commerce, Science, and 
                             Transportation








                 [GRAPHIC NOT AVAILABLE IN TIFF FORMAT]








                Available online: http://www.govinfo.gov

                               ______
                                 

                 U.S. GOVERNMENT PUBLISHING OFFICE

53-086 PDF                WASHINGTON : 2024










       SENATE COMMITTEE ON COMMERCE, SCIENCE, AND TRANSPORTATION

                    ONE HUNDRED SEVENTEENTH CONGRESS

                             FIRST SESSION

                   MARIA CANTWELL, Washington, Chair

AMY KLOBUCHAR, Minnesota             ROGER WICKER, Mississippi, Ranking
RICHARD BLUMENTHAL, Connecticut      JOHN THUNE, South Dakota
BRIAN SCHATZ, Hawaii                 ROY BLUNT, Missouri
EDWARD MARKEY, Massachusetts         TED CRUZ, Texas
GARY PETERS, Michigan                DEB FISCHER, Nebraska
TAMMY BALDWIN, Wisconsin             JERRY MORAN, Kansas
TAMMY DUCKWORTH, Illinois            DAN SULLIVAN, Alaska
JON TESTER, Montana                  MARSHA BLACKBURN, Tennessee
KYRSTEN SINEMA, Arizona              TODD YOUNG, Indiana
JACKY ROSEN, Nevada                  MIKE LEE, Utah
BEN RAY LUJAN, New Mexico            RON JOHNSON, Wisconsin
JOHN HICKENLOOPER, Colorado          SHELLEY MOORE CAPITO, West 
RAPHAEL WARNOCK, Georgia                 Virginia
                                     RICK SCOTT, Florida
                                     CYNTHIA LUMMIS, Wyoming

                    David Strickland, Staff Director
                 Melissa Porter, Deputy Staff Director
       George Greenwell, Policy Coordinator and Security Manager
                 John Keast, Republican Staff Director
            Crystal Tully, Republican Deputy Staff Director
                      Steven Wall, General Counsel

                                 ------                                

          SUBCOMMITTEE ON COMMUNICATIONS, MEDIA, AND BROADBAND

Ben Ray Lujan, New Mexico, Chair     JOHN THUNE, South Dakota, Ranking
AMY KLOBUCHAR, Minnesota             ROY BLUNT, Missouri
RICHARD BLUMENTHAL, Connecticut      TED CRUZ, Texas
BRIAN SCHATZ, Hawaii                 DEB FISCHER, Nebraska
EDWARD MARKEY, Massachusetts         JERRY MORAN, Kansas
GARY PETERS, Michigan                DAN SULLIVAN, Alaska
TAMMY BALDWIN, Wisconsin             MARSHA BLACKBURN, Tennessee
TAMMY DUCKWORTH, Illinois            TODD YOUNG, Indiana
JON TESTER, Montana                  MIKE LEE, Utah
KYRSTEN SINEMA, Arizona              RON JOHNSON, Wisconsin
JACKY ROSEN, Nevada                  SHELLEY MOORE CAPITO, West 
JOHN HICKENLOOPER, Colorado              Virginia
RAPHAEL WARNOCK, Georgia             RICK SCOTT, Florida
                                     CYNTHIA LUMMIS, Wyoming









                            C O N T E N T S

                              ----------                              
                                                                   Page
Hearing held on April 15, 2021...................................     1
Statement of Senator Lujan.......................................     1
Statement of Senator Thune.......................................     3
Statement of Senator Klobuchar...................................    21
Statement of Senator Tester......................................    27
Statement of Senator Peters......................................    29
Statement of Senator Cantwell....................................    31
Statement of Senator Warnock.....................................    33
Statement of Senator Rosen.......................................    34
Statement of Senator Blumenthal..................................    36
Statement of Senator Sinema......................................    38
Statement of Senator Cruz........................................    42

                               Witnesses

Tracie Collins, M.D., M.P.H., Secretary, New Mexico Department of 
  Health; and Member, Association of State and Territorial Health 
  Officials......................................................     5
    Prepared statement...........................................     6
Hon. Gordon H. Smith, President and CEO, National Association of 
  Broadcasters...................................................     7
    Prepared statement...........................................     9
Yonaira Rivera, Ph.D., M.P.H., Assistant Professor of 
  Communication, Rutgers University School of Communication and 
  Information....................................................    13
    Prepared statement...........................................    15

                                Appendix

Ad Council, prepared statement...................................    45
AHIP, prepared statement.........................................    57
Carmen Scurato, Senior Policy Counsel; Jessica J. Gonzalez, Co-
  CEO, Free Press Action Fund, prepared statement................    60
Media Matters for America, prepared statement....................    63
Tara Kirk Sell, PhD, MA, Senior Scholar; Marc Trotochaud, MSPH, 
  Senior Analyst; Divya Hosangadi, MSPH, Senior Analyst; Ellie 
  Smith, MSPH, Graduate Research Assistant; Johns Hopkins Center 
  for Health Security, Johns Hopkins Bloomber, prepared statement    66









 
        SHOT OF TRUTH: COMMUNICATING TRUSTED VACCINE INFORMATION

                              ----------                              


                        THURSDAY, APRIL 15, 2021

                               U.S. Senate,
        Subcommittee on Communications, Media, and 
                                         Broadband,
        Committee on Commerce, Science, and Transportation,
                                                    Washington, DC.
    The Committee met, pursuant to notice, at 10:27 a.m., in 
room SR-253, Russell Senate Office Building, Hon. Ben Ray 
Lujan, Chairman of the Subcommittee, presiding.
    Present: Senators Lujan [presiding], Cantwell, Klobuchar, 
Blumenthal, Schatz, Peters, Tester, Sinema, Rosen, Warnock, 
Thune, Cruz, Fischer, Blackburn, Young, and Scott.

           OPENING STATEMENT OF HON. BEN RAY LUJAN, 
                  U.S. SENATOR FROM NEW MEXICO

    Senator Lujan. Come to order. Let me start by welcoming you 
to today's hearing, Shot of Truth: Communicating Trusted 
Vaccine Information.
    I first want to thank Ranking Member Thune for working with 
me to develop this hearing and reach a consensus panel. John 
and I look forward to partnering with you this Congress to 
deliver results for the American people and the State of New 
Mexico. And thank you, Chair Cantwell, Ranking Member Wicker 
for your leadership.
    We have a distinguished group of witnesses today to help us 
examine the ways in which the media is disseminating vaccine 
safety and COVID health-related information. They are experts 
in public health broadcast communication. Each brings a 
critical piece of the puzzle for solving this crisis. I welcome 
you and thank you for your expertise.
    This subcommittee has an important responsibility to look 
at our national communications strategy, to encourage all 
Americans to get vaccinated. This morning, we will also explore 
what more can be done to encourage media outlets, including 
television, radio, and online platforms to promote reliable, 
trustworthy, and evidence-based vaccine information.
    For the last year, our Nation has faced a once in a 
lifetime challenge. As President Biden has said, ``we remain on 
a war footing.'' Dedicated researchers spent tireless months 
developing safe and effective vaccines in a record time. Now, 
with safe and effective vaccines increasingly available, the 
Nation must work to get vaccination rates up to defeat this 
pandemic. Communicating reliable, trustworthy, and evidence-
based vaccine information is the final step to getting our 
lives back.
    I am particularly proud of the efforts by Governor Lujan 
Grisham of New Mexico, Secretary Collins at the New Mexico 
Department of Health. New Mexico has been a national 
frontrunner in efficient vaccine distribution, and I am deeply 
grateful for their efforts and the lives they have saved.
    Tuesday's decision, by the CDC and FDA, regarding the 
Johnson & Johnson vaccine underscores the importance of 
communicating trusted vaccine information. State and Federal 
partners are working now to get anyone scheduled for a Johnson 
& Johnson vaccine quickly rescheduled for a Pfizer or Moderna 
vaccine. This recent announcement should not cause worry. But 
make it clear that the FDA and the Federal Government is taking 
every step necessary to ensure that the American people have 
clear and transparent information about the safety and 
effectiveness of these vaccines. That is what this hearing is 
all about.
    Unfortunately, in too many places, we are struggling to 
provide trusted, evidence-based information, creating a void. 
Misinformation and disinformation rushes to fill this gap. A 
lie can travel halfway around the world, while the truth is 
putting on its shoes. We have heard that before. Folks worry. 
They hear confusing and conflicting messages on the internet, 
the radio, cable television. Even today, a U.S. Census survey 
found that over three million Americans were not sure if they 
would receive the vaccine, due to fears of how much it would 
cost. They are worried about the cost of a free vaccine. Let me 
be clear. The vaccine is provided at no cost. It is free. We 
must do better.
    A clear and consistent message will save lives. Realizing 
this, Congress appropriated $15 million to educate the public 
about the COVID-19 vaccine in the December Consolidated 
Appropriations Act. Since then, we have seen hesitancy rates 
fall dramatically. But we knew it would not be enough. Reaching 
every single American who can safely get a vaccine is critical 
to defeating this virus. That is why the American Rescue Plan 
increased funding for the program by $1 billion. This was a 
historic investment in public health communication. It will 
help us rebuild a framework for all future health crises. We 
have also seen State health departments rise to the occasion, 
through vaccine equity programs and trusted community partners.
    Before we start, I want to make one thing crystal clear. 
Most Americans want to get vaccinated, across all ages and 
races, no matter where they live. But first, we must stop the 
spread of this deadly virus. The only way to win this fight is 
by getting every American the information they need, from 
sources they trust, so they can make the right decision for 
their health and the health of their community.
    Vaccines save lives and I urge all Americans to continue 
their plans to get vaccinated as soon as possible. Today, our 
witnesses will help ensure the national vaccine rollout is 
paired with an effective communication campaign. They will 
share their insight on how to achieve an effective and 
consistent message across all forms of media. I thank them all 
for the vital role they will play in shaping this discussion.
    And now, I will turn this over to Senator Thune for his 
opening statement.

                 STATEMENT OF HON. JOHN THUNE, 
                 U.S. SENATOR FROM SOUTH DAKOTA

    Senator Thune. Thank you, Chairman Lujan, and let me begin 
by saying I am looking forward to working with you on this 
subcommittee. And this subcommittee has a long history of 
bipartisan cooperation when confronting a number of issues, 
like rural broadband, spectrum availability, and illegal 
robocalls. And I am optimistic that we will be able to continue 
that bipartisan collaboration on matters within this 
subcommittee's purview.
    Today, we are here to discuss ensuring reliable information 
relating to the coronavirus pandemic is reaching Americans. 
Since the beginning of the pandemic, the communications 
landscape has played a critical role in disseminating health-
related information to the public. As more and more Americans 
have access to the vaccine, it remains important that they have 
the ability to easily access reliable information on the 
vaccines and other COVID health-related information.
    This is certainly true this week, as the Federal Government 
encouraged a pause on the use of the Johnson & Johnson vaccine. 
It is imperative the FDA, CDC, and J&J communicate next steps 
to healthcare providers and the public, in an understandable 
and transparent way, to assure them of the vaccine's safety, as 
more information becomes available. With more trusted experts 
examining vaccines, I am confident they will ensure vaccines 
are safe and effective, so that we can maintain our momentum in 
vaccine distribution.
    Since COVID vaccines became available, I have encouraged 
folks to get vaccinated. But more important than hearing from 
me is hearing from healthcare providers and trusted community 
leaders. Which is why, last Congress, I supported legislative 
efforts to fund a science-driven, public advocacy campaign to 
help build confidence in vaccines. Each family and individual 
must take the time to talk to the experts, get the facts, and 
make an informed decision for themselves and their families. 
But while I am optimistic that we are nearing the end of the 
pandemic, there is certainly more work to be done to get past 
this pandemic.
    But it is more important to know where we are today 
compared to a year ago. Today, more than 37 percent of the 
country has received at least one dose of the vaccine and 
nearly a quarter of the population has been fully vaccinated. 
And importantly, nearly 80 percent of those most at risk for 
the coronavirus have received one dose of the vaccine, with 
more than 60 percent being fully vaccinated.
    I have also had the opportunity to visit multiple vaccine 
sites across my home state of South Dakota the last few weeks. 
And I am pleased with the work South Dakota and our healthcare 
providers have done to inform the public and to get fully 
vaccinated. I should say, and to get folks vaccinated. At this 
time, more than 36 percent of South Dakotans are fully 
vaccinated, and more than 50 percent of the population has 
received their first shot. As of April 1st, South Dakota has 
opened up vaccines for anyone who would like to receive it.
    Those are pretty amazing statistics, when you consider that 
more than a year ago, we did not even know about this virus. 
And it is a tribute to the innovative power of the private 
sector, the efforts of Congress, and the Trump Administration 
to expedite vaccine development.
    As vaccine availability has expanded in recent weeks, so 
have efforts to raise public awareness about the vaccine. 
Recently, the Biden-Harris Administration launched a new 
campaign to promote vaccines by working with specific 
community-based organizations. I hope the recent comments made 
by the White House about reaching certain communities through 
public service announcements on select programming, such as 
deep-sea fishing, or country music outlets is not the only 
piece of this equation.
    Looking at what we can do--or I should say, looking at the 
We Can Do This campaign's vaccine hesitancy data, rural or 
western states are among some of the areas with the highest 
projected hesitancy. This is where the trusted local 
connections is going to be the key, and why I am interested 
today, to hear from our witnesses about the steps that have 
been taken to ensure rural areas are receiving information 
about the pandemic, and through what means of communication.
    Radio and television broadcasters have played a large role 
in providing information to rural and communities of color. Out 
of the bipartisan year end coronavirus relief package, the 
Department of Health and Human Services was allocated funding 
to support educational activities around vaccine distribution. 
Several entities represented on today's panel, like radio and 
television broadcasters, are eligible for that funding. It is 
important that funding be distributed efficiently and 
effectively.
    I appreciate all the witnesses being with us here today. 
And before I close, I would like to congratulate Senator Smith 
on his recent announcement, stepping down as President and CEO 
of the National Association of Broadcasters. And I want to 
extend my thanks to him for his friendship through the years. 
He was a valued and treasured colleague here, as United States 
Senator. And although we hated to lose him in the Senate, his 
role has been extraordinarily important as the head of National 
Association of Broadcasters. He has been a loud, clear voice, 
advocate for local broadcasters around this country and been an 
extraordinary leader for that fine organization. And so, 
Gordon, we will miss you, but we are grateful--grateful for 
your friendship and your many contributions to making this 
country stronger and better. So----
    Mr. Chairman, I yield back my time. I guess I am out of 
time.
    Senator Lujan. Thank you, Senator Thune. And I certainly 
agree with the sentiment with Senator Smith. Everyone that has 
met him is a friend of his, as you know, John. And it is going 
to be something to see him in whatever that new role is that he 
plays.
    But I appreciate what Senator Thune just laid out. As two 
western state Senators--rural states, we share those same 
concerns, making sure that our constituents are hearing, as 
well.
    So, with that being said, we are going to go to our first 
witness, which is Tracie Collins. Dr. Tracie Collins, who is 
the Secretary of the New Mexico Department of Health, 
Association of State and Territorial Health Officials, out of 
Santa Fe, New Mexico. Dr. Collins, the floor is yours. You are 
recognized for 5 minutes for your opening statement.

           STATEMENT OF TRACIE COLLINS, M.D., M.P.H.,

          SECRETARY, NEW MEXICO DEPARTMENT OF HEALTH;

                AND MEMBER, ASSOCIATION OF STATE

          AND MEMBER, AND TERRITORIAL HEALTH OFFICIALS

    Dr. Collins. Thank you, good morning. Chairman Lujan, 
Ranking Member Thune, and distinguished members of the 
Subcommittee, I am pleased to testify before you today to 
discuss New Mexico's efforts to disseminate accurate, timely 
information about vaccine safety to rural areas and communities 
of color, and to encourage more Americans to get vaccinated.
    In New Mexico currently, more than 55 percent of the 
population has received at least one shot, and approximately 36 
percent are fully vaccinated. Thanks to our state's vaccine 
equity plan, this includes high proportions of minority and 
socially vulnerable communities.
    Since the pandemic began, the Governor and other State 
leaders held weekly or biweekly press conferences about the 
coronavirus, and now the vaccine. These are widely covered by 
our State Press Corps and disseminated through Facebook Live. 
We have also expanded our Department of Health communications 
operation. Thanks to Federal funding, we have hired two 
additional communications specialists, one focused specifically 
on outreach to communities of color. In addition, we have 
benefited from FEMA support in establishing a multi-agency 
Incident Command Structure, including a Joint Information 
Center, or JIC, comprising public information officers, 
emergency management personnel, hotline staff, and other key 
communicators. The JIC is subdivided into eight teams, 
including an Outreach Team that keeps close tabs on rumors, 
misinformation, and other vaccine communications challenges 
from constituencies and communities across New Mexico, and a 
Product Team that designs communications materials to meet 
those challenges.
    But many of our best communications efforts do not involve 
State employees. Instead, they involve the voices of New 
Mexicans from across the State. Our Trusted Voices campaign, 
for example, is a series of YouTube videos featuring more than 
50, and counting, New Mexicans from every walk of life, ethnic 
and racial background, and professional affiliation. We 
understand that persuasion is built on trust, and trust is 
often founded on shared roots and experiences. These videos, 
available in multiple languages, allow New Mexicans to address 
one another about their experiences with the vaccine, to speak 
their minds, and share from the heart. The videos have received 
thousands of views and more volunteers each week.
    Of course, trust requires more than one-way communication. 
Often, dialogue is key. And dialogue tends to work best in 
respectful, non-judgmental, open-ended settings. To that end, 
we have leaned heavily on virtual town hall events. Our 
communications director has co-led five of these events so far, 
each with a co-host chosen for both their medical expertise and 
their credibility within a geographic area or racial or ethnic 
community. Future events will be aimed at younger cohorts, 
Native American communities, agricultural and rural 
communities, and the LGBTQ community, among others.
    Our Office of Health Equity has also held culturally and 
linguistically appropriate town halls with trusted messengers 
from the Black and African-American communities, the mono-
lingual Spanish-speaking Latinx community, Spanish-speaking 
health care providers in the border region, the Vietnamese 
community, and the disability community. Each of these events 
provides community members a chance to ask questions, voice 
concerns, and hear from scientific experts about what we know, 
what we do not know, and what we are still learning about 
COVID-19 and the vaccines. These events have proven especially 
valuable at building vaccine confidence. In fact, we regularly 
see a spike in vaccine registrations following these town 
halls, which is important to our ongoing health equity efforts.
    I have mentioned language several times but allow me to 
linger there a moment longer. Reaching people, especially in a 
diverse state like New Mexico, means speaking to people in 
their languages and at the appropriate level of health 
literacy. We are extremely grateful to Congress for approving 
the American Rescue Plan, which appropriated billions of 
dollars to strengthen vaccine confidence and improve rates of 
vaccination, goals we strive to reach every day.
    Of course, all of this is just a summary. I have much more 
to say, for example, about how our vaccine operations and 
planning teams integrate racial, ethnic, and geographic 
considerations into their work, as well as how we communicate 
our policy plans and integrate feedback from New Mexicans. But 
I will save some of these details for our conversation. Again, 
I thank you for the invitation, and I look forward to your 
questions.
    [The prepared statement of Dr. Collins follows:]

            Prepared Statement of Tracie Collins, MD, MPH, 
                    New Mexico Department of Health
    Chairman Lujan, Ranking Member Thune, and distinguished members of 
the subcommittee, I am pleased to testify before you today to discuss 
New Mexico's efforts to disseminate accurate, timely information about 
vaccine safety to rural areas and communities of color, and to 
encourage more Americans to get vaccinated.
    In New Mexico currently, more than 55 percent of the population has 
received at least one shot, and approximately 36 percent are fully 
vaccinated. Thanks to our state's vaccine equity plan, this includes 
high proportions of minority and socially vulnerable communities.
    Since the pandemic began, the Governor and other state leaders held 
weekly or biweekly press conferences about the coronavirus, and now the 
vaccine. These are widely covered by our state press corps and 
disseminated through Facebook Live.
    We've also expanded our Department of Health communications 
operation. Thanks to Federal funding, we've hired two additional 
communications specialists, one focused specifically on outreach to 
communities of color.
    In addition, we've benefited from FEMA support in establishing a 
multi-agency Incident Command Structure, including a Joint Information 
Center (JIC) comprising public information officers, emergency 
management personnel, hotline staff, and other key communicators. The 
JIC is subdivided into eight teams, including an Outreach Team that 
keeps close tabs on rumors, misinformation, and other vaccine 
communications challenges from constituencies and communities across 
New Mexico--and a Product Team that designs communications materials to 
meet those challenges.
    But many of our best communications efforts don't involve state 
employees. Instead, they involve the voices of New Mexicans from across 
the state. Our Trusted Voices campaign, for example, is a series of 
YouTube videos featuring more than fifty--and counting--New Mexicans 
from every walk of life, ethnic and racial background, and professional 
affiliation.
    We understand that persuasion is built on trust, and trust is often 
founded on shared roots and experiences. These videos--available in 
multiple languages--allow New Mexicans to address one another about 
their experiences with the vaccine: to speak their minds and share from 
the heart. The videos have received thousands of views--and more 
volunteers each week.
    Of course, trust requires more than one-way communication. Often, 
dialogue is key--and dialogue tends to work best in respectful, non-
judgmental, open-ended settings.
    To that end, we have leaned heavily on virtual town hall events.
    Our communications director has co-led five of these events so far, 
each with a co-host chosen for both their medical expertise and their 
credibility within a geographic area or racial or ethnic community. 
Future events will be aimed at younger cohorts, Native American 
communities, agricultural and rural communities, and the LGBTQ 
community, among others.
    Our Office of Health Equity has also held--or is planning--
culturally and linguistically appropriate town halls with trusted 
messengers from the Black and African-American communities, the mono-
lingual Spanish-speaking Latinx community, Spanish-speaking health care 
providers in the border region, the Vietnamese community, and the 
disability community.
    Each of these events provides community members a chance to ask 
questions, voice concerns, and hear from scientific experts about what 
we know, what we don't know, and what we're still learning about COVID-
19 and the vaccines.
    These events have proven especially valuable at building vaccine 
confidence. In fact, we regularly see a spike in vaccine registrations 
following these town halls--which is important to our ongoing health 
equity efforts.
    I've mentioned language several times, but allow me to linger there 
a moment longer. Reaching people--especially in a diverse state like 
New Mexico--doesn't mean just publishing an English-language press 
release and hoping for the best. It means speaking to people in their 
languages--and at the appropriate level of health literacy.
    Our Office of Health Equity (OHE) translates all Covid-related 
material into Spanish, Vietnamese, Dine/Navajo and Arabic to reach 
border, frontier, colonias, immigrant, refugee and asylum-seeking 
community members, and has worked hard to calibrate health literacy 
levels appropriately across all communication materials. In addition to 
digital messaging, we send multilingual paper and poster notifications 
statewide for communities with low broadband connectivity. And DOH 
staff regularly appear on radio and television in both English and 
Spanish.
    We are extremely grateful to Congress for approving the American 
Rescue Plan, which appropriated billions of dollars to strengthen 
vaccine confidence, improve rates of vaccination, and provide 
information on EUA-approved vaccinations--goals we strive to reach 
every day.
    Of course, all of this is just a summary. I have much more to say, 
for example, about how our vaccine operations and planning teams 
integrate racial, ethnic, and geographic considerations into their 
work--as well as how we communicate our policy plans and integrate 
feedback from New Mexicans.
    But I will save some of these details for our conversation. Again, 
I thank you for the invitation, and I look forward to your questions.

    Senator Lujan. Thank you so much, Dr. Collins. Next, we 
will hear from the Honorable Gordon Smith, the former United 
States Senator, President and CEO, the National Association of 
Broadcasters. Senator Smith, the floor is yours.

STATEMENT OF HON. GORDON H. SMITH, PRESIDENT AND CEO, NATIONAL 
                  ASSOCIATION OF BROADCASTERS

    Mr. Smith. Good morning, Chairman Lujan, Senator Thune. May 
I just go off script a minute and thank you both for your 
courtesy to have me back in this room. It holds so many fond 
memories, and memories of colleagues of yesterday and both of 
you, friends every day. Thank you.
    My name is Gordon Smith. I am the President and CEO of the 
National Association of Broadcasters. On behalf of free and 
local broadcast stations serving your hometowns, I appreciate 
this opportunity to testify before you today, about the unique 
and vital role that trusted, local broadcasters are playing to 
effectively deliver vaccine information to their communities 
and to your constituents.
    In times of emergency, history is showing very clearly that 
Americans turn first to their local broadcasters for the most 
trusted information, reliable things that help keep them safe 
and to keep them informed. Broadcasters' guiding principle is 
to serve on the front lines of every crisis, staying on the air 
to provide critical information even at times at the risk of 
their own lives.
    Just over a year ago, all of our lives were turned upside 
down by the COVID-19 pandemic. While the country shut down and 
many Americans worked from home, broadcasters began scrambling 
to set up makeshift studios and to modify camera and microphone 
equipment, so they could continue reporting breaking news and 
sharing vital information. Now, as hope abounds and vaccines 
roll out across the nation, broadcasters are again anxious to 
serve as your critical partners to government agencies and the 
public health and medical communities to make sure that people 
are armed with timely, accurate information about vaccines.
    Last fall, NAB partnered with the Reynolds Journalism 
Institute on a nationwide research project to identify the most 
effective vaccine messaging possible. Our research yielded very 
encouraging news and found a public eager for the vaccine. 
However, our research also, and that of other studies, 
identified challenges to some demographics--African-Americans, 
Hispanics, conservative-leaning whites, and women age 18-34.
    Our research showed that everyone simply wants the facts. 
News stories that make recommendations based on factual 
reporting. Fortunately, that is what broadcasters do best and 
endeavor to do always. To dig deep to provide accurate 
information to their communities, not spin, not rumors, and 
hopefully, never with political theater.
    Our survey research also showed that local news to be the 
very most reliable and trustworthy information source. 
Interestingly, social media was ranked least reliable by the 
American people. Our data demonstrates and makes clear that the 
public values a trusted local source more than any other, 
especially the voices of local doctors, local nurses, local 
pharmacists. This research made it clear that a local and 
regional approach, therefore, would be far more effective than 
a one-size-fits-all national messaging campaign.
    So, with the highest reach of all media platforms, into 
more than 90 percent of the American households, and also a 
service which we provide, which is ubiquitous and free to the 
public, broadcast radio and TV stations are the best managed 
carriers to reach vulnerable populations. Importantly, local 
stations serve communities of color, multilingual ethnic 
minorities, and rural areas of the country, where all of us 
come from, to make sure, in those places where vaccine 
hesitancy is highest, that they get the facts and can make 
their choice.
    Acknowledging this vast and unique unparalleled reach, we 
appreciate the many senators, of this committee, also, who 
worked this past year to support broadcasters, providing CARES 
relief and urging the Administration, past and present, to 
utilize local stations to educate Americans during the 
pandemic. We are gratified that the Department of Health and 
Human Services identified local broadcast stations as effective 
advertising partners. Additionally, NAB is proud to be a 
founding member of the Administration's recently announced 
Community Corps, whose mission is to galvanize trusted 
messengers in local communities to encourage people to get 
vaccinated.
    Since the early days of the pandemic, broadcasters have 
donated unprecedented airtime to keeping the public informed 
and to address mistrust and concern, in the hundreds of 
millions of dollars of value. Local broadcasters have been a 
constant companion, shining light, spreading hope, and 
supporting communities, as Americans have experienced acute 
isolation from their families, their neighbors, and their loved 
ones.
    As this pandemic has shown, once again, localism and 
journalism are essential to broadcasting's franchise. 
Therefore, we are eager to continue to work to assist you in 
Congress, the Administration, and local leaders by using our 
airwaves to carry the message America needs and the message 
that America trusts, to get over the finish line with this 
pandemic. Further, as Congress considers how best to direct 
Federal advertising dollars, we are confident that all 
broadcasters, especially those small and rural markets, like we 
all come from, can drive these messages home better than any 
other medium.
    Thank you for this opportunity to testify today. I look 
forward to your questions.
    [The prepared statement of Mr. Smith follows:]

    Prepared Statement of Hon. Gordon H. Smith, President and CEO, 
                  National Association of Broadcasters
Introduction
    Good morning Chairman Lujan, Ranking Member Thune and members of 
the subcommittee. My name is Gordon Smith and I am the president and 
CEO of the National Association of Broadcasters. I am honored today to 
testify on behalf of our 7,200 free, local television and radio station 
members and the broadcast networks that bring the most trusted news and 
information to our communities each and every day. This critical role 
has been especially vital to the public during the COVID-19 pandemic.
    Survey after survey shows that in times of emergency, Americans 
turn to their local broadcasters first for the most trusted and 
reliable information to stay safe and informed. Unlike other 
communications mediums, broadcasters' guiding principle is to serve on 
the front lines of every crisis, staying on the air to provide critical 
information even when their own lives are in danger. This service is 
how we earn our broadcast licenses and fulfill a mission that no other 
medium can, and that has been especially vital during the past year.
    Just over a year ago, all our lives were turned upside down by the 
COVID-19 pandemic. While the country shut down and many Americans 
worked from home, broadcasters scrambled to set up makeshift studios 
and modify camera and microphone equipment so they could continue 
reporting breaking news and sharing vital information with their 
communities while trying to stay safe.
    Despite facing major economic and physical challenges created by 
the pandemic, local broadcasters stepped up to provide their 
communities with accurate and timely information on COVID-19 on every 
platform--on air, online and through social media. Broadcasters led 
educational efforts to help prevent the spread of the virus and 
provided resources and help to those impacted, donating hundreds of 
millions of dollars in free airtime to preventative education in the 
first six months alone of the pandemic.
    In addition to providing local news and updates vital to their 
communities, broadcasters worked to raise awareness of mental health 
resources, supported and promoted local businesses and frontline 
workers and shared positive stories about people helping their 
neighbors in need.
    Now, as hope abounds and vaccines roll out across the nation, 
broadcasters are once again leading the way in serving the public. 
Stations are serving as critical partners to government agencies and 
the public health and medical communities to arm listeners and viewers 
with timely, accurate information about vaccines. We are helping 
Americans protect themselves and others by getting inoculated, and 
helping our Nation reopen and return to normalcy--something we all 
desperately crave.
Identifying Effective Messaging and Messengers
    Broadcasters' vaccine education efforts have been comprehensive and 
fortified by in-depth research. In the fall of last year, NAB partnered 
with the Reynolds Journalism Institute on a nationwide research project 
\1\ to identify effective vaccine education messaging that would best 
resonate with Americans. What we found helped guide our efforts to 
prepare our Nation's journalists for the critical mission of helping 
our country emerge from the pandemic.
---------------------------------------------------------------------------
    \1\ Research survey conducted by SmithGeiger of 3,046 adults aged 
18-64, December 4-11, 2020
---------------------------------------------------------------------------
    Our research yielded encouraging news and found a public eager for 
the vaccine. In fact, six in 10 respondents wanted a shot as soon as it 
was available to them, with only 13 percent saying they would not get 
vaccinated. I'm pleased to report that the number of Americans who want 
to be vaccinated has continued to rise as more information has become 
available.
    However, our research findings also helped us identify challenges 
to vaccine acceptance. Our data, in addition to research conducted by 
numerous groups, indicates greater hesitancy among certain 
demographics, such as African Americans, Hispanics, conservative-
leaning Whites, and women aged 18-34. Identifying this early helped us 
to prepare our stations that reach these critical demographics and arm 
them with information to help them deliver effective messages 
specifically tailored to these audiences.
    We found that the biggest motivating factor in getting a vaccine is 
the desire to get back to normal, as well as to protect vulnerable 
friends and family members. However, Americans want to know that the 
vaccines are safe and effective. Our research shows that they simply 
want the facts--news stories that make recommendations based on 
detailed reporting, not a personal perspective. Fortunately, that is 
what broadcasters do best--they dig deep to provide accurate 
information to their communities--not spin, rumors or political 
theater.
    Our research also deemed local news the most reliable and 
trustworthy information source by our survey respondents. Social media 
was ranked least reliable by Americans. Our data demonstrates that the 
public values a trusted local source over personalities, politicians 
and pundits, and the most trusted voices are those of their local 
doctor, nurse or pharmacist.
    This research made it clear from the outset that a local and 
regional approach would be more effective than a one-size-fits-all 
national message.
    These research findings became the basis of NAB's vaccine education 
toolkit, nab.org/vaccine, that was produced as a comprehensive resource 
for our member stations and other local journalists. This online 
resource provides messaging guidance, access to local and national 
healthcare experts and public service tools to help stations craft news 
stories and campaigns that best resonate with their listeners and 
viewers.
    The vaccine education toolkit also includes resources and research 
provided by many well-respected partners, such as the U.S. Department 
of Health and Human Services, the Kaiser Family Foundation, Asian 
Americans Advancing Justice, the Hispanic Federation, National Urban 
League, Trust for America's Health and countless others.
    These partnerships are critical to our work in reaching vulnerable 
populations with information that is accurate and impactful. Most 
recently, we added the great work of the Ad Council to our toolkit and 
encouraged our radio and television station members to utilize the 
``It's Up to You'' campaign resources, which encourage the public to 
get the latest vaccine information, understanding that personal 
education is the first step in building vaccine confidence.
Partners in Public Education
    Armed with the research and messaging to best educate the public, 
and routinely cited by Americans as the most trusted news source, 
broadcasters are uniquely positioned to effectively deliver vaccine 
information to their communities.
    With the highest reach of all media platforms into more than 90 
percent of households, and a service that is ubiquitous and free to the 
public, broadcast radio and TV stations are clearly the best message 
carriers to reach vulnerable populations. Local stations serve 
communities of color, multilingual ethnic minorities and rural areas of 
the country where vaccine hesitancy is highest.
    In fact, African American, Hispanic and Latino, Asian American, 
Native Hawaiian and Pacific Islander communities rely on free and local 
TV and radio broadcast stations more than the general U.S. population. 
According to Nielsen, the number of broadcast-only households in the 
United States continues to rise, increasing nearly 14 percent from 2019 
to 2020. More than one-third of minority households in the country rely 
on a television antenna to get free, over the air TV. At least 40 
percent of African American households and 44 percent of Hispanic 
households in the U.S. own a TV antenna.\2\
---------------------------------------------------------------------------
    \2\ Horowitz Research, ``State of OTA'', October 2020
---------------------------------------------------------------------------
    Acknowledging this vast, unique and unparalleled reach, we 
appreciate the many senators and members of Congress that have worked 
over the past year to support broadcasters, providing robust relief and 
funding, and urging the administration to utilize local stations to 
educate Americans during the pandemic. We are gratified that the U.S. 
Department of Health and Human Services (HHS) has identified local 
broadcast stations as effective advertising partners and conduits to 
share clear, reliable information with those demographics and regions 
that need it the most through their vaccine education advertising 
campaign. We look forward to continuing to work closely with HHS on 
these efforts to reach those most at risk.
    Additionally, NAB is proud to be a founding member of the 
Administration's recently announced Community Corps, whose mission is 
to galvanize trusted messengers in local communities to encourage 
people to get vaccinated. The program, spearheaded by HHS and the 
Centers for Disease Control and Prevention, is working with 
broadcasters to deliver messages to the public in the fight against 
COVID-19 and share the importance of vaccinations in every community.
    We also look forward to the role broadcasters can play in the 
Administration's forthcoming ``You Can Do It,'' campaign to encourage 
Americans--particularly those in rural communities, young adults, 
African Americans and Hispanics, to get vaccinated. Broadcasters are 
particularly well situated to boost vaccine confidence among these 
populations and help them make the critical decision to be vaccinated.
    Finally, NAB is active in several private sector campaigns to 
supplement our work with the Federal government. We are supporting the 
Greater Than COVID initiative called ``The Conversation: Between Us. 
About Us.'' This campaign includes prominent Black doctors, nurses and 
researchers dispelling misinformation and providing accessible facts 
about COVID-19 vaccines for the Black community. NAB is also a member 
of the COVID Collaborative, a national assembly of experts and 
organizations working on unified action against the COVID-19 pandemic. 
I am honored to serve on its National Advisory Council in their efforts 
to ensure that we reach vulnerable communities to defeat the virus both 
equitably and effectively.
Broadcasters in Action
    Since the early days of the pandemic, broadcasters have donated 
unprecedented airtime to keeping their listeners and viewers safe and 
informed--from airing public service announcements to hosting 
fundraisers for the community to giving free promotion to small 
businesses. Stations continue to host townhall meetings with medical 
experts and post easy-to-access information on their websites, 
providing a platform for the public to get answers to their vaccine 
questions. Not only are broadcasters working to educate the public, 
they are focused on addressing the mistrust that exists and acknowledge 
the concern among vulnerable communities.
    For example, last month Gray Television's WSFA in Alabama hosted a 
live townhall titled, ``Fear, Facts, Future: The COVID-19 Vaccine 
Explained,'' to discuss concerns and misconceptions about the COVID-19 
vaccine in the Black community. The station teamed up with health 
experts and community leaders to answer questions and address 
skepticism. The panel discussion took place in Tuskegee, the site of a 
1932 medical study where the government examined the effect of syphilis 
on Black men. This location was chosen specifically to acknowledge that 
the community has a reason for mistrust, but also to allow medical 
experts from the Black community to explain how those issues are being 
addressed with solid, reliable information.
    Univision Communications launched a national bilingual vaccine 
hotline as part of its Unidos Por Los Nuestros (United For Each Other) 
COVID-19 campaign, which the public can call to access accurate 
information about the vaccine and receive personalized assistance on 
how to sign up for the vaccine. They also provide an online vaccine 
finder and are hosting a statewide forum in California featuring Sen. 
Alex Padilla and Rep. Tony Cardenas to help address some of the issues 
surrounding vaccine disparities.
    In addition to covering COVID-related educational topics on 850 
local radio stations with an array of health experts, government 
leaders and nonprofit organizations, iHeartMedia recently launched the 
``COVID-19 Immunity in Our Community'' podcast series, produced in 
partnership with HHS to share timely and accurate information about 
vaccines. Designed to separate fact from fiction, ``COVID-19 Immunity 
in Our Community'' will arm listeners with the tools they need to make 
educated decisions about getting vaccinated. The show is hosted by ABC 
News' Robin Roberts and features experts such as Dr. Anthony Fauci and 
other respected voices from the medical and scientific communities. The 
new podcast will also draw perspectives from Americans across different 
communities, who will share their unique and personal experience with 
vaccination.
    Tegna's WXIA Atlanta took an innovative approach to addressing 
concerns and mistrust over COVID-19 vaccines by handing over the 
microphone and camera to a skeptical area mom, allowing her to 
interview the experts and get her questions answered. This novel and 
transparent approach gave the audience a voice in a minority community 
with high levels of hesitancy. The interviews aired during the morning 
and evening newscasts, as well as during a special half-hour news 
report.
    Hearst Television's KOAT Action 7 news in Albuquerque is educating 
viewers about how to sign up for vaccine appointments online or by 
phone, informing them about who is eligible to receive a shot and 
answering important questions and dispelling myths about vaccine 
safety. They are also providing localized information about how many in 
the state are already vaccinated and how that compares with the rest of 
the country.
    Celebrities such as Whoopi Goldberg on ABC's The View and trusted 
local anchors such as Tom Wills, a veteran reporter for Graham Media's 
WJXT in Jacksonville, Florida, are sharing their vaccination stories 
with viewers and encouraging viewers to get inoculated.
    Audacy's KCBS Radio in San Francisco recently tackled questions 
about vaccine efficacy during its ``Ask an Expert'' segment, responding 
to listener concerns about the differences between the types of 
vaccines available.
    Fox-owned Q13 News in Seattle is putting experts on the air, 
including Dr. Scott Lindquist, Washington State's epidemiologist, to 
talk about travel restrictions as vaccinations continue and Dr. John 
Dunn of Kaiser Permanente to discuss new trials for a vaccine to combat 
the South African COVID variant.
    These are just a handful of examples of the work being done 
throughout the country by thousands of radio and television stations as 
the public turns to broadcasters to get trusted answers to their 
vaccine questions.
Conclusion
    It has been more than a year since the beginning of this 
devastating pandemic, and the enduring value of local broadcasters to 
our communities and your constituents has never been clearer. They have 
helped keep the fabric of our communities--and the very fabric of our 
democracy--connected during one of the most challenging years in our 
Nation's history. In fact, local broadcasters have been a constant 
companion shining light, spreading hope and supporting communities as 
Americans have experienced acute isolation from their families, 
neighbors and loved ones.
    According to Nielsen, at home news consumption grew significantly 
in the second quarter of last year and news was the most popular TV 
genre viewed as Americans left their TV sets on throughout the day. The 
most popular source was local television among 64 percent of 
respondents, as viewers tuned into local stations to get the 
information most relevant to their community and the content they 
trust.\3\
---------------------------------------------------------------------------
    \3\ The Nielsen Total Audience Report: August 2020
---------------------------------------------------------------------------
    A separate Nielsen survey yielded compelling findings about radio 
as ``comfort food'' during the pandemic, with 83 percent of Americans 
reaffirming that they were listening to as much or more radio as they 
were before the pandemic. ``As is the case with local TV viewership in 
times of crisis, radio and on-air personalities present a connection to 
the real world that listeners gravitate toward and trust,'' said 
Nielsen.\4\
---------------------------------------------------------------------------
    \4\ Nielsen: Radio is Comfort Food as Media Consumption Rises Amid 
Covid-19 Pandemic
---------------------------------------------------------------------------
    Providing a lifeline to communities--particularly in times of 
crisis--is what broadcasters do best, and they do it better than all 
other mediums combined.
    As Americans' most-trusted source for news, local radio and 
television stations understand their responsibility to deliver 
reliable, fact-based journalism and have demonstrated their indelible 
value. Broadcasters are delivering life-saving information and hope 
during a time when fear, uncertainty and loss have bonded us.
    Broadcasters stand ready and prepared to continue helping Americans 
get the information they need to safeguard their health and return to 
normalcy. We are eager to continue to assist Congress, the 
Administration, Federal agencies and local leaders by using our free, 
local airwaves to carry the message America needs--and trusts--to get 
over the finish line with the COVID-19 pandemic.
    Thank you again for the opportunity to discuss this issue, which is 
critical to America's broadcasters and the communities we serve. I look 
forward to your questions.

    Senator Lujan. Thank you, Senator Smith. Next, we are going 
to hear from Yonaira Rivera. Dr. Rivera, an Assistant Professor 
of Communications at Rutgers University School of 
Communications and Information, from New Brunswick, New Jersey. 
Dr. Rivera, you are recognized for five minutes.

STATEMENT OF YONAIRA RIVERA, Ph.D., M.P.H., ASSISTANT PROFESSOR 
 OF COMMUNICATION, RUTGERS UNIVERSITY SCHOOL OF COMMUNICATION 
                        AND INFORMATION

    Dr. Rivera. Thank you. Chairman Lujan, Ranking Member 
Thune, distinguished members of the Senate Subcommittee thank 
you very much for inviting me to speak to you today about how 
we can reach Latinos and other communities of color with 
effective communication strategies to encourage the uptake of 
COVID-19 vaccinations. It is a great honor and privilege to be 
here.
    My name is Yonaira Rivera, and I am an Assistant Professor 
at Rutgers University's School of Communication and 
Information. My scholarship is centered around reducing Latino 
health inequities through effective, health communication, with 
a focus on social media and community engaged research. But I 
have also served as a community health educator for Latinos in 
Florida and Puerto Rico. And I have worked alongside community 
leaders in Puerto Rico in long-term relief efforts after 
Hurricane Maria. It is from these collective experiences that I 
speak to you today to share insights on how to best reach 
Latino and other communities of color.
    I first want to address how misinformation undermines our 
ability to reach these communities, particularly on social 
media. As you can see in my written testimony, findings from my 
research on cancer misinformation suggests that we should 
address digital health literacy among adult populations to help 
reduce the spread of health misinformation on social media 
platforms. But interventions at the platform level are also 
imperative. As individuals may not be sufficiently motivated or 
skilled to verify the health information they encounter on 
these platforms.
    You may recall that platforms began self-regulating and 
monitoring the dissemination of some health content in 2019, 
after public and media concerns surrounding misinformation 
about the measles, mumps, and rubella vaccine. Yet, this 
reactive response leaves many questions unanswered, including 
what makes a public health problem important enough to 
regulate, and in what ways this content should be regulated--
issues that we have only seen grow during the current pandemic.
    These and other topics are at the core of a recent report 
released by the Johns Hopkins Center for Health Security. This 
report calls for a national strategy to combat health 
misinformation and disinformation and, among other things, 
suggests that a national commission be established to provide 
evidence-based guidelines and recommendations for neutral 
oversight. Such a commission would include multiple 
stakeholders to address these very difficult issues from 
multiple angles.
    I will now turn my attention to my second point of 
discussion, how to reach communities of color with evidence-
based messages, to encourage vaccine uptake, while we embark on 
efforts to minimize health misinformation. Again, drawing from 
my work with the Latino community, some of these 
recommendations include, first, utilizing community health 
educators or other trustworthy figures to deliver evidence-
based messages on social media and beyond. Second, to 
counteract misinformation by disseminating culturally tailored 
narratives. And third, partnering with local organizations and 
community leaders in bottom-up outreach efforts.
    And I want to emphasize this last point. While it is 
crucial to invest in communication using traditional media 
outlets, it is just as essential to invest in bottom-up efforts 
that leverage the work already conducted on the ground by 
trusted community leaders and organizations. My experiences in 
the field have taught me that listening to community leaders, 
and working around their needs, is key for success. Local 
leaders know what efforts are feasible and what will benefit 
their community. So, listening to their concerns and assisting 
them in finding solutions cements trust and fosters a sense of 
ownership, which are instrumental to these and other public 
health efforts.
    It is also important to note that blanket messages will not 
be successful with Latinos and other communities of color, as 
we are not monolithic. Tailored messaging is required to 
adequately promote vaccine uptake.
    We must also remember that issues related to vaccine 
hesitancy are not all due to misinformation. And issues related 
to vaccine uptake are not all due to hesitancy. This is why 
working with, and listening to, leaders of grassroots 
organizations can facilitate communication efforts.
    A final point I want to highlight is that we need more 
research. Addressing vaccine hesitancy and health 
misinformation is an extremely challenging endeavor. There are 
still many questions we do not have answers to, making this a 
very important opportunity to get it right and fund research 
and communication initiatives that adequately meet the 
challenge.
    As I conclude, I want to re-emphasize the importance of 
leveraging trusted sources when reaching Latinos and other 
communities of color. This is instrumental, as building trust 
takes time and cannot be done overnight. We need more people 
who look like us delivering messages, more scientists who 
understand our communities conducting the research, and more 
funding directed toward our communities and organizations to 
end the disparities that we face.
    I look forward to our conversation. Thank you.
    [The prepared statement of Dr. Rivera follows:]

Prepared Statement of Yonaira M. Rivera, PhD, MPH, Assistant Professor, 
  Department of Communication, School of Communication & Information, 
              Rutgers--The State University of New Jersey
    Chairman Lujan, Ranking Member Thune, and distinguished members of 
the United States Senate Subcommittee on Communications, Media, and 
Broadband: thank you for inviting me to speak to you today about how we 
can reach Hispanic/Latino (henceforth Latino) and other communities of 
color (which I will refer to as BIPOC \1\ communities) with effective 
communication strategies to encourage the uptake of COVID-19 
vaccinations. It is a great honor and privilege to be here.
---------------------------------------------------------------------------
    \1\ Brown, Indigenous and People of Color
---------------------------------------------------------------------------
    My name is Yonaira Rivera, and I am an Assistant Professor at 
Rutgers University's School of Communication and Information in New 
Jersey. My testimony today is based on over a decade of research and 
practice that impact BIPOC communities in this country.
    My academic background includes a master's degree from Rollins 
School of Public Health at Emory University and a Ph.D. from Johns 
Hopkins School of Public Health. My scholarship is centered around 
reducing Latino health inequities through effective, theory-driven 
health communication, with a focus on social media and community 
engaged research.
    But my experiences extend beyond academic research. I have served 
as a community health educator for the National Cancer Institute, 
educating Latino communities in Florida and Puerto Rico. I have also 
worked alongside community leaders in Puerto Rico in long-term relief 
efforts after Hurricane Maria, building the trust necessary to conduct 
fruitful community-based research and interventions.
    It is from these collective experiences, and the published research 
of many scientists in the fields of public health and health 
communication, that I speak to you today to share insights on how to 
best reach Latino and other BIPOC communities through health 
communication initiatives that can assist in comprehensive COVID-19 
vaccination efforts.
    Vaccination efforts are instrumental as the Nation battles this 
pandemic. The success of these efforts undoubtedly relies upon 
accurate, effective health communication to ensure communities are 
well-informed about vaccine safety and efficacy, as well as where and 
how to access vaccinations. Despite this, there is still vaccine 
hesitancy among members of BIPOC communities for a myriad of reasons. 
These include medical and government mistrust, confusion about vaccines 
and where to get them, language barriers, and misinformation related to 
access, who is eligible, and fear of getting COVID-19 from the vaccine.
Misinformation undermines our ability to reach Latino and other BIPOC 
        communities
    While issues related to vaccine hesitancy go beyond social media, 
evidence suggests that these platforms contribute to the spread of 
misinformation that can bolster these beliefs and misperceptions. The 
rise of misinformation on social media has caused public health 
scholars to express deep concerns over how health misinformation is 
shared, how vulnerable populations respond to it, and how it may 
negatively impact public health outcomes.
    This concern is at the core of my empirical work, which focuses on 
understanding how U.S. Latino adults engage with and act upon health 
information and misinformation on social media. I have explored this 
within the context of cancer communication, which is another health 
equity issue that disproportionately impacts Latino communities.
    Findings from my work, which focus on Latinos ages 40-75, highlight 
that many individuals do not have the time, skills or motivation to 
adequately verify content they encounter. Instead, they trust the 
sources who share it--despite content having low scientific credibility 
and being distributed by potentially unreliable sources.
    In light of these findings, efforts that tackle digital health 
literacy among adult populations may be necessary to address the spread 
of misinformation on social media. Structural interventions (i.e., 
those at the platform level) are also imperative, as individuals may 
not be sufficiently motivated or skilled to verify health information 
they encounter on social media. And while social media platforms have 
begun self-regulating and monitoring the dissemination of some health 
misinformation since the public and media outcry surrounding measles, 
mumps and rubella vaccine misinformation in 2019, this reactive 
response leaves many questions unanswered, including what makes a 
public health problem ``important enough'' to regulate, and in what 
ways should this content be regulated--issues we have only seen grow 
during the current pandemic.
    These and other topics are at the core of a recent report released 
by the Johns Hopkins Center for Health Security, ``National Priorities 
to Combat Misinformation and Disinformation for COVID-19 and Future 
Public Health Threats: A Call for a National Strategy'' (led by Dr. 
Tara Sell). The report proposes for four pillars to assist in 
developing this strategy: (1) intervening against false/damaging 
content and its sources; (2) promoting and disseminating abundant 
factual information; (3) increasing public resilience to misinformation 
and disinformation; and (4) responding via multi-sector and multi-
agency collaborations. It also recommends that a national commission be 
established to provide evidence-based guidelines and recommendations 
for nonpartisan oversight. Such a commission would include multiple 
stakeholders to address these difficult issues from multiple angles.
How might we reach Latino and other BIPOC communities with messages to 
        effectively increase vaccine uptake?
    In light of the current health misinformation landscape, I will now 
turn to my second point of discussion: how to reach Latino and other 
BIPOC communities with evidence-based messages to effectively increase 
vaccine uptake.
    Other findings from my work with the Latino community emphasize 
that messages and their sources should be culturally relevant to boost 
effectiveness. These findings add to existing cancer communication 
literature and they are easily transferrable to the vaccine 
communication efforts we are tackling today. Some recommendations 
include:

   Utilizing promotores or other trustworthy figures to deliver 
        evidence-based messages on social media. Trusted sources with 
        perceived topic expertise/authority and similar cultural 
        identity heavily contributed to engagement with information. 
        Sources appear to enhance engagement with (or be more important 
        than) culturally-relevant content. This suggests that receiving 
        reputable health information from trusted individuals may 
        assist in counteracting and dispelling myths. Initiatives can 
        embed trusted sources in the Latino community--like promotores 
        (community health workers) and other community leaders--into 
        their outreach efforts. These individuals could be trained to 
        engage with community members on social media through efforts 
        that leverage the dialogical education enabled by platforms 
        like Facebook, an approach that has been successful in tobacco-
        cessation interventions (see Ramo et al., 2018).

   Counteracting misinformation by disseminating culturally-
        tailored narratives. Our findings present new considerations 
        for social media interventions to adequately deliver evidence-
        based, culturally-tailored information to intended audiences. 
        Narratives may be one tool to effectively counteract 
        misinformation online, as the shared experiences of others had 
        a strong influence in credibility assessments among interviewed 
        participants. These findings align with other health 
        communication efforts that have successfully used persuasive 
        narratives containing Latino cultural values, language, and 
        country of origin as a way to promote cancer prevention and 
        screening (see Murphy et al., 2015).

   Partnering with local organizations and community leaders in 
        bottom-up outreach efforts. While it is crucial to invest in 
        communication using traditional media outlets, it is just as 
        essential to invest in bottom-up efforts that leverage the work 
        already conducted on-the-ground by trusted community leaders 
        and organizations. My experiences as both a community health 
        educator and through my disaster relief work in Puerto Rico 
        taught me that listening to community leaders and working 
        around their needs is key for success. Local leaders know how 
        feasible projects are locally, as well as what will be of 
        benefit to the community. Taking their needs into account and 
        assisting them in finding solutions foments trust and fosters a 
        sense of ownership. This is instrumental in creating an 
        environment of mutual collaboration where everyone involved has 
        a seat at the table. For a detailed agenda on how to establish 
        this kind of outreach, I will refer you to this recent report 
        by the Working Group on Equity in COVID-19 Vaccination.

    It is important to note that blanket messages will not be 
successful within Latino and BIPOC communities, as these are not 
monolithic. Tailored messaging is required to adequately promote 
vaccine uptake, which is why working with leaders and grassroots 
organizations can facilitate these and other communication efforts.
More research is needed
    A final point I want to highlight is that we need more research. 
This current public health crisis has emphasized the relevance of 
research that assesses the impact of health misinformation on public 
health outcomes. Yet, addressing vaccine hesitancy and health 
misinformation among Latino audiences (and in general) is an extremely 
challenging endeavor. There are still many questions we do not have 
answers to, making this an important opportunity to get it right and 
fund research and communication initiatives that adequately meet this 
challenge.
    That is why investing in future research is of paramount 
importance, as is the establishment of interdisciplinary, 
transnational, and multilingual collaborations. Transnational, multi-
lingual initiatives are necessary to be informed on health 
misinformation trends happening in Latin America (and other countries) 
that are shared through social media. This will require international 
collaborations between researchers, journalists, government agencies, 
and non-profit organizations to share resources and best practices (see 
The ComProp Navigator for an example of similar efforts in political 
misinformation and disinformation).
    Before concluding, I want to re-emphasize the importance of 
leveraging trusted sources when reaching Latinos and BIPOC communities. 
This is instrumental, as building trust takes time and cannot be done 
overnight. We need more people who look like us delivering messages, 
more scientists who understand our communities conducting the research, 
and more funding directed towards our communities and organizations to 
be successful at these efforts. I look forward to our conversation. 
Thank you.

    Senator Lujan. Thank you, Dr. Rivera for being available 
today, as well. I am going to now recognize myself for five 
minutes for questioning.
    Secretary Collins, I want to first thank you for attending 
this important hearing. As State House Secretary New Mexico, 
you are leading a critical effort to get the spread of this 
disease under control, and it is working. New Mexico is leading 
the Nation in its vaccine rollout. For every new case of COVID-
19, 92 people are vaccinated. In our state, nearly 55 percent 
of residents 16 and older have received their first shot, and 
36 percent are fully vaccinated. This Ranking Member's state, 
Mr. Thune, of South Dakota, is a close second at 27 percent 
fully vaccinated. And we do not mind this competition. We are 
going to keep going for first and second here.
    What can the Nation learn from New Mexico, Dr. Collins? How 
has your message strategy been so successful, especially 
considering the diverse and highly rural communities across New 
Mexico?
    Dr. Collins. Thank you, Senator. You know, it takes a 
really good team with strategy and organization. So, what we 
have done, we set up an online portal, an app, where New 
Mexicans can go and get registered. And also, we have a team, 
what we call an instant command structure, which I mentioned in 
my opening remarks, which keeps us organized. So, we have a way 
of making sure we have communications set up, logistics, 
operations to make sure that we are getting vaccine doses out 
to vaccine providers throughout the state. And we are 
constantly messaging through public services announcements, 
through press conferences, we are engaging the communities. And 
we are also working with community leaders to allow them to 
serve as our trusted voices to engage New Mexicans to get 
vaccinated.
    Senator Lujan. Dr. Rivera, you have spent years studying 
how to best address health misinformation spread through online 
platforms, targeting Hispanic communities. However, companies 
like Facebook, Twitter, and Google will repeatedly reassure us 
that all of their content moderation efforts are effective in 
English, as well as Spanish. Data suggests otherwise, with 
research finding Facebook's algorithms less than half as 
effective as labeling misleading content about the coronavirus 
in Spanish than they are in English. Dr. Rivera, what are the 
long-term consequences of this gap?
    Dr. Rivera. Thank you for that question, Senator. I want 
to--I want to remind everyone that the pandemic has only 
amplified inequities and disparities that already exist, and 
disproportionately affect communities like the Latino 
community. This is not new to COVID, right? We have seen the 
same thing happen in Puerto Rico after Hurricane Maria, where 
structural inequalities, that already existed, were 
exacerbated, and they led to the unnecessary loss of thousands 
of lives. We have also seen similar things happen in other 
disasters in the U.S. and across the world.
    So, with this in mind, it is critical that everyone has 
access to the same kind of information and protective measures, 
no matter the language. Otherwise, any of these gaps and 
inequities are going to continue to grow. And that is really 
why it is important that, when we are thinking about platforms 
and what to do, to establish a neutral commission that really 
has multiple sectors and agencies who can develop--help develop 
guidelines and recommendations that can identify these and 
other gaps that are really important for public health efforts.
    Senator Lujan. Thank you, Dr. Rivera. Senator Smith, in 
order to understand and address the challenges of their 
communities, we need networks owned and operated by people who 
understand the communities they serve. And I think that is 
reflected all across America, especially in small towns.
    You have long advocated for increased diversity in network 
ownership, and I agree, because, frankly, this is a problem 
that is impossible to ignore. Women are over half the 
population but only own 5.3 percent of full power commercial 
television. Hispanic people only own 4.2 percent. African-
Americans own less than 1 percent. And I believe that we can 
not have an effective local public health communication 
strategy without a diverse media landscape.
    In light of the testimony, we have heard on broadcasters' 
role as trusted voices during the pandemic, do you believe 
Congress and the FCC should be taking active steps to encourage 
diverse media ownership?
    Mr. Smith. Yes, of course, I do agree with that, Senator, 
and there is two ways to do it. It can be mandated in statute, 
but it also could be incentivized by statute. Before I came to 
Congress, in 1995, there was something called the Minority Tax 
Certificate Program. It worked very well, but admittedly, there 
were abuses. So, in 1995, as part of a budget deal, with the 
Clinton Administration, the Republican Congress ended it. They 
should have mended it, not ended it.
    And when I came to the Senate in 1996, starting in 1997, I 
became aware of this problem you identify. As a member of the 
Commerce Committee, and later the Finance Committee, I made it 
my bill to restore the Minority Tax Certificate Program. 
Because, yes, you can do it by a stick, but it is better with a 
carrot. And I want to credit Senator Peters. He has picked up 
that bill and I think it will work very well.
    Diversity among broadcast management and ownership, there 
is not a lack of will. It is a lack of capital, access to 
capital. This helps fix that. And it can be done where purging 
the abuses of yesteryear in a way that really help broadcasters 
achieve what they already want to do, which is the diversity of 
its ownership with management, with the diversity of our--the 
American people.
    Senator Lujan. Appreciate that, Senator Smith, and I look 
forward to a second round of questions, if we get a chance. I 
will now recognize the Ranking Member, Mr. Thune, for five 
minutes.
    Senator Thune. Thank you, Mr. Chairman. And, Senator Smith, 
again, a long-time alum of this room. And I am sure it feels 
somewhat surreal, maybe, to be here again but in a different 
role. But we are, as I said earlier, grateful for your many 
contributions as a member of this body and since, and for the 
very effective way you have represented the broadcasters across 
this country who, as you point out, have, I would say, the most 
credibility among news organizations these days.
    And people ask me all the time, where do I go if I want to 
get just news and journalism, and it is so hard anymore because 
so many media outlets have become echo chambers. They reinforce 
what people already believe and it is more opinion and 
commentary. And so, I often recommend that they go and get it 
from their local broadcasters, and that is probably the most 
straight, down the middle news you are going to get.
    As you know, Congress has allocated funds to support 
vaccine public awareness campaigns. And since the beginning of 
the pandemic, NAB and its members have been working to 
disseminate health-related information to the public, including 
educating the public and pointing them toward testing sites, 
vaccine registration websites, and vaccine sites. What modes of 
communication have your members serving more rural areas seen 
to be the most effective way to reach individuals? And what 
specific steps are broadcasters taking when partnering with 
their Federal Government to reach rural communities?
    Mr. Smith. Well, Senator, I know Chairman Lujan has the 
same concern. And you know as well as I, that if you want to 
send a message to Sioux Falls, it is going to be a different 
message or a different method to reach Deadwood, or 
Albuquerque, or Clovis. And for messaging to get out credibly, 
through our medium, which is the most biggest and demonstrably 
the most effective, takes a little more time, a little more 
patience. You all represent agriculture states. If you want a 
good crop, you have got to get the water to the end of the row. 
That takes time. That takes a little more patience.
    And that is what needs to happen as we roll out these 
messages, to make sure that we get on Spanish radio, to make 
sure that we get on rural radio. Farmers listen to the radio 
almost constantly. So, use those stations. And of course, 
include urban areas, as well.
    So, I am just--I am here to say that that money can reach 
90 percent plus of the American people with effective targeted 
advertising, if you use all the tools available to you through 
broadcasting. Television and radio, rural, urban, small, and 
large, the American people will get the message because they 
tune into broadcasting and they find it the most credible.
    Senator Thune. And the airtime that they're offering up is 
valuable to all of your members, no matter the scale of their 
operations or audiences. Has the NAB been able to quantify this 
public interest effort, in terms of the monetary value of 
airtime donated by your members throughout the pandemic?
    Mr. Smith. I know when COVID first hit, I directed my staff 
to produce some advertising, which was run throughout the 
country on saturation levels, at an approximate cost of 
commercial value of $160 million. In addition to that, many 
local broadcasters have done additional things in their 
communities. In the Ad Council--we work with the Ad Council to 
produce national rollout campaigns, as well, that are 
informative and, I think, have been well received by the 
American people.
    I do not have a final number, but it would be in the 
hundreds of millions of dollars of advertising time that has 
been donated by broadcasting. And I am very proud of that.
    Senator Thune. There are recent reports of vaccine demand 
falling as the number of cases falls and the number of deaths 
also fall. What is the role of local broadcasters and pushing 
people to continue to get vaccinated, even as the pandemic 
seems to have currently plateaued in some regions?
    Mr. Smith. I think the main thing that our responsibility 
is, is to make sure they have the facts. And obviously, there 
are things that government can do to give them hope, that these 
vaccines are incredibly effective, and that--but when there is 
something like a Johnson & Johnson issue that comes up, our job 
is to give the people the facts, and ultimately, that is 
trusted, and the people seem to be responding to it. And 
fortunately, these vaccines are so effective that the death 
rate is dropping like a rock and that says we are getting the 
job done. But there is more to do.
    Senator Thune. Thanks. Dr. Collins, with respect to the 
news about Johnson & Johnson, my question is are we going to 
need to pivot when it comes to the PR strategy that was laid 
out by the Administration a couple of weeks ago? And what is 
the best strategy for quickly addressing this new and emerging 
issue?
    Dr. Collins. Thank you for the question. What we need to do 
is certainly recognize that more data is needed to understand 
J&J. There were six cases out of 6.8 million doses received. 
So, that is less than one in a million. Keep in mind that one 
in 10 Americans have gotten COVID, and one in 558 have died.
    What we need to do now is pause on J&J until we get more 
information, and then, certainly ramp up the amount of Pfizer 
and Moderna that we are getting out to communities. And, as an 
example, one of our FEMA Urban Mobile Units, we were planning 
to use J&J and we quickly pivoted to Moderna, once we had to 
pause the use of J&J.
    Senator Thune. OK, thank you. Mr. Chair, my time has 
expired, and I do have to run to ask a question at Finance on 
another issue. But I did want to point out that, to your point 
about the competition, that 37 percent of South Dakotans are 
fully vaccinated.
    Senator Lujan. I like that competition, Senator Thune. And 
we are going to keep racing for first. That is good.
    Senator Thune. All right.
    Senator Lujan. Between South Dakota and New Mexico, let us 
see who gets--stays in that slot. But with that being said, I 
am now going to recognize my friend, Senator Klobuchar, for 
five minutes for questions.

               STATEMENT OF HON. AMY KLOBUCHAR, 
                  U.S. SENATOR FROM MINNESOTA

    Senator Klobuchar. Of course, I am now quickly checking my 
Minnesota numbers, to see where we are. I did note a local news 
story, though, that said that South Dakota, because it is in my 
region, Mr. Chair----
    Senator Lujan. Uh-huh.
    Senator Klobuchar. Is actually doing a very good job. They 
had a story on red states and blue states and what is happening 
and how we get the information out. And they said that South 
Dakota had, kind of, risen to the occasion and was getting 
their vaccines out, and--which I have also found in rural 
Minnesota, spending the last few weeks there, at the same time, 
which is a great topic for this hearing. Thank you, Mr. 
Chairman.
    A lot of misinformation. One guy at a cafe told me his 
mother-in-law--this is a month ago--was--got an appointment 
time and she canceled it because she read on the Internet that 
there would be a tracker planted in the vaccine in her arm. And 
she read that on the internet. And that has been, by the way, a 
common thing out there.
    Getting to your work, Senator Smith, and I know you know 
how much I respect you and how hard we have worked together 
and----
    Mr. Smith. That is very mutual, Senator.
    Senator Klobuchar. Thank you. And I am wishing you good 
fortune in everything you do going forward.
    And one of the things that is frustrating for me is that 
the local news has tended to report things as they are at home, 
and then, people are reading this crazy stuff on the internet, 
OK? That is what is happening. There is some good stuff on the 
Internet and there is some really bad stuff on the internet. 
And you, just to, kind of, go into this larger issue, you would 
not be able to put stuff on your news stations that are total 
lies, or ads that are total lies, for instance, without running 
into regulatory problems.
    Mr. Smith. Right.
    Senator Klobuchar. OK. So, one of the things that I would 
like to see, in a bigger picture, is to give broadcasters more 
of a--more possibility and also, newspapers and all of our 
content producers to be able to keep going with trying to put 
the news out there. I think you know--I think you guys have 
come on board with us on this bill to create an exemption from 
the anti-trust laws----
    Mr. Smith. We have, and we thank you for that, Senator.
    Senator Klobuchar. Yes, but to allow news--So, this is a 
bill I have with Senator Kennedy of Louisiana. It is bipartisan 
in the House. Senator McConnell was on it last year. It is a 
big deal.
    Mr. Smith. Mm-hmm.
    Senator Klobuchar. Can you just explain why it is--why this 
feeds into misinformation? Because we have to allow our news 
organizations to keep going. They have got to be able to 
negotiate content rates, so they have the funds to be able to 
keep being strong, so that we do not have everyone getting 
their news from misinformation on the internet. Can you, kind 
of, tie that together?
    Mr. Smith. Senator, since the 17th century--16th--17th 
century, when Edmund Burke looked up to the gallery in the 
Parliament and said, ``there lies the fourth estate more 
powerful than they all,'' he was recognizing the importance of 
journalism in democracy--in the healthy democracy.
    And it should be obvious to everyone and our surveys are 
pointing this out that people really are struggling now, to 
find out what the facts are. Where can truth be found? And 
fortunately, for the people I represent, broadcasters, they are 
number one on the list as most trusted, most reliable. I even--
I remember even Senator Schumer spoke to our broadcasters, not 
too many years ago, and he said, you know, the only place I can 
go anymore, just to get the facts and not be spun, so I can 
communicate clearly with my constituents, is my local 
broadcasters.
    I am proud to represent them, but everybody needs to 
understand, journalism is not free. It is free speech.
    Senator Klobuchar. Mm-hmm.
    Mr. Smith. But to get the facts, sometimes takes 
journalistic digging. And what has always sustained 
broadcasters is advertising. And when COVID came, and Wall 
Street to Main Street advertising collapsed, it was a huge hit. 
But predating that was the consequence of the unfettered growth 
and domination of the Internet and social media that takes well 
over half the advertising dollars today. So, there is a real 
issue about how they take our content and they put it on their 
platforms and then, sell ads against us.
    Senator Klobuchar. Mm-hmm.
    Mr. Smith. And ultimately, countries like Australia, 
European Union, Canada even, I believe are taking up bills just 
like the one you are talking about, to make sure, while 
government is not funding journalism, and it should not, it is 
actually making sure that those revenue streams exist. Because 
government has--our government has an incentive to keep its 
democracy healthy.
    Senator Klobuchar. Yes. Thank you for putting that in that 
context. And I am going to be pushing hard for this bill. 
Clearly we have some issues in rural areas. Mine have been, 
actually, doing pretty well of having just been up to about 
eight rural towns, big and small, in the last week, and are 
proud of their vaccination rate. But across the country, I 
think your information getting out there on the airwaves, and I 
know you have a major effort going on, would be really helpful. 
And could you talk about what you think we need to do to get 
the information out there rural, to get more people to get the 
vaccine?
    Mr. Smith. Well, again, I want, as I did in my testimony, 
thank the Department of Health and Human Services and for the 
Congress in allocating these dollars.
    If you want to reach everyone--if you want to get the water 
to the end of the row, you have got to--you have got to include 
large and small, urban and rural, ethnic and otherwise, you 
have got to do--use all the tools in the toolbox. And you have 
got to be persistent at it, and if you are, the American people 
will get the accurate information, as on no other medium, 
through broadcasting, radio and television.
    Senator Klobuchar. Mm-hmm, very good. Dr. Collins--this 
will be my last question, Mr. Chair. Oh, I have time. OK, well 
then, let me use that time to report that 48 percent of 
Minnesotans over 16 have had at least one vaccine dose. But I 
will continue on.
    OK, so, Dr. Collins, a recent poll by the Blue Star 
Families found that almost half of veterans' families surveyed 
do not expect to receive a vaccine, with 75 percent of those 
families citing some of these, what I believe, are false 
information that they have heard and their concerns about 
efficacy, safety. Last month, Senator Portman and I sent a 
letter to the Department of Veteran's Affairs to ensure that 
veterans have accurate information. Dr. Collins, can you speak 
to the importance of ensuring that veterans and military 
personnel--I know you have many in your state--receive accurate 
and timely information about the vaccine?
    Dr. Collins. Yes, thank you, Senator and congratulations on 
the status of Minnesota for vaccines. Certainly, it is 
important to make sure that our veterans are getting the 
correct information and we have multiple avenues to achieve 
that. We really want to look at the risk factor profile, also, 
of veterans. Which means that they are more likely to have an 
adverse event if they actually get COVID, which highlights the 
value of getting the vaccine.
    So, it is really a matter of working with the Department of 
Veteran's Affairs, to ensure that they can get messaging out 
and facts to these families and to their veterans, about the 
value of the vaccine, and that we have enough vaccine doses 
going out to our veterans.
    Senator Klobuchar. Very good, thank you. Dr. Rivera, my 
last question. One report last year found that social media 
platforms failed to act on 95 percent on the COVID and vaccine 
misinformation reported to them. I led a letter on this. I have 
been doing a lot of work, it is no secret, on trying to hold 
these companies accountable for various things. Following the 
letter we did, Facebook announced new policies to expand 
efforts to counter vaccine misinformation.
    Can you speak to the importance of ensuring that the social 
media platforms do their part? And again, I was actually on a 
hearing yesterday, on the Joint Economic Committee, and one of 
the witnesses there, a doctor, talked about how a recent study 
showed that 73 percent of vaccine disinformation posts on 
Facebook, and 17 percent on Twitter, originate from the same 12 
sources. And I know you mentioned this report earlier in the 
hearing. I am just picturing these 12 people out there pumping 
out lies. In light of that report that you co-authored, can you 
speak to the key measures that should be taken? Like, maybe 
trying to take down 12 people's accounts?
    Dr. Rivera. Thank you so much for that question. Just to 
highlight a little bit more about the report, it really argues 
four pillars. We need to be reducing the level of 
misinformation, while we are increasing the accurate 
information that is out there, while we are building resilience 
within communities and audiences, so that they are able to 
identify things when they see it. But then, also, and very 
importantly, this is a multi-sectoral, multi-agency issue.
    Helpless information has huge ramifications on quality of 
life and livelihood. And it is important that we have multiple 
people at the table who can identify appropriate 
recommendations and guidelines to help curtail disinformation 
on these platforms.
    So, just having the platforms do it, presents some issues, 
right? What makes something important enough to be pulled? 
Where is that line--that very delicate balance between freedom 
of speech and harmful content that can impact people's 
livelihoods? And that is why a lot of--this is complex. It is 
very multi-layered. We need to have a lot of people at the 
table to be able to provide those guidelines on 
recommendations.
    Senator Klobuchar. OK, good. Well, I have with me here the 
12 top sources of anti-vaccine disinformation online. I just 
cannot help but think that the companies that are the biggest 
companies the world have ever known cannot find some way to 
deal with this. But I guess I will have to take it on myself. I 
am not going to read their names in, although I would love to. 
Mr. Chair, I will just simply put it on the record. Thank you.
    [The information referred to follows:]

    Twelve individuals who have played leading roles in spreading 
digital disinformation about coronavirus vaccines \1\:
---------------------------------------------------------------------------
    \1\ Center for Countering Digital Hate. (March 24, 2021). The 
Disinformation Dozen. https://252f2edd-1c8b-49f5-9bb2-
cb57bb47e4ba.filesusr.com/ugd/f4d9b9_b7cedc0553604720b7137f8663
366ee5.pdf

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   1.  Joseph Mercola

   2.  Robert F. Kennedy, Jr.

   3.  Ty and Charlene Bollinger

   4.  Sherri Tenpenny

   5.  Rizza Islam

   6.  Rashid Buttar

   7.  Erin Elizabeth

   8.  Sayer Ji

   9.  Kelly Brogan

  10.  Christiane Northrup

  11.  Ben Tapper

  12.  Kevin Jenkins

    Senator Lujan. I appreciate that, Senator Klobuchar. And I 
think you are going to have a lot of interest of members that 
want to work with you on that, including me, in that effort, as 
well. We need to stop the spread of misinformation out there, 
as we have heard from every one of our witnesses today. It is 
so important to share facts, accurate information with our 
constituents, with people across the United States of America. 
And that there needs to be an active effort to stop the lies, 
to stop the spread of misinformation because it is costing 
people their lives. And so, thank you so much for bringing that 
forward, as well, Senator Klobuchar.
    Secretary Collins, as testimony shows, effective 
communication and outreach can change the course of a pandemic. 
Most Americans want to get vaccinated, across all ages, 
ethnicities, and races. No matter where they live, Americans 
want to get back to their lives. Over the last 3 months, we 
have seen vaccine hesitancy numbers drop dramatically. The 
number of African-American, Hispanic adults who are not sure if 
they will get the vaccine, have dropped in half. We are also 
seeing incredible progress made in Native American communities, 
as well. People see the vaccine working and they are excited to 
return back to normal.
    What would you say to folks who are still--are waiting to 
get the vaccine?
    Secretary Collins. Thank you for that question. What I 
would say to those who are still waiting is that there is 
tremendous value in getting this vaccine and preventing--
protecting yourself and your loved ones from COVID-19 and 
protecting our union. We want to keep Americans safe. And so, 
the vaccines have high efficacy. We know Moderna and Pfizer, we 
have not seen any adverse events that are concerning with those 
vaccines. So, I strongly encourage all of you, if you have not 
been vaccinated and you receive the opportunity to be 
vaccinated, go and get your vaccine.
    Senator Lujan. Dr. Collins, providing clear and consistent 
health information comes at all levels. And I appreciate what 
you just shared with us. I also want you just to remind us of 
the Johnson & Johnson numbers that you shared a little bit 
earlier. Could you please share that information and talk about 
that a little bit more?
    Dr. Collins. Yes, so when you think about hearing about an 
outcome, like a blood clot with J&J, there is the immediate 
idea of, oh no, it is very concerning. But if you really stop 
and think about the statistic here, we are talking about six 
cases out of 6.8 million doses of the vaccine that were 
received. And so, that is less than one in a million.
    Now, when we think about the number of Americans who 
actually had COVID, that is actually one in 10. And the number 
who die from that, one in every 558 Americans. So, you are more 
likely to be struck by lightning than to succumb to J&J. 
However, we need to pause now and get more information to 
ensure the safety of the public. But I do want to strongly 
encourage people that, the vaccine--getting a vaccine is your 
best option.
    Senator Lujan. Thank you so much for that clarification. 
Now, Dr. Rivera, as we have talked about the importance of 
providing clear and consistent health information, more often 
than not, it falls to friends, family, and community members. 
And I think nearly all of us this year have had a friend or 
family member share incorrect information, maybe they have come 
across online. Based on your research, what are effective 
approaches to correcting faulty vaccine information when it is 
shared by friends and family?
    Dr. Rivera. Thank you so much for that question, Senator. I 
want to start by reminding everyone that correcting 
misinformation is notoriously difficult. And we are still 
trying to identify what the best ways are, what the most 
effective ways are, which is why we need to continue this 
research and fund these kinds of evaluations and initiatives.
    But some recommendations that can help slow down these 
things. It really links back to my comments about leveraging 
the power of trusted sources. We know that sources influence 
trust in information. And in my work, sources were just as 
important, right--the person sharing information was just as 
important, if not more, than the actual content in cancer 
related information.
    So, we can leverage those things when we are having 
conversations with our friends and family. Of course, they are 
hard conversations, right? These are the people that are 
closest to us. And we know, as well, that misinformation tends 
to come with sensationalist headlines or things that really 
invoke an emotional response. Especially in the environment of 
uncertainty, like the one we are living in today, where there 
is so much information and people are trying to find where the 
accurate information is.
    So, I always recommend first to take a--take a second to 
pause and let those emotions get calm, and share correct 
information that is relatable, from a reputable source. If you 
are able to find that in the form of narratives, even better, 
because stories really stick. People like stories. They 
understand them. So, there is power in narratives and we have 
seen that with cervical cancer work among Mexican American 
communities in the U.S. where narratives have been able to--
culturally tailored narratives have helped raise numbers of pap 
smears and HPV vaccinations.
    So, there are resources out there on different platforms, 
like the World Health Organization, CDC, etc., local health 
departments. Share them, but also it stops with you. You have 
the ability to, when you get misinformation, when you get 
something that is sensationalist or causes this emotional 
response, stop and maybe do not share it.
    Senator Lujan. Thank you so much, Dr. Rivera. Senator 
Smith, Senator Thune asked a question along these lines, and I 
appreciate your response. I really want to emphasize it. And 
this is just a clear message to the Administration, to the team 
that has been assigned by President Biden to make these 
investments across America, in educating the American people 
about facts, and stopping the spread of misinformation, with 
the dollars that were included in the appropriation and the 
American Rescue Plan, to work with broadcasters, as well. And I 
certainly hope the buyers that, maybe, they are going to be 
working with are listening loud and clear to what I have to 
say.
    It is easier to buy with the larger conglomerates. And they 
touch a lot of people. They are able to find people where they 
are. What is harder is to find those family owned Ma and Pop TV 
and radio stations and newspapers across America. But that is 
where we know the vaccine is needed and information is needed 
most. What can you share with me, Senator Smith, about the 
importance of what it will take to be able to connect with 
those family owned, Ma and Pop----
    Mr. Smith. Yes.
    Senator Lujan.--radio stations and newspapers across 
America? Those broadcast television stations owned by people of 
color? And should there be a, you know, percentage of that buy 
that, maybe, goes to those folks? But what are your thoughts 
there?
    Mr. Smith. It is such an excellent question and--now, I am 
obviously not here to argue for one--some sort--group of my 
members versus another. But I am here to say, all of the above. 
Because again, if you want to get the water to the end of the 
row, it takes more time. It takes more effort. It takes more 
patience. But you have got to do it. And broadcasting is the 
medium that can reach them all. It can get everything to the 
end of the row. But it does take more effort on the part of 
government.
    And as I was listening to your excellent witnesses and the 
points they were making, and it is also important who is 
delivering the message. And to her point, I think is so 
excellent, we need Hispanic broadcasters, as well, to be 
speaking to Hispanic people. And I know that as I say that I 
remember from my chair on the Senate floor, you see the 
national motto, E Pluribus Unum, out of many one. What I am 
saying is, sort of, intention--intention with that. But it is, 
kind of like, being a dad. All your kids are a little bit 
different. And if you want to treat them fairly, sometimes you 
have to treat them differently and specially, in order to reach 
them and bring them to the same place.
    That is what we need to do. And it takes time, being a dad. 
It takes time being a farmer getting the water to the end of 
the row. And it takes time for government, using one of its 
greatest tools, which is its airwaves, and FCC licensees to get 
these messages out in a way that ultimately gets all the way to 
the end and produces the result, which is a vaccinated and 
healthy public.
    Senator Lujan. Appreciate that Senator Smith. I know I will 
be asking for a thorough oversight to make sure that some of 
these small Ma and Pop, family owned stations and papers across 
the country are being included in that. So, thank you for that.
    Next, I want to recognize Senator Tester for five minutes 
for questions.

                 STATEMENT OF HON. JON TESTER, 
                   U.S. SENATOR FROM MONTANA

    Senator Tester. Well, thank you, Chairman Lujan. That 
sounds pretty good, Chairman Lujan. We need to have more of 
these. I want to thank the witnesses for being here. A special 
thank you to my friend, Gordon Smith. And I would be remiss if 
I did not point out the fact that Gordon is retiring. I had 
hoped you would wait a few years before you did that, Gordon, 
but the broadcasters are going to miss you. And I just want you 
to know that if you get bored and you have got nothing to do, 
come on up and I will send you out with a pickup and you can 
pick rocks on the farm in Montana.
    Mr. Smith. I will look forward to that.
    Senator Tester. No, you will not. You know that. But the 
truth is that you have done a great job with the broadcasters. 
I did--and I just want to say what a pleasure you have been to 
work with in that role.
    Mr. Smith. Thank you, my friend.
    Senator Tester. You bet. And look, in Montana, as of the 
1st of this month, vaccine eligibility was extended to 
everybody over the age of 16. As the availability of the 
vaccine has increased, and it is probably the same in your 
States, the problem of vaccine hesitancy is turning into a 
problem, because we have got the vaccine now, and now, we have 
got people who are resisting to get it into their arms. It is 
particularly a problem in the more rural areas, particularly in 
the eastern part of our state.
    Earlier this week, I spoke with a bunch of Montana 
community health centers. They were talking about this 
hesitancy. They had said the largest city, Billings, about 25 
percent of their vaccine appointments were accounted for, 
three-quarters were not.
    Back in February, the Senate Veteran's Affairs Committee 
hearing, which I chair, I asked the head of VHA about how the 
VA is tracking refusal rates, because they are high, once again 
more--higher in the rural areas than anywhere else. And I 
remain concerned about how we are tracking it and how we are 
understanding the half-apprehensions. And I would--I would just 
say--if you have covered this already, I apologize. I have got 
three committees going on at the same time.
    But the question I have, and this is for you, Dr. Collins, 
New Mexico--I heard the Chairman talk about how you guys are 
doing a great job, and congratulations on that. But are you 
able to track the vaccine refusal rates across your state?
    Dr. Collins. Thank you, Senator Tester, I appreciate that 
question. We are definitely using our dashboards to track, sort 
of, reactions and how many people are getting registered. And 
we are working closely with community leaders to understand 
what is behind anyone who is refusing, or not interested in the 
vaccine. So, we have set up what is called an Equity Task Force 
to address this very issue that you are raising.
    Senator Tester. And then, so--so, that Equity Task Force, 
is that--is that--are they recommending adjustments when the--
or when the population that is refusing the vaccine is found? 
Or--what are you doing? What kind of adjustments are you making 
to try to make end roads there to the folks that say, you know, 
I don't want to do--I don't want to do this?
    Dr. Collins. Yes, the idea is that we want to understand 
why. So, we have had surveys that have been distributed to 
certain communities, like Latino, and we have also are working 
with interfaith agencies. So, if we understand what is behind--
is it because you want to see someone who looks like you, 
believes like you, evangelicals, who gets the vaccines, then we 
need to find that role model to communicate with those various 
sectors. And so, it is really about gathering various data and 
acting on it. And so, we are using Trusted Voices.
    Senator Tester. I just want to build on that, for a second, 
with you, Gordon. And that is the broadcasters do play a 
critically important role in getting the message out and you do 
hit a lot of households. And--and have you guys sat down and 
determined--and if you have covered this, I apologize--but 
determined what are the important factors in a message that you 
are sending to vaccine hesitant households?
    Mr. Smith. Well, first of all, Senator, we are anxious to 
report the facts as we get them. That is our job. And in the 
end, I think the more clarity that the government can speak 
with, the more hopeful it can be, in terms of its own messaging 
that if you get the vaccine, not only are you virtually 
eliminating your chances to die of this, but others around you 
that you love. And life can return to normal. That kind of 
messaging has strong incentive to it. If the government mixes 
its message and says, well, but things may never change, then 
now, you are discouraging people. I am saying that, not as a 
broadcaster, but just as a citizen who is watching the news.
    And, you know, the way you combat bad information is with 
more information. And we are anxious to report the facts that 
are accurate and get them out, to the end of the row, so that 
people in rural communities can get the information, too. And 
minority communities, that otherwise may not get to the truth 
and get to the vaccine.
    Senator Tester. Right on. Hey, Gordon, I appreciate that 
point. I mean, the truth is is that, if people do not see--and 
by the way, I have got the vaccine and I am sure you have, too.
    Mr. Smith. I did, too.
    Senator Tester. Probably everybody on this call has got it. 
It would take a tremendous load off your shoulders, but if you 
are still required to live the same lifestyle after you take 
the vaccine, as you did before, that is a real negative for 
people, getting it in people's arms.
    Mr. Smith. It is just it cross-purposes, Senator. And that 
is the important point I think you are making. Our message is 
not just to be about the facts of the effectiveness of this but 
encouraging hopefulness and to return to normalcy. I think the 
country is so hungry for that. And broadcasters can certainly 
help do that. But our job is to report the truth, the facts as 
we are able to dig them out and distinguish them from the 
falsehoods you find on the internet.
    Senator Tester. Yep. Amen, brother. Thank you, Mr. 
Chairman.
    Senator Lujan. Thank you, Chairman Tester. Appreciate that. 
Next, we are going to hear from Senator Peters. Mr. Chairman, 
you are recognized for five minutes.

                STATEMENT OF HON. GARY PETERS, 
                   U.S. SENATOR FROM MICHIGAN

    Senator Peters. Well, thank you, Mr. Chairman. Thank you 
for this hearing and to the witnesses here today, it is great 
to hear your testimony.
    You know, as our Nation clearly continues to see a rise in 
variants of the coronavirus, we know these variants are more 
infectious than the original one. Michigan, right now, is 
seeing a pretty dramatic surge in infections and certainly 
variants are playing a role in that. And certainly, at least 
the evidence that I have seen shows that the vaccines that are 
out right now appear to be very highly effective against these 
variants.
    And so, my question to you, Dr. Collins is, you know, how 
should we discuss the potential impact of these variants on 
vaccine effectiveness with our constituents, particularly at a 
time when we are dealing with vaccine hesitancy, to let people 
know that getting this vaccine now is going to deal with the 
vaccines? But what is the best way to approach that--that 
issue?
    Dr. Collins. And I appreciate your question, Senator. 
Really it is working with broadcast to get the message out 
that, just as you just stated, the vaccines, Pfizer and 
Moderna, are efficacious against that B.1.1 variant that you 
are seeing in Michigan.
    So, the idea is that we initially really wanted everyone to 
get the vaccine. We are seeing these variants. We are seeing an 
uptick in cases. It is still important to get the vaccine 
because it can stop the replication of COVID and, therefore, 
stop the mutation, and reduce the chances for more mutations.
    So, it is really making sure we work with the communities 
to get that messaging out there, and we do it often and 
consistently.
    Senator Peters. Right, absolutely. You know, as Chairman of 
the Senate Homeland Security Committee, I have been working 
with FEMA to deal with all of the various aspects of this 
emergency. And in light of their role as on the frontline of 
combatting this pandemic, FEMA has established a rumor control 
website, which is there to help the public distinguish between 
the rumors and facts regarding the coronavirus response. The 
website addresses common questions like vaccines, medical 
supplies, personal protective equipment, financial assistance, 
all the things--really key facts that people need to have.
    My question to you, Dr. Collins, is how has your state been 
able to leverage FEMA resources to combat mis- and 
disinformation on the ground?
    Dr. Collins. FEMA has been instrumental in helping us set 
up our instant command structure, in which we have our Joint 
Information Center. So, they have guided us as to how best to 
set up our communications structure, such that our messaging in 
New Mexico is really strong. And again, that we are reaching 
throughout the entire state rural, urban areas, and to really 
help people understand the value of the vaccine.
    Senator Peters. Well, that is great to hear. And, Dr. 
Rivera, Mr. Smith, a question for you. What are the ways that 
an agency, like FEMA, can take the useful information, that 
they have published online on that rumor control site that I 
mentioned, and ensure that it is reaching the maximum amount of 
people in our communities. Not everybody is necessarily going 
to that site. How can we leverage it? Do you have any 
suggestions?
    Dr. Rivera. Yes, I can give some quick suggestions and let 
the other witness attest to broadcast. We--first of all, it 
needs to be available in as many languages as possible. There 
are huge disparities and a lot of issues related to hesitancy, 
that has to do with lack of information, like, access to 
information in multiple languages, in addition to access to the 
actual vaccine, because of many structural issues, 
transportation, childcare, etc.
    So, we need to make sure that this is available to these 
communities multilingual and identify the places where these 
individuals go for their information, whether it be broadcast, 
also have a social media platform for it. I know that the 
Latino community uses Facebook, in particular, and WhatsApp a 
lot, to share information amongst each other. So, if there can 
be ways to leverage those types of platforms, as well. But at 
the end of the day, it gets to really understanding your 
audience and where they are. And leveraging--and pointing them 
into the direction, not on one platform, but in multiple 
avenues.
    Senator Peters. That's great advice. Mr. Smith?
    Mr. Smith. Yes, Senator. Let me first note, if you did not 
hear it. I was bragging about you earlier, thanking you for 
your picking up what was an old bill of mine to reintroduce or 
reestablish the Minority Tax Certificate Program. But look, 
the--the way----
    Senator Peters. Well, thank you for doing that. Let me 
thank you for doing that. I appreciate it.
    Mr. Smith. That is a great cause, and we fully support your 
efforts in that. I think she--your witness before me has 
answered it perfectly. You have got to beat that information 
with more information. You have to be persistent in using all 
the broadcasters to make sure they cover all the American 
people because that is our ability uniquely to do. And you just 
have to keep combatting falsehoods with hope and with facts.
    Senator Peters. Well, I appreciate that and keep doing 
that, each and every day. Thank you, Mr. Chairman.
    Senator Lujan. Thank you, Senator Peters. I now recognize 
the Chair of the Full Committee, Senator Cantwell, for five 
minutes for questions.

               STATEMENT OF HON. MARIA CANTWELL, 
                  U.S. SENATOR FROM WASHINGTON

    The Chair. Well, thank you, Senator Lujan. Thank you so 
much for holding this important hearing and for the witnesses 
being here today. Senator Smith, good to see you. Sorry to hear 
about your retirement. Well, actually, not sorry for you 
because, you know, I know you are returning to the beautiful 
Northwest. And so, hard to--hard to beat where you and I come 
from.
    I did want to--I know we--I have heard a little bit of the 
dialogue this morning. But obviously, the Paycheck Protection 
Program extending to newspapers and to TVs, I believe is really 
critical in continuing to tell the story. I mean, that is what 
the premise was, to make sure that radio and TV broadcasters, 
and others who have unique reach into particular communities, 
whether that is African-American radio stations or, in the 
Northwest, it could have been the Asian broadcasters, or what 
have you. So, how important is it for us to continue to make 
investments to keep these diverse sources? I do not think 
people really understand how close we are to losing more and 
more.
    Mr. Smith. You know, I did say earlier, to other questions, 
Senator. But I think before I reiterate some of those things, I 
just want to express to you, personally, how much we appreciate 
your extra mile efforts with the CARES Act to make sure more 
and more broadcasters, who provide--uniquely provide localism 
and journalism to your constituents and our communities. You 
have been a superstar in our eyes, and we thank you for it.
    The Chair. Thank you.
    Mr. Smith. But as I said earlier, you know, ever since the 
beginning of democratic institutions, a free press and serious 
journalism have been really important to preserving the trust 
in democracy, and we are losing that. We are losing it because 
the revenue streams, which are advertising that move goods and 
services and promote jobs and enterprise, that is drying up for 
broadcasting and for newspapers. And we are suffering the 
consequence of it in our democracy.
    Now, you cannot put the genie back in the bottle, in terms 
of social media. We all--I love my--my iPads and all, and 
iPhones and we--it is a part of it. But freedom of speech, yes, 
it is free, but when it comes to journalism, it comes at a 
price. And there is a--it needs to be a way to pay for it, good 
investigative journalism.
    And so, we want to work with you for ways to accomplish 
that. With Senator Klobuchar, earlier, who mentioned her 
approach on that. We are interested in all of the above, 
because, I think, if we are to preserve our republic, we have 
to preserve the fourth estate which is freedom of the press. It 
is in the First Amendment because it is first in importance. 
That is the keystone of our democracy and we want to support 
those things--those policies, in the future, which will leave 
other platforms in business. That is fine. But not sacrifice 
the ones that have helped us to have a trustworthy democracy.
    The Chair. Well, the focus of this is COVID. So, do you 
consider news critical infrastructure, as it relates to 
delivering key public health information?
    Mr. Smith. Completely. I mean, there is no platform quite 
like broadcasting to reach nearly--you know, well above 90 
percent of the American people and it is free, and it is local, 
and it is live, and includes all ethnicities, all of the 
diversity of America. And--and we have anchors of all the 
diversity of America and management. We need to do even more, 
in terms of ownership diversity. But there are great ways to 
accomplish that and there are other ways, as well.
    But I just think we have a really important interest in 
getting the truth out there, and we have the desire to do it. I 
know, in every newsroom and every broadcast station I have ever 
visited, they want the facts, and they want to report it in the 
way that is trustworthy.
    The Chair. Well, I think that is the key thing that struck 
me is that, when you have a pandemic like this, people want the 
local news.
    Mr. Smith. They do.
    The Chair. They do not really--I mean, they are not as 
interested in what's happening somewhere else, as like, what is 
happening in our community. And they want it to come from a 
trusted source. They want it to be from somebody that, they 
believe, is in the community, is going to be straight with 
them.
    I thought, to me, when we were falling behind in Yakima, 
because we were not doing enough--you know, so many in the 
community--General Mattis, who lived down the road, basically 
did his own thing to try to communicate to the community. Lot 
of people--I kept thinking, well, if we did not have the Yakima 
Herald, where would we be if we were not able to use that as a 
vehicle, at a time when the pandemic was roaring in that 
community? Where would we be if we did not have those vehicles 
of broadcasters and newspapers to communicate to them?
    So, I plan to, Mr. Chairman, push this issue as it relates 
to this critical infrastructure investment we are making. I 
think news--local news, particularly, a trusted source is 
frayed beyond belief. And if we do not shore it up, at least 
until the legal battles play out with the tech industry, then 
we will be making a big mistake. So, I continue to appreciate 
this hearing, because I think it was a good diagnosis of how 
important local journalism was. And I think the critical 
infrastructure needs to be preserved.
    Mr. Smith. Thank you, Senator.
    The Chair. Thank you.
    Senator Lujan. Thank you, Chair Cantwell. Next I will 
recognize Senator Raphael Warnock for five minutes for 
questions. Senator?

              STATEMENT OF HON. RAPHAEL WARNOCK, 
                   U.S. SENATOR FROM GEORGIA

    Senator Warnock. Thank you very--thank you very much. As I 
talk to Georgians, especially from those in communities of 
color, they are excited to get the vaccine, especially after 
they have seen that their friends and neighbors are safe after 
receiving the vaccine. And they are saying they want these 
shots in their arms. The problem I hear over and over again is 
not of vaccine hesitancy, but of vaccine access.
    Could I have one of the panelists speak to the barriers--
what barriers do people of color face in getting vaccinated, 
and what steps should Congress take to ensure these communities 
can access vaccines equitably?
    Dr. Collins. Senator I would be happy be to.
    Senator Warnock. Thank you.
    Dr. Collins. Yes, thank you for the question. I think the 
barriers that are faced really relate to the vaccine providers 
and neighborhoods of communities of color. So, we have to look 
and see, do we have the Walgreen's or the CVS, federally 
qualified healthcare centers? Do we have doses at the actual 
offices--doctors' offices, for those communities?
    So, it is really a matter of making sure, geographically, 
that as a state gets doses of vaccine, that they distribute 
those doses, and they reach areas of communities of color. And 
one of the things that we are doing here in New Mexico is, we 
are looking at our social vulnerability index. And where we 
have a high social vulnerability, we are ensuring that we are 
pushing doses to those areas, to reach those communities. Thank 
you.
    Dr. Rivera. Hi, Senator, I would like to add to what was 
just stated by Dr. Collins. So, another thing is that it is 
really important that we have clear communication about where 
to get the vaccine, and specific rollout plans by state, by 
local areas. So, audiences know exactly where things stand in 
their--in their community. In addition to that, continuing to 
address issues like, access to transportation, childcare--
really understanding what those structural barriers are 
locally, and addressing those while also promoting a message 
about the vaccine efficacy and safety.
    Mr. Smith. And I would simply add, Senator, and I am sure 
in your campaign you were in many broadcast stations, radio and 
television, as I have been, and have been since. And in every--
before every broadcast, there is a huddle of editors, of 
anchors, of reporters digging for the information that you are 
asking for, to get it to your constituents. They are hungry to 
have that information. They are anxious to report it. So, I do 
not think it is a lack of will, it is just we need the 
information from government. We will get it to the people.
    Senator Warnock. So, what role do you think Trusted 
Partners play in this? I mean, there is the issue of access. 
You know, I come from, the faith community and I know that 
churches, for example, have stepped up. My own church is--is a 
site for vaccinations. Do you see this as a critical part of 
our approach?
    Mr. Smith. Senator, I have--in a pro bono sense, I served 
in one of the Senior Councils of the Church of Jesus Christ of 
Latter-Day Saints. So, I am very appreciative of the fact that 
the faith communities have a role to play here and can have 
great influence encouraging people to get vaccinated. And so, I 
know my own denomination is doing that. I believe yours is, as 
well, and I think that is very commendable. And ministers can 
help swat away these falsehoods that may be circulating on the 
internet, because they are also very trusted public figures, 
among our constituents.
    Dr. Rivera. Absolutely. I would like to echo that, and I 
would also like to say that having people on the ground that 
already have trust within communities is instrumental, because 
a lot of individuals are going to go to those people to access 
information. I have seen that in my work within the Latino 
community. I know that there are a lot of Latinos in Georgia. I 
used to work in Florida, directly with Latinos in Tampa. And 
community leaders were instrumental in getting the message out 
about cancer screenings, about cancer services, about 
education.
    So, in this moment, where there is so much mistrust, 
leveraging and establishing those contacts with faith-based 
organizations, grassroots organizations, that are already 
trusted, is going to be instrumental in vaccine rollout.
    Dr. Collins. I just want to say that I agree with the 
panelists and I do not want to restate what they have already 
stated. But I do know it is critical to work with our faith-
based partners, our leaders, and we have a Trusted Voices 
campaign, in New Mexico, in which we are engaging those who 
have been vaccinated who represent communities of color, to be 
examples of the value of this vaccine.
    Senator Warnock. Right. Thank you all so much for your work 
and for your insights.
    Senator Lujan. Thank you, Senator Warnock. Next, I will 
recognize Senator Rosen for five minutes of questions.

                STATEMENT OF HON. JACKY ROSEN, 
                    U.S. SENATOR FROM NEVADA

    Senator Rosen. Well, thank you, Chair Lujan. 
Congratulations on your first hearing as Chair. Good to see you 
there, and of course, Ranking Member Thune for holding this 
important hearing today. And I want to welcome Senator Smith 
back to the Committee that, of course, he was once on and so, 
welcome back.
    Mr. Smith. Thank you. Thank you.
    Senator Rosen. I want to build on what Senator Warnock was 
talking about about trusted messengers. You know, it is 
critical, but we have to make the vaccination process as 
seamless, as transparent as possible, and that we meet people 
where they are.
    You have been talking about faith-based communities, 
community partners. And that is why I am so pleased that a 
number of Nevada's key hospitality and gaming partners--our 
work force, our employers, they are including, and they are 
hosting in-house COVID-19 vaccination clinics, many including 
in our hotels on our Las Vegas strip. And so, it is especially 
important for our state, where our hospitality workforce is 
primarily Latino, and we know Latino communities, in both 
Nevada and across the country, have been so disproportionately 
affected by COVID-19.
    So, Dr. Collins, can you talk about--can you talk about, in 
addition to our faith-based community, in addition to our 
community allies and partners, what about our workforce 
partners? Employers, co-workers, what part do they play in 
helping to communicate reliable vaccine information to their 
employees and, of course, our communities as a whole? And how 
these in-house clinics, at large employers--like I said, our 
hotels on the Las Vegas strip--how it can alleviate the 
employees needs to make that time sacrifice, either to take off 
work or find the time to go to a remote clinic somewhere?
    Dr. Collins. Thank you, Senator Rosen. It is a great 
question. And it is imperative that we partner with employers, 
so that--and either work with them to ensure that employees 
have time off to go and get the vaccine, or that the employer--
that we set up a site near the employer, where the employee can 
get vaccinated.
    So, it is really key, because we have to keep in mind, the 
people who, like you mentioned, who have been greatly impacted 
by this--this virus, is really a population that is working. 
And we cannot expect them to take time off from work and lose 
wages to get the vaccine.
    So, we need to make sure that we are working with these 
employers, and we are doing so efficiently. And that the 
employer has good messaging to give to their employees about 
the value of the vaccine and how they can get access to it, and 
that it is free.
    Senator Rosen. Thank you. I would like to continue to build 
on access, because in Nevada, we are, like New Mexico, lots of 
remote, rural areas, hard to get to. And so, rural access, 
mobile units are really, really important. Over--about 10 
percent of Nevadans live in rural and frontier counties. They 
are spread out across 87 percent of our state's geographic 
area. They are hard to reach populations. They often lack 
broadband. They often lack reliable cell phone service, other 
kinds of communication methods that are readily available in 
our urban areas. Nevada's nine counties, the third largest 
county by size, but only has 45,000 residents. And so, the 
Emergency Management Department, they have relied heavily upon 
word of mouth and to communicate information about the mobile 
vaccination sites.
    So, Dr. Collins, I know in New Mexico you have some of the 
same rural issues that we do. How is word of mouth been 
leveraged in--to disseminate information, critical information 
about these mobile units, so we are sure that everybody gets 
their vaccine? Anyone who wants one, gets one.
    Dr. Collins. Yes, and it is really word of mouth that has 
come through our community health brokers, our promotores, have 
gotten out into these rural areas to tell people about where 
they can the vaccine, how efficacious it is. We also have 
partnered with pharmacies to get out to residents who cannot 
leave their home, to provide home vaccinations.
    So, the word of mouth is key. The access is key. And it is 
really about making sure we are reaching those folks who may 
not have access to the internet.
    Also, I want to thank our Governor because she is, you 
know, working to--she just signed a bill to really expand 
broadband access and Internet connectivity. So, we are really 
moving in the right direction in New Mexico.
    Senator Rosen. Do you have any other suggestions? Other 
things besides expanding broadband access, of course, is going 
to take some time. But how Congress--how we can maybe help 
reach some of those remote areas, and do a better job, 
particularly as we navigate through COVID and maybe there will 
be boosters that are necessary, or what have you, going 
forward.
    Dr. Collins. I think that you have been very supportive of 
the American Rescue Plan. That is really helpful. It is a great 
start. But the idea is that, how can we get more of these 
mobile units out to these rural areas? We set them up so they 
can distribute vaccine. And how can we leverage existing 
infrastructure, to actually increase messaging to the very 
remote areas and the underserved?
    Senator Rosen. Yes. Thank you. I appreciate it. I look 
forward to working on all of this and I yield back, Mr. Chair.
    Senator Lujan. Thank you, Senator Rosen. Next, I will 
recognize Senator Blumenthal for five minutes for questions.

             STATEMENT OF HON. RICHARD BLUMENTHAL, 
                 U.S. SENATOR FROM CONNECTICUT

    Senator Blumenthal. Thank you, Mr. Chairman. Very good to 
be calling you, Mr. Chairman, I think for the first time, not 
for the last. And thank you for holding this hearing, which is 
so important to our state. And welcome, I would like to say, a 
former colleague, but I feel you are still here in spirit. 
Thank you----
    Mr. Smith. Thank you, Senator.
    Senator Blumenthal. For being here this--this morning.
    Mr. Smith. It is great to be here.
    Senator Blumenthal. I want to just say, right at the 
outset, how much I appreciate the role of broadcasters in my 
state, Connecticut. I, very simply, do not have enough time or 
words adequate to thank them for the public service they have 
provided in their reporting, in showing us the hardship and 
heartbreak, but also, the hope that we have in acts of kindness 
and caring and generosity, on the part of the Connecticut 
people.
    Our TV and radio stations have been airing programs in 
Spanish, as well as English, that show us a side of this 
pandemic that otherwise would have been completely lacking. And 
they have performed an enormous public service in informing the 
public about the precautions that are necessary. The 
commonsense steps that will save lives. They have spoken truths 
to the people of Connecticut. They have spoken truth to power 
and, we all know that that is particularly important in 
encouraging people to listen to scientists, to get vaccinated, 
to follow not only their cautious and caring instinct, but also 
to follow the facts.
    Most broadcasters and newspapers have done reporting during 
this pandemic that has addressed the misinformation, and they 
have helped to change lives. So, I really am very, very 
grateful to the broadcasters, to the media, to our newspapers 
that you represent, Senator Smith. And I know I have spoken 
about the efforts to promote valid information.
    What I would like to ask you is, how will local media ramp 
up in the future, their efforts to promote trust in vaccines, 
especially at this moment, when the inclination may be, after 
the Johnson & Johnson pause to avoid it? States are opening up 
appointments to all adults, and I wonder if you could reflect 
on what more I can do, as a public official, and others can do 
in our state of Connecticut, to support these local media 
efforts?
    Mr. Smith. A little, round the corner kind of answer, 
Senator. I appreciate you recognizing Chairman Lujan. He sits 
in the seat of my cousin, Tom Udall.
    And one of the things I love about being a broadcaster, I 
learned at the knee of my Udall mother. Now when you are weaned 
from a Udall mother, you have an ethic of public service. And 
what I find among broadcasting, and why I am so proud to 
represent them, is there is this heart of a public servant, 
still in this, the fourth estate of our democracy. And we are 
hungry for the facts. And even when they are not what we hoped 
for, like the J&J announcement, we want to disseminate what is 
true and what people can count on.
    And as a consequence, we have put out hundreds of millions 
of dollars of advertising, and we are thankful for the efforts 
of the government to assist in its own advertising. It helps 
keep us alive and journalism and localism alive. And we are 
certainly involved with the Biden Administration in the COVID 
collaborative, which has just been organized. And we are a part 
of the delivery system of that.
    But I think, to your point earlier, you get people one at a 
time. And so, everything is--Tip O'Neill said, ``All politics 
is local''. It is really true with this. It is one person at a 
time, giving them what is truthful and factual, and that they 
can rely on, with--and also, induce some sense with true facts. 
There is hope at the end of this tunnel. There is light.
    And there are lots of advantages, far outweighing risks, to 
getting the vaccine, for themselves, for their loved ones, for 
their neighbors. It is part of how you keep the second great 
Commandment to love your neighbor, is to do what you can to be 
healthy yourself, and helping others to stay healthy, because 
they have a relationship with you.
    And so, every newsroom, that I represent, is anxious for 
the facts, and to deliver them locally. Because that is where, 
survey after survey shows, it is trusted.
    Senator Blumenthal. Thank you. One last question. I know 
there has been misinformation on social media--
    Mr. Smith. Yes.
    Senator Blumenthal.--which broadcasters have helped to 
counter. Have you efforts, in terms of the Spanish speaking 
viewers that broadcasters have, to counter that kind of 
misinformation that may be on social media?
    Mr. Smith. Yes, and as has been pointed out by some of the 
other witnesses, there really does need to be, from 
broadcasters--you know, Hispanic radio is very alive and 
healthy in this country. And Hispanic television, and Hispanic 
anchors, to make sure that we cover all the ethnicities, all 
the diversity that is the pluribus, out of the one, Nation that 
we have.
    And so, we are anxious to fill in these gaps to help treat 
everyone in a way they need to be treated, in order to be 
treated equally. And so, it takes a real effort. And on the 
part of government, it takes persistence to use, not just a few 
of broadcasting's tools, but all of its stations, to make sure, 
with a little more effort or a little more labor or a little 
more patience, a little more time, we get the water to the end 
of the row, and everybody included.
    Senator Blumenthal. Thank you. Thank you, Senator Smith. 
Thank you to all of our witnesses. And thank you, Mr. Chairman.
    Senator Lujan. Thank you, Senator Blumenthal. Honored to 
have you here today. Next, I will recognize Senator Sinema for 
five minutes for questions.

               STATEMENT OF HON. KYRSTEN SINEMA, 
                   U.S. SENATOR FROM ARIZONA

    Senator Sinema. Well, thank you, Mr. Chairman. And I want 
to thank our witnesses for joining us today.
    My top priority for the last year has been working with 
local, state, and Federal partners to keep Arizonans healthy 
and safe from the pandemic. Today's hearing addresses a crucial 
issue: making sure that Arizonans have accurate, effective, and 
evidence-based information about the vaccines and opportunities 
to get vaccinated. I look forward to working with my colleagues 
on this committee to develop bipartisan solutions, to address 
this ongoing challenge, as we continue to help Arizonans get 
vaccinated.
    My first question is for Dr. Rivera. Your testimony 
encourages partnering with local organizations and trusted 
community leaders on public health messaging campaigns. In my 
state, we have seen successful collaborations between the 
University of Arizona, the Arizona Telemedicine Program, and 
community health providers in leading free webinars. These are 
open, virtual events where people can ask questions and receive 
answers from public health experts from their own communities. 
And these webinars focus on two medically underserved 
populations, working with leaders in Latino and Tribal 
communities.
    We have also seen effective messaging from everyday 
Arizonans, who shared their stories and reasons for getting 
vaccinated. These stories are often deeply personal, and they 
speak to shared experiences or fears. Can you speak more about 
the kinds of training that community messengers, professional 
and non-professional, may need to successfully deliver 
effective, evidence-based vaccine messages?
    Dr. Rivera. Thank you so much for that question, Senator 
Sinema. In my experiences as a previous community health 
educator, it is crucial that those of us that are promotores, 
that are developing train the trainer programs to further 
educate other lay workers about how to reach communities, that 
that needs to continue to happen, to get funded, and to be 
built within sustainable infrastructure. So that once the 
program is done, or funding is done, those infrastructures are 
still in place. So, that is incredibly important.
    I also think that it is important to look at how we can 
train these lay workers, or other community leaders that are 
delivering information, on digital health literacy, on how to 
share narratives, how to share other types of corrective 
messages within the community where they are. Whether that be 
in person, whether that be through different social media 
platforms, those are things we are looking to do in research 
now.
    This is an issue that we are still trying to understand. We 
still need to continue to find what the most effective ways are 
and evaluate them for future--right, for future health and 
health communication initiatives. But those are the things that 
we need to do. We need to make sure that we are building 
infrastructures, where we are training these individuals on the 
things that they are going to be delivering in the community.
    But I want to commend you for all of the things that you 
have been doing within your state, because those are exactly 
the things that we need to be doing to reach the people that 
need it the most.
    Senator Sinema. Well, thank you. My next question is for 
both Dr. Collins and Dr. Rivera. There have been concerns from 
public health leaders and community organizations in Arizona, 
when vaccine information and registration websites were 
launched in Arizona, without making the same information 
available in other languages, or in accessible formats. What is 
the impact and message we are sending to vulnerable 
communities, people for whom English is not their first 
language, or people with disabilities, when essential public 
health information is not readily accessible for underserved 
communities until many weeks later?
    Dr. Collins. And so, thank you for that question. What I 
will say is that, for our online portal, we provided that in 
English and Spanish. And also, we setup a call center for folks 
who do not have access to the Internet and that is available in 
multiple languages. We have also partnered with our aging and 
long-term services to make phone calls to seniors who may not 
have access to the Internet or may not feel comfortable 
accessing it.
    So, it is huge that we do not send the message that you do 
not matter. That, in fact, you do very much matter and that is 
why we are not going to rely on one mode of communication.
    Dr. Rivera. I will echo what Dr. Collins just said. It is 
really important that we have, not only information that is in 
multiple languages, but that it is at a literacy level that the 
audiences can understand. That it is on devices and in formats 
that are easy to navigate, right? Where they know exactly where 
to click to find the information that they need at the moment.
    And it just gets back to the importance of clear, 
transparent, accurate, culturally tailored content that is 
going to allow people to make informed decisions and know where 
to get access to, in this case, vaccinations. But in the future 
of public health--any kind of public health access.
    Mr. Smith. I might add to their excellent answers, Senator 
Sinema, that Univision, one of my excellent members, has 
provided Spanish language materials, where before there were 
none. They are staffing a hotline, helping people to sign up 
for shots, and they are putting native Spanish speakers on TV 
and radio to share accurate information in the Spanish 
language.
    Senator Sinema. Well, Mr. Chairman, I see my time has 
expired and I yield back. Thank you.
    Senator Lujan. Senator Sinema, thank you so very much. And 
we are just waiting on one other Senator to come to the hearing 
room to ask some questions. And while we are waiting for that 
arrival, Dr. Collins, in New Mexico, our retailers and 
businesses getting information to employees and providing time 
to get vaccine has been a critical part of getting vaccinated. 
The Retail Industry Leaders Association and its members have 
been important partners in this effort. Secretary Collins, can 
you expand upon working with businesses, big and small, in New 
Mexico and why that is important across America?
    Dr. Collins. Yes and thank you for the question. It is very 
important that we work closely with the businesses. That they 
understand, they have facts about the vaccine. They understand 
the importance of messaging to their employees, and that they 
are really supporting their employees to get vaccinated.
    So, working with my fellow secretary, Mr. Kenney, we are 
really trying to create a very seamless approach for DOH to get 
vaccines to these employers, or to at least set up mobile 
units, so that their employees can go out quickly, get 
vaccinated, and then, just return to work without suffering a 
loss of wages.
    Senator Lujan. Thank you, Dr. Collins. Dr. Rivera, Senator 
Klobuchar shared a concern with, especially, 12 people who seem 
to be the influencers of spreading a lot of that misinformation 
on social media. We also know that it is not contained to 
social media. That there is also spreading of misinformation 
even on cable networks.
    What has your research shown about the importance of 
stopping the spread of misinformation? We have talked a lot 
about the importance of getting facts out. I mean, that is the 
goal. But there is also a responsibility to stop the spread of 
misinformation. What does your research show there, Dr. Rivera?
    Dr. Rivera. Yes, absolutely. Thank you for that question. 
There was--there was an example from my research that I want to 
share because it really hones in this point that this is not 
just about COVID. It is not just about the pandemic.
    I was interviewing a Latina in Florida and we were talking 
about a post that she had engaged with. It was a video from a 
Hispanic individual who was claiming that mammograms cause 
cancer. And in response to the fear that that video created to 
her, she called her doctor, and she canceled her mammogram. She 
had it scheduled for a few weeks after and she called and she 
canceled, just in case.
    So, these--these platforms and the misinformation that is 
there, has negative repercussions. And it is really important 
that we are, particularly with health misinformation and 
disinformation, but we are establishing ways where we have 
multiple people, interdisciplinary work at the table. 
Multilingual work at the table. To be able to address what it 
is, and what qualifies as something that really needs to be 
monitored, regulated, and taken down? Those are very complex 
issues.
    As I mentioned before, we are still looking to see what the 
most effective ways are. But we need to have all of these 
people at the table to have these very difficult conversations, 
and have a neutral, non-partisan way of identifying 
recommendations and guidelines that can be applied across the 
board.
    Senator Lujan. Dr. Rivera, I very much appreciate your 
response to that. The profoundness of the example that you use, 
which is a Latina that canceled her mammogram appointment, is 
that this responsibility extends much further than with the 
world we are living in now, and the attention around COVID and 
vaccinations. This is about healthcare. And in every other 
aspect, where there can be spreading of misinformation that can 
make someone less healthy, cost someone their life, and even 
prevent someone from getting a regular screening or a checkup 
that is part of our daily health. And it only puts an 
exclamation point on the work that we have left to do in this 
particular area. Very much appreciate that, Dr. Rivera.
    Senator Smith, in the work that you have done, not just in 
your role as a public servant, but now with the Association of 
Broadcasters, getting those diverse voices--I know, as I said 
earlier, it has been a priority of yours. There was a meeting 
that we recently had with the Congressional Hispanic Caucus 
about increasing diversity, whether it is on boards or, as you 
said, with anchors or even managing stations across the 
country. What are your thoughts there with those growing 
efforts? And how that also helps to make sure that the American 
people are seeing themselves, and hearing themselves, if you 
will, on radio, and on television, and in print?
    Mr. Smith. I do not know that we have any other higher 
priority at NAB than to try to increase diversity. I do not 
know whether you are fully apprised of some of the efforts we 
have with our--our Education Foundation, or leadership training 
programs, which specifically, use expert resources and bring in 
women and minorities and--to a course that is very esteemed by 
my members. And they hire out of that. And to the degree that 
we have ownership of diversity in broadcasting and management 
and anchors. It is coming out of that program.
    But there is so much more that we can do and want to do. 
And again, it is not a want of will. It is a want of access to 
capital that some of these who would be broadcasters, simply do 
not have. And that is why the Minority Tax Certificate Program 
really should be put back in place. And that is the help that 
we need because you will find a lot of helping hands reaching 
out from broadcasters to people of color, of diversities, 
ethnicities of all kinds.
    We want to represent what America is, what America look 
like. And out of many, one.
    Senator Lujan. I appreciate that, Senator Smith. It is a 
program that I have gotten a chance to learn more about and 
appreciate the talented voices and the diverse voices that have 
been part of that effort across the country, including some 
fellow New Mexicans.
    Mr. Smith. Yes.
    Senator Lujan. And appreciate what I have learned from them 
about the effectiveness of that particular program. So, thank 
you for that and hope that that is something that we can grow 
across America.
    Mr. Smith. Absolutely.
    Senator Lujan. With that being said, I now want to 
recognize Senator Cruz for five minutes for questions.

                  STATEMENT OF HON. TED CRUZ, 
                    U.S. SENATOR FROM TEXAS

    Senator Cruz. Thank you, Mr. Chairman. Welcome, good to see 
you again.
    Mr. Smith. Thank you, Senator Cruz.
    Senator Cruz. More than 120 million Americans have received 
at least on dose of a COVID vaccine. The fact that so many 
Americans have been vaccinated against a highly transmissible 
virus, less than 15 months since the pandemic began, is nothing 
short of a medical marvel.
    Mr. Smith. Yes.
    Senator Cruz. Operation Warp Speed, founded on May 15, 
2020, was an incredible success and I am grateful to the 
scientists and the public health experts involved in the task 
force, who contributed to the development and the distribution 
planning of vaccines. One of the biggest hurdles to overcome is 
inspiring confidence in individuals in certain communities to 
get the vaccine. How effective do you believe public officials 
are at inspiring confidence in individuals to get the vaccine?
    Mr. Smith. Senator, I am not here to criticize anybody, but 
I will tell you--and I--in this answer, I want to speak as just 
an American citizen, not necessarily for broadcasters. But I 
know Sharon and I were very anxious, because we are approaching 
69 years of age, to get vaccinated. So, we worked really hard 
at it, trying to get online, and it was not easy here in DC, 
but we did. And the motivator was, we could return to normal. 
We could be hopeful.
    That hope was a big--I think, the great passion America has 
right now that, to the degree that public officials can be 
consistent in their messaging, that this gets you and your 
loved ones out of danger of death, at a minimum, and a real 
chance at return to normalcy, I just think that that sells. And 
so, to the degree that hesitancy is developing outside of false 
information on social media, if it is developing because you 
take away the incentive to go get a shot, then I think--I think 
we make a mistake, as government, by sending mixed messages.
    Senator Cruz. Well, I--I agree with you. And I have been 
vaccinated. My wife, Heidi, has been vaccinated. My parents 
have been vaccinated. I certainly encourage people to get 
vaccinated.
    But I also think, over the past year, the conduct of many 
Democrats, and the conduct of much of the media, has been very 
counterproductive. That we have seen Democrats in the media 
playing politics with this pandemic. We saw, then Senator, 
Kamala Harris saying, ``She would not trust Donald Trump if a 
vaccine were developed before the election''. We saw New York 
Governor Andrew Cuomo saying ``he did not trust President Trump 
or the FDA, saying he did not have confidence in them to 
develop a vaccine.'' Candidate Joe Biden said, ``I trust 
vaccines. I trust scientists. But I do not trust Donald Trump, 
and, at this moment, the American people cannot either.'' That 
was misinformation. It was deliberate misinformation.
    And unfortunately, the media was more than happy to suit up 
in this partisan battle to also mislead the American people. 
For example, in October, President Trump said that every 
American would be able to get a vaccine by April. We are in 
April right now. CNN, home of self-declared purveyors of truth 
like Brian Seltzer and Chris Cuomo, declared, that is not 
likely. Well, CNN was full of crap. They were misleading the 
American people and they were doing it because it was October 
of an election year, and they did not want people to think they 
were going to get a vaccine.
    Or take the case of Amber Athey, the Editor at the 
Spectator who said, ``Trump was universally panned by the media 
for saying a vaccine would be coming by the end of the year''. 
When in fact, a vaccine came by the end of the year. Or take 
the case of the Miami Herald, which quoted, ``scientific 
experts'', as saying, regarding a COVID vaccine being approved 
in the late Fall of 2020 that, ``There is no way that is 
happening, at least not with a vaccine that has proven safe and 
effective''. I wonder if the Miami Herald has apologized to its 
readers, who they misled and misinformed.
    Tens of millions of Americans have now received a vaccine 
that the media and Democrats told the American people, over and 
over again, would not be available. That misinformation was 
harmful. What effect, in your judgment, does this kind of 
political rhetoric, undermining confidence in a vaccine, that 
came through media outlets across the country--what effect do 
you think that has in the American people's confidence in being 
able to take a vaccine that will work?
    Mr. Smith. Well, as I hear you articulate the question, 
Senator, I am reminded of the rough and tumble of my own 
campaigns and a lot of things are said that you would not want 
to say in a non-campaign environment. But I am as gratified 
that the sources you were criticizing were not specifically 
broadcasters. In fact, they were newspapers and cable.
    And what I have been trying to focus on here today is--and 
I think I can honestly say I have heard from Chuck Schumer to 
broadcasters, and even Mitch McConnell in different broadcast 
settings, say something to this effect. I know when I want just 
to talk to my constituents. When I do not want to be spun, or 
whatever, I just want a clarity of an opportunity to talk, I 
can go to my local radio and TV broadcasters and they get it 
through.
    So, what I have been saying this morning, in relationship 
to COVID vaccinations, is that we are anxious and hungry for 
the facts. I am talking about, you know, your newsroom in San 
Antonio. They are not going to spin you. They do not want--they 
just want to serve their community and your constituents.
    So, I think, rather than focusing on criticizing or making 
any enemies here this morning--because that is not why I am 
here. I am here to spread hope and make clear the incredible 
platform that broadcasting--local broadcasting, radio and TV, 
have to get the facts out that you need them to have, and so 
that your constituents can be safe.
    Senator Cruz. Thank you.
    Senator Lujan. Thank you, Senator Cruz. I want to thank all 
of our colleagues who participated in today's hearing, to all 
of our panelists, as well. And as I conclude today, look, we 
have heard from witnesses about the massive national effort to 
fight the COVID-19 pandemic. So much hard work and funding has 
gone into making sure everyone has access to reliable, timely 
information from sources they trust. But it only takes a single 
thoughtless moment for someone on social media, television, or 
radio to undermine that trust. Decades of work put in jeopardy, 
in only a few seconds.
    By now, we know that vaccines work. Over 120 million 
Americans have been vaccinated and the end is in sight. Yet, 
many major stations are still airing content that undermines 
our effort to get back to normal. And I want to continue where 
my colleague left off. Just this last Tuesday--Tuesday evening, 
Tucker Carlson said, on a national cable television that, 
``Maybe the vaccine does not work, and they are simply not 
telling you''.
    I pose the following question to the panel, as we close the 
hearing today. Does airing a statement like that bring us 
closer to defeating this virus and getting back to our lives? 
Secretary Collins, yes or no?
    Dr. Collins. It does not. I mean, we really--the vaccines 
are efficacious and so, we need to make sure the public 
realizes that. That we can prevent hospitalizations and deaths 
by getting those vaccines.
    Senator Lujan. Dr. Rivera?
    Dr. Rivera. I agree, and it is important that we are 
delivering clear, transparent, and accurate information, so 
everyone is able to make an informed decision about vaccine 
safety.
    Senator Lujan. Senator Smith?
    Mr. Smith. Broadcasters want to put out over the airwaves 
what is true.
    Senator Lujan. I appreciate that. And look, I hope Tucker 
Carlson just cuts it out. Enough with this nonsense. And anyone 
else that is out there spreading this misinformation, stop. You 
are hurting people. You are costing people their lives. And 
just as much as we want to see investment in getting accurate 
information out, we also want to see the stop of spreading of 
misinformation.
    So, Senator Smith, thank you for being here today and your 
testimony to say trust your local sources. Everyone simply 
wants the facts, accurate information, not spin. And that is 
what I appreciate from those efforts and those commitments 
across the country. Make sure they have the facts, the 
importance of what we did today.
    I want to urge everyone out there that has a 
responsibility, to take a look at those organizations and just 
stop this stuff. You know, you all huddled before these shows 
start. Stop them.
    Now, as I close here, I just want to thank the witnesses 
for this productive discussion. And the hearing record will 
remain open for two weeks, until April 29, 2021. Any Senators 
that would like to submit questions for the record, for the 
witnesses, should do so by that date. We ask that your 
responses be returned to the Committee by May 31, 2021.
    That concludes today's hearing. Thank you again to 
everyone.
    [Whereupon, at 12:03 p.m., the hearing was adjourned.]

                            A P P E N D I X

                  Prepared Statement by the Ad Council
INTRODUCTION:
    Thank you to both Chairman Lujan and Ranking Member Thune for the 
opportunity to submit written testimony that outlines the Ad Council's 
efforts to educate and inform the American public about the COVID-19 
vaccines. COVID-19 has killed more than half a million of our fellow 
Americans. To prevent the loss of hundreds of thousands more lives, our 
Nation needs extensively researched, customized and data-driven 
communication efforts to boost vaccine confidence and help address the 
misinformation and confusion that are driving vaccine hesitancy. The Ad 
Council is doing just that.
    The Ad Council was founded as a national nonprofit in 1942 on the 
promise and potential of the communication industry's capacity to do 
good. We have a long history of working across the public and private 
sectors to spur behavioral change. We are behind well-known PSA 
campaigns such as ``Smokey Bear,'' ``Love Has No Labels'' and ``Friends 
Don't Let Friends Drive Drunk.''
    In times of crisis, the Ad Council has led similar programs before. 
In the 1950s, the U.S. Public Health Service and the American Medical 
Association recruited the Ad Council and the industry's creative and 
media talent to assist in the drive to convince Americans to take the 
polio vaccine. Today, thanks to widespread vaccinations, the disease is 
virtually nonexistent.
    We've also recently demonstrated the incredible power to mobilize 
the industry against COVID-19. Over the past year, we've launched an 
unprecedented, multi-pronged COVID effort, working with multiple 
creative agencies to disseminate lifesaving information to the public. 
In addition to essential social distancing messages targeting at-risk, 
general market, young adults, parents, and Black Americans, we've also 
distributed campaigns on bias, plasma donation and mental health/
coping. Collectively, these efforts have resulted in $462.4 million in 
donated media, 66.2 million engagements and 33.6 million visits to 
coronavirus.gov (as of 4/20/21).
    We recognize the arrival of the vaccines mark the onset of another 
momentous public health messaging challenge. We are meeting this moment 
with the most ambitious effort in our nearly 80-year history: More than 
500 major brands, media companies, community-based organizations, faith 
leaders/organizations, medical experts and other trusted messengers are 
supporting the campaigns designed to reach distinct audiences.
THE CHALLENGE:
    Last fall, with the promise and prospect of the COVID-19 vaccines, 
we knew we faced a huge communications challenge to address 
misinformation, questions and hesitancy.
    Various surveys and research revealed that many Americans reported 
they would not get the vaccine, revealing alarming gaps that would 
prevent the country from achieving the roughly 70 percent coverage rate 
needed to get the Nation back on track.
    We identified four formidable communications challenges that would 
need to be addressed:

        We needed a massive and unified communications effort to the 
        public. A national vaccination program involves three 
        components: 1) vaccine development and FDA authorization or 
        approval; 2) manufacturing and distribution; 3) vaccine uptake 
        by the public. While substantial funding, innovation and 
        planning had been invested in the first two components, the Ad 
        Council identified the need for unprecedented public-private 
        sector efforts to address the third component.

        We needed to overcome multiple and complex attitudes and 
        behaviors. COVID-19 vaccine hesitancy and resistance is highly 
        complex, with many factors coming into play, including fear, 
        distrust, confusion, misinformation and complacency.

        We needed tailored messages to multiple audiences: There is no 
        single ``vaccine hesitant'' mindset. It's clear that a ``one 
        size fits all'' campaign, with a ``we're all in this together'' 
        message, is unlikely to gain significant traction.

        We still needed messaging as part of a comprehensive approach 
        to defeat COVID-19, such as masks: We knew that mask wearing 
        would remain critical for many months to come. Depending on the 
        efficacy rate of vaccines, a significant proportion of those 
        vaccinated will remain vulnerable to infection. Therefore, we 
        knew we would need an unprecedented public commitment to 
        getting vaccinated and wearing a mask.

    We kicked off this unparalleled effort by joining forces with the 
COVID Collaborative to activate their bipartisan network of leaders in 
public health, education, the business community and more. Our goal was 
to quickly tap into the cutting-edge expertise and talent across all 
sectors. The Ad Council would leverage its deep relationship with the 
media, creative agencies, insight and analytic firms, corporate brands, 
social platforms and influencers. The COVID Collaborative would 
leverage the leading experts and institutions across health, education 
and the economy.
    The intent was to build a unified, coordinated communications 
campaign in partnership with every sector (healthcare, insurance, 
pharmacies, education, corporations, state/local public health 
departments, academic institutions, faith-based communities, 
communities of color, community organizations, media, tech, etc.), 
which would allow us to have exponentially more impact than a patchwork 
response.
    Together, we are coalescing the public and private sectors to 
deploy the campaign: state and local health departments, governors and 
mayors, K-12 schools and universities, faith-based communities, medical 
associations and hospitals, healthcare industries, insurers, 
pharmacies, corporations, nonprofit networks and community 
organizations.
    Throughout our efforts, we have consulted closely with our 
longstanding partners at HHS and CDC, who provided insights and 
scientific review of all aspects of our efforts.

OUR RESEARCH EFFORTS & FINDINGS:
    Back in the fall, we conducted extensive research and in-market 
testing to develop audience profiles and multiple creative briefs as 
fast as possible. We knew we didn't need more generic hesitancy 
research--we needed to pinpoint messaging that would best resonate with 
vaccine hesitant individuals so we could be in-market as fast as 
possible. This initial formative research phase helped us uncover:

   What is the state of knowledge and attitudes about COVID 
        vaccination among key audiences?

   What are the most persuasive messages with key audiences?

   Which audience segments need to hear which message? How 
        granular can we be?

   Who are the trusted messengers who can help deliver those 
        messages?

   How do people respond differently across demographics, 
        psychographics, and geographies?

   What language choices could benefit the entire movement 
        (i.e., ``Immunization'' vs. ``Vaccine'')?

    By relying on real-time testing and analytics, we could then 
develop relevant and engaging content and optimize results through an 
iterative test/learn/scale approach. Our research, in addition to 
guiding our initial message testing, would also serve as the core 
analytic resource for the entire effort so that we could create our 
multi-prong campaigns via ongoing, real-time testing and optimization.
    The Ad Council and COVID Collaborative felt strongly that we should 
share any of our insights with others working on vaccine education in 
an ``open-source'' approach. That is, we synthesized our research and 
created six online toolkits for grassroots, local, state and national 
partners. These toolkits were created for the public health community, 
Black community, Hispanic community, Black faith community, Hispanic 
faith community and the corporate sector. They include customized 
resources such as core insights, creative briefs, messaging tips and 
customizable creative and digital assets for each audience. Links to 
these toolkits can be found here.
    Our research and data-driven approach was guided by these 
principles:

   Research that's additive: The Ad Council deeply reviewed and 
        synthesized the vast array of research that had been conducted 
        on vaccine hesitancy among different audiences. We did not 
        pursue or conduct additional research in this area. Rather, we 
        sought to rapidly identify messaging frames and creative that 
        will overcome hesitancy, dispel misinformation and inspire 
        individuals to get the vaccine.

   Unified communications strategy: To effectively educate and 
        motivate the public to get the COVID vaccine over the next 
        year, we wanted to build a united front: one with cohesive, 
        multipronged communications that is built on rapid consumer 
        insights and agile testing to ensure impact.

   Phased approach: Our campaign would be timed to be in sync 
        with the supply of vaccines and focus on priority audiences in 
        a phased approach.

   Building trust: The campaign would focus on diminishing 
        hesitancy and building confidence and trust, driving key 
        audiences to get more information from a science-based resource 
        as the call-to-action.

   Rely on trusted messengers: Our entire communications effort 
        would rely on research-based messaging with trusted messengers 
        (e.g., healthcare providers, faith leaders, etc.) who have 
        credibility in local communities with our target audiences. We 
        would not rely on one single message or campaign. The campaign 
        goes well beyond pre-produced PSAs to include tools, messages 
        and content for influencers to use in their communications and 
        channels.

   Science and data will drive everything: The COVID 
        Collaborative brought the expertise of its scientific advisors 
        to advise on all aspects of this effort, including insights/
        research, target audiences, deployment and evaluation.

   Rapid response: We would utilize a rapid response ``war 
        room'' strategy to combat misinformation in real-time and 
        leverage micro-influencers, especially in communities of color 
        (partnering with already existing groups that have 
        sophisticated technology and practices to monitor and combat 
        vaccine misinformation in real-time.)

    Specifically, we worked with a number of best-in-class partners to 
build what we called our ``Communications Insights Engine'' which can 
be found in Appendix A.

MESSAGING INSIGHTS:
    Broadly, our research indicated that Americans' hesitancy across 
all demographics is driven by three primary areas where information 
deficits and misinformation exist:

   Concerns about safety and side effects from COVID-19 
        vaccination, driven by the speed of the clinical development 
        process and the vaccines' novelty.

   Lack of knowledge.

   Distrust in the political and economic motives of the 
        government and corporations.

    Knowing these barriers, we then synthesized our research into the 
following messaging guidelines:

   Lead with empathy. Respect people's hesitancy and 
        acknowledge that it's okay to have questions. Avoid 
        condescension, lecturing, negativity and guilt mongering.

   Facts about safety are important. Don't just say, ``The 
        science is solid.'' Explain why vaccines are safe, despite the 
        fast timeline of development. Information needs to be clear, 
        honest and presented in plain language.

   Emotional triggers are important. Highlight how vaccinations 
        are a pathway to helping us get back to the moments of human 
        connection that we are all yearning for.

   The messenger is just as important as the message. Most 
        people who are hesitant to get vaccinated are open to listening 
        to a wide variety of messengers whom they trust, but they want 
        to receive information about COVID-19 vaccines from 
        credentialed health experts. They are also open to hearing 
        personal testimonials.

   Recommended messaging tone:

     Should be welcoming, personal and authentic.

     Provide a safe space that's focused on dialogue, not 
            debate.

     Leverage emotional touchpoints to remind people about 
            those moments of human connection once we get past COVID-
            19.

   Specific insights regarding Black Americans:

     Understandable distrust is especially salient because 
            of medical and government mistreatment (e.g., Tuskegee 
            experiments) that has contributed to cultural trauma.

     Many often feel excluded from other health-related 
            discussions, so Black Americans tend to question just how 
            open, diverse and transparent vaccine conversations will 
            be.

     We also felt it was important that our communications 
            acknowledge longstanding health equity disparities and 
            vaccine supply issues and therefore messaging should not be 
            framed this way nor imply that vaccination uptake rests 
            entirely on Black Americans' shoulders.

   Specific insights regarding Hispanic community:

     Messages should lead with empathy and acknowledge that 
            a desire to learn more and ask questions is okay. People 
            want to know the vaccines are safe and that the benefits 
            outweigh the risk.

     Questions and concerns around vaccine accessibility 
            were a theme.

     Compared to the other groups, Hispanics were more 
            receptive to messages from voices within their inner circle 
            such as neighbors, their mayor and posts by people they 
            follow on social media.

     Institutions like the Centers for Disease Control and 
            Prevention carry credibility, but for Hispanics, it may be 
            best to focus on trusted experts rather than institutions. 
            We also found that faith in government and the 
            pharmaceutical industry was lower among this demographic.

    You can view our full audience profile snapshots and messaging 
recommendations (for General Audiences, Black Americans and Hispanic 
Americans) on our six different toolkits.
    In addition, we recognize the need to reach the Asian American, 
Native Hawaiians, and Pacific Islanders communities as well as Native 
American communities. Specifically, we are working with the CDC and HHS 
and other organizations that are leading efforts in this space to help 
amplify their work, including collaborating with Urban Indian Health 
Institute (on toolkit materials), the Asian and Pacific Islander 
National American Forum and the COVID Collaborative (on consumer 
research and toolkit materials). Finally, we are working with the 
Asian-American Advertising Federation (3AF), to inform best practices, 
cultural resonance and create media partnerships targeting the AAPI 
vaccine hesitant community.
THE CAMPAIGN'S ``IT'S UP TO YOU'' CREATIVE PLATFORM:
    Knowing the high rates of hesitancy and need to boost vaccine 
confidence, our campaign is designed to target the undecided segment of 
the population who are taking a ``wait and see'' approach. 
Specifically, we define this ``movable middle'' as those who range from 
``skeptical'' to ``open but uncertain.'' That is, we are not targeting 
those who are firmly pro or anti-vaccine, but rather those individuals 
who have questions and reservations. These are people who are seeking 
tangible evidence from trusted sources that the benefits outweigh the 
perceived risks of vaccination.
    The Ad Council's model is unique in that for all of our campaigns 
we tap the pro bono talents of the Nation's leading agencies to create 
our campaigns. For this effort we initially tapped Pereira O'Dell to 
help create our umbrella campaign, knowing that it needed to not only 
unify all of our creative efforts but also offer the flexibility for 
multiple creative agencies, influencers, media platforms, and brands to 
run with it and make it their own. In addition, Pereira O'Dell 
collaborated with Alma DDB and JOY Collective to ensure that the 
platform was culturally relevant and could be customized for key 
audiences, particularly Black (Joy Collective) and Hispanic (Alma and 
Pereira O'Dell) audiences most impacted by COVID 19.
    This unifying platform, ``It's up to You'' (or ``De Ti Depende'' in 
Spanish) aims to reduce vaccine hesitancy by empowering people to get 
the answers they need, overcome misinformation and make an informed 
decision to protect themselves and their loved ones. It serves as the 
roadmap for all of the campaign's creative, based on these six 
mandatories:

  1.  Appeal to people's desire to protect their loved ones.

  2.  Respect people's independence and urge them to make an informed 
        decision.

  3.  Lead with empathy and respect that people have real questions or 
        concerns.

  4.  Gain trust by being honest and transparent.

  5.  Remind people of the desire to get back to life and missed 
        moments like visiting family and friends.

  6.  Welcome people's questions, and point them to trusted sources and 
        messengers.

    We tested this creative platform and found that it succeeded in 
motivating vaccine hesitant individuals with its positive, yet 
realistic tone and it's pairing of the rational information with the 
emotional side of the moments we all miss.
    To bring this idea to life, we worked the campaign's three creative 
agencies (Pereira O'Dell, JOY Collective and Alma DDB) who have 
extensive multicultural expertise: That's because we knew there was not 
a single ``vaccine mindset'' and were mindful of the outsized impact of 
COVID on communities of color, so we launched distinct creative for the 
general public as well as tailored efforts to Black and Hispanic 
communities. Our work for the Black and Hispanic communities was vetted 
by a diverse group of experts and organizations including the NAACP, 
Black Coalition Against COVID-19, Color of Change, National Urban 
League, UnidosUS, Salud America!, National Hispanic Medical Association 
and faith leaders in the Black and Hispanic community.
    We also created a comprehensive website, driving audiences to 
GetVaccine
Answers.org (DeTiDepende.org in Spanish), a site which poses and 
answers some of the top questions from vaccine hesitant individuals. 
Vetted by experts at the CDC, HHS, FDA and COVID Collaborative, content 
on the website is available in seven languages (English, Spanish, 
Simplified Chinese, Korean, Russian, Haitian Creole and Vietnamese) and 
is continually updated as new information and data become available.
    Since the launch of our campaign (late February, 2021) with 
advertising in all media formats (English and Spanish assets), the Ad 
Council campaigns rely primarily on a donated media model to drive 
impact. This initiative--due to the enormity of the challenge and the 
short time window for success--is also tapping on paid programmatic 
supplemented by donated, owned, and earned media across thousands of 
media platforms and properties. To do that, we secured the pro bono 
resources of Dentsu Aegis (multinational media and digital marketing 
communications company) to develop a communications architecture and 
media strategy.
    This strategy is driving our media outreach for the assets the Ad 
Council is directly producing as well as for our partners who are 
producing their own platform-specific assets. Leading brands, media 
companies and social platforms are developing custom content and 
donating media to extend the ``It's Up to You'' message, connecting 
their audiences with crucial and vetted information about the COVID-19 
vaccines.
    We've formed partnerships with varied brands and organizations 
including, but not limited to:

   Adobe

   American's Health Insurance Plans

   American Heart Association

   American Medical Association

   Amazon

   Apple

   Bank of America

   BIN: Black Information Network

   BNY Mellon

   Budweiser

   Business Roundtable

   Cisco

   Citi

   Complex

   CVS Health

   Enthusiast Gaming

   Facebook

   Ford Motor Company

   FOX

   General Motors

   Google/YouTube

   Holler

   Honeywell

   Humana Foundation

   iHeartMedia

   JPMorgan Chase

   LinkedIn

   Match Media Group

   Meredith Corporation

   NBCUniversal/Comcast and Telemundo

   New York Life Foundation

   OWN

   Pandora/SiriusXM/SoundCloud

   PatientPoint Health Technologies

   Pinterest

   Reckitt

   Reddit

   Salesforce

   Sesame Workshop

   Snapchat

   Spotify

   Stanley Black & Decker

   Synchrony

   Target

   TikTok

   Twitter

   Twitch

   Unilever

   Univision

   ViacomCBS, including BET

   Verizon

   Walgreens

   Walmart

   Walt Disney Television

   WarnerMedia

   Wells Fargo

   What If Media

    In addition, our industry's major trade associations have joined 
forces to drive an industry movement around the Ad Council-COVID 
Collaborative's campaign. Each association is developing innovative 
ways to promote the campaign in ways that resonate with its industry in 
support of the ``It's Up to You'' message. They include: The 
Association of National Advertisers, Alliance for Inclusive and 
Multicultural Marketing, American Advertising Federation, American 
Association of Advertising Agencies, Interactive Advertising Bureau, 
Internet & Television Association, Licensing International, Mobile 
Marketing Association, National Association of Broadcasters, News Media 
Association, Out of Home Advertising Association of America, Radio 
Advertising Bureau and the Television Bureau of Advertising.
    Finally, we are funding this massive effort by tapping the 
generosity of the private sector. Leading contributors to date include 
Amazon, Apple, Bank of America, Cisco, CVS Health, Facebook, General 
Motors, Google and YouTube, Humana Foundation, NBCUniversal/Comcast, 
Reckitt, Salesforce, Verizon, Walgreens and Walmart. Significant 
contributions have also been provided by Adobe, America's Health 
Insurance Plans (AHIP), American Heart Association, American Medical 
Association, BNY Mellon, Budweiser/Anheuser-Busch Foundation, Business 
Roundtable, Citi, Ford Motor Company, Honeywell, JPMorgan Chase, New 
York Life Foundation, Stanley Black & Decker, Synchrony, Target, 
Unilever, Wells Fargo and ViacomCBS.
OUR ``GROUND GAME'':
    Recognizing that the ``who'' behind our communications is just as 
important, if not more, than the content of the messages themselves, we 
kicked off our ``ground game'' strategy.
    This is an intensive ground game of partners and trusted community-
based organizations who are critical to ensuring our messages reach 
local communities and build trust and transparency given the high 
degree of misinformation and rapidly changing updates about the 
vaccines that will be distributed.
    We are building this ground game in three ways:

  1.  We have launched separate coalition-building programs targeting 
        different audiences: Black communities, Hispanic communities, 
        faith communities, conservative/rural communities, the 
        corporate sector and more recently, young adults and parents. 
        Our goal has been to provide various platforms to facilitate 
        culturally relevant conversations within each of these 
        communities on COVID-19 vaccines, leveraging trusted messengers 
        from each of their communities. These efforts include virtual 
        townhall and online events, customized media and content 
        partnerships and tailored efforts for each community. We're 
        partnering with JOY Collective for the Black community and 
        Latinovations and Republica Havas to develop and execute these 
        programs. Examples include:

     A series of virtual townhall events including:

     NAACP UNMASKED: A COVID-19 Virtual Town Hall Series in 
            partnership with the Black Coalition Against COVID-19 
            (which garnered 96,680 views)

     MusiCares: Facts, Fears & Honest Dialogue: COVID-19 
            Vaccines and the Black Music Community (24,569 views)

     Special edition of Hispanicize featuring Dr. Anthony 
            Fauci, Beto Perez, John Leguizamo, Karen Martinez, Luis 
            Guzman and others (15,000 online attendees)

     BET NAACP Image Awards Content Integration (3,000,000 
            views)

     The Faith Community on COVID-19 Vaccines: What You 
            Need to Know (230,000 reach; 165,000 Views)

     UnidosUS & Telemundo National Town Hall Vaccine 
            Education Event (80,000 views)

     Two national Town Halls with the Sororities and 
            Fraternities, in partnership with the Black Coalition 
            Against COVID-19 and BlackDoctor.org *Please note that the 
            video views increase daily, given the content remains in 
            social media (Facebook, YouTube, etc.) for the various 
            audiences to consume.

   Partnership with Values Partnership (social impact agency 
        founded by Joshua DuBois who led the White House Office of 
        Faith-based and Neighborhood Partnerships in President Obama's 
        first term) to target Black, Hispanic and evangelical 
        community, as well as faith communities broadly. Our faith 
        strategy includes conducting research, providing resources for 
        the faith community through trusted messengers and tailored 
        forums and outlets. We are also creating content intended to 
        empower clergy nationally to have these conversations in their 
        own local contexts. For example, we launched a National Faith 
        Steering Committee to reach Black and Hispanic congregants to 
        help educate and strengthen vaccine confidence. The Committee 
        consists includes 21 highly influential faith leaders from 
        around the country who are leading the charge in getting 
        accurate information to the communities that need it most. For 
        example, members include the National Association of 
        Evangelicals, National Latino Evangelical Coalition, Bishop T. 
        D. Jakes, Dr. Barbara Williams-Skinner, Rev. Dr. Gabriel & Rev. 
        Jeanette Salguero, Rev. Dr. Otis Moss III, Rev. Enid Almanzar, 
        Rev. John K. Jenkins, Rev. Traci Blackmon, Father Manuel 
        Dorantes and Rev. Dr. Walter Kim. We're partnering with them to 
        help inform our work, participate in national events, host 
        their own local events, and distribute educational materials.

    We also launched a special series entitled ``Faith & Facts Family 
        Conversations,'' which leverages icons in the gospel community, 
        their family/friends, and a medical expert to have more 
        intimate conversations on COVID-19 vaccines to help educate the 
        community. We kicked off this program by partnering with David 
        and Tamela Mann, award-winning gospel artists, actors and 
        authors, on a special installment of the ``Mann Family Dinner'' 
        series, which has 342K followers on YouTube, focused on COVID-
        19 vaccines. The video completed for this program has already 
        received over 113,000 views.

   We're also partnering with Choose Healthy Life, a program 
        focused on improving the health and wellness of the faith 
        community. We will have collateral in their focused markets to 
        help educate the community on COVID-19 vaccines--markets 
        include New York, Newark, Atlanta, Detroit, and Washington, DC.

   A series of PSAs featuring former U.S. Presidents and First 
        Ladies (Presidents Barack Obama, George W. Bush, Bill Clinton, 
        Jimmy Carter and former First Ladies Michelle Obama, Laura 
        Bush, Hillary Clinton and Rosalynn Carter). The videos are 
        designed to encourage all Americans to get answers to the top 
        questions about the COVID-19 vaccines at GetVaccineAnswers.org 
        and to get a vaccination when it's available to them.

   PSA partnership with 13 major sports leagues and 
        organizations (American Horse Council, Athletes Unlimited, 
        Major League Baseball, Major League Soccer, National 
        Association for Stock Car Auto Racing (NASCAR), National 
        Basketball Association, National Football League, National 
        Hockey League, National Women's Soccer League, PGA TOUR, U.S. 
        Open Tennis Championships, Women's National Basketball 
        Association and WWE. Highlighting iconic moments in sport and a 
        brand-new recording of ``I'll Be Seeing You'' performed by 
        Grammy Award-winning musician, Willie Nelson; the videos 
        encourage fans to visit GetVaccineAnswers.org for the latest 
        information about the COVID-19 vaccines.

   An always-on PR strategy leveraging medical experts, faith 
        leaders, and influential voices for ongoing TV/radio interviews 
        in key markets in English and Spanish, pegged to new campaign 
        announcements and vaccine rollout news.

  2.  We are tapping and expanding the COVID Collaborative's incredible 
        network of health and community partners who have local 
        channels within their organizations. These include:

        317 Vaccine Coalition

        American Academy of Family Physicians

        American College of Physicians

        American Heart Association

        American Lung Association

        American Nurses Association

        American Public Health Association

        Asian & Pacific Islander American Health Forum

        Association of Immunization Managers

        Association of State and Territorial Health Officials

        NAACP

        National Academy of Medicine

        National Association of Community Health Centers

        National Association of County and City Health 
            Officials

        National Black Nurses Association

        National Hispanic Medical Association

        National Indian Health Board

        National Medical Association

        National Urban League

        Trust for America's Health

        UNCF

        UnidosUS

        Vaccinate Your Family

  3.  We have created a Dissemination Working Group in partnership with 
        the COVID Collaborative. This group is lending their 
        perspective on how best the Ad Council can share and distribute 
        its campaign messaging and assets with grassroots, local, state 
        and national partners. Members include:

        American Heart Association

        American Medical Association

        American Public Health Association

        Asian & Pacific Islander American Health Forum

        Association of Immunization Managers

        ASTHO

        Big Cities Health Coalition

        Black Coalition Against COVID-19

        COVID-19 Prevention Network

        Health Leads

        Infectious Disease Society of America

        NAACP

        National Association of County & City Health Officials

        National Coalition of 100 Black Women

        National Congress of American Indians

        National Council on Aging

        National Rural Health Association

        National Urban League

        NIH's National Institute on Minority Health & Health 
            Disparities

        NYU School of Global Public Health

        Rockefeller Foundation

        U.S. Chamber of Commerce

        UnidosUS

        Vaccinate Your Family

  4.  We launched a business coalition (the Health Action Alliance), a 
        joint effort between the Ad Council, Business Roundtable, CDC 
        Foundation, de Beaumont Foundation and Robert Wood Johnson 
        Foundation to empower the business community and address health 
        inequities in the fight against COVID-19.

RELYING ON TRUSTED MESSENGERS:
    Our research revealed that credible, local messengers are critical 
to engaging vaccine hesitant individuals, including local doctors and 
pharmacists and others at the community level.
    We therefore launched a plan for engaging trusted messengers and 
influencers:

   We know that with this campaign the messengers are just as 
        important as the message. We have identified eight influencer 
        categories that cover broad perspectives and roles, with the 
        medical community and government being the fact creators.

   We created a communications framework that is providing 
        structure and consistency across all types of influencer 
        engagements. We are using this framework for content partners, 
        agencies and influencer groups.

   We kicked off this program by partnering with medically 
        credentialled experts to provide approachable yet compelling 
        fact based content that are distributed to their digital and 
        social platforms.

   We are also working with relevant trusted messengers that 
        are helping to amplify the facts with relevance and 
        credibility. These critical amplifiers will help further 
        disseminate the factual information by sharing, reposting or 
        curating the content.

   Finally we plan to activate both the fact creators and the 
        fact amplifiers to share the personal vaccination experiences 
        on their social channels--this could include their own 
        vaccination or that of a love one the accompanied. This is 
        critical to build up a volume of experiences that will help 
        normalize the vaccination process and reduce hesitancy.

    Examples of these efforts include:

   Produced COVID Vaccine Sports Roundtable Q&A discussion with 
        Dr. Tom Frieden, former head of the CDC, and multiple 
        professional athletes: Sean Johnson (MLS), Preston Wilson 
        (MLB), Chester Pitts (NFL), Drew McIntyre (WWE) and 
        RockyNoHands (eSports). The athletes were able to get all of 
        their vaccine-related questions answered by a prominent medical 
        professional.

   Produced a Conversation Between Legends: Kareem Abdul-Jabbar 
        Talks COVID-19 Vaccines with Dr. Kizzmekia Corbett that 
        discusses vaccine development and safety and the importance of 
        vaccine education for the Black community specifically.

   Produced a Fireside Chat between Former Governor Chris 
        Christie and President of the AMA, Dr. Susan Bailey to discuss 
        top questions about the vaccine raised by U.S. conservative 
        audiences

   Tapping trusted faith leaders and influencers, including 
        Curtis Chang and NIH Director Dr. Francis Collins, who is 
        outspoken about how his Christian faith informs his work as a 
        scientist. Our partnership with theologian and Duke Divinity 
        School professor Curtis Chang and ChristiansAndTheVaccine.com 
        is providing brief, informative videos that specifically and 
        explicitly addresses potential concerns from the evangelical 
        community about the vaccines, and shares ideas about how 
        Christians might think about the choice to get vaccinated. In 
        addition, in partnership with Values Partnerships and 
        ChristiansAndThe
        Vaccine.com, we are facilitating events and messages that 
        feature prominent evangelicals, speaking from their own, faith-
        informed perspective, about the vaccines, including: Dr. Walter 
        Kim, who leads the National Association of Evangelicals; the 
        evangelical writer and advocate, David French; local Christian 
        pastors like Joel Rainey of Shepherdstown, West Virginia; and 
        Christian medical practitioners.

   Engaged Eric Church, Ashley McBryde and Darius Rucker to 
        create a PSA that aired in the Country Music Awards on 4/18/21 
        (details in this Rolling Stone article)

   Role in the upcoming Global Citizen concert VAX LIVE: The 
        Concert to Reunite the World and the incorporation of our 
        medical expert ambassadors in the www.vaxbecause.org website

   Partnered with prominent celebs to share their personal 
        vaccine experiences using the #IGotTheShot hashtag; including: 
        Wanda Sykes, Nile Rogers, Sterling Sharpe, etc.

   Created repository of face-based video content created by 
        our network of medical experts that can be share by 
        influencers, brands and partners at www.adfactlibrary.org

COMBATTING MISINFORMATION:
    To combat misinformation in real-time and leverage micro-
influencers, especially in communities of color, we are partnering with 
Bully Pulpit Interactive and the Public Good Projects (PGP), which has 
sophisticated unparalleled technology and practices to monitor and 
combat vaccine misinformation.
    Bully Pulpit Interactive pairs traditional research with advanced 
social listening to understand not only the volume of misinformation 
being spread, but the relative impact and harm of various 
disinformation messages. This allows the Ad Council to track not only 
what is said online, but more importantly, what a vaccine-hesitant 
audience actually hears and understands, and the narrative conclusions 
they draw. Our framework helps prioritize different narratives--from 
what is high awareness and high risk that we absolutely must address--
to what is low awareness and low risk, which we simply must keep an eye 
on. This allows us to work against disinformation, address the 
underlying doubt, and thus take away its power among key audiences.
    Alongside this work, PGP's tools use machine learning, 
epidemiology, and investigative journalism to identify mis/
disinformation in real-time and then disseminate counter-messages that 
draw on deep expertise and strategies to combat vaccine hesitancy 
through a network of several hundred influencers as well as several 
hundred community organizations. PGP's systems are used by the U.S. and 
Canadian governments, and are the engine behind UNICEF's global efforts 
to combat vaccine misinformation. PGP has built out a custom alert and 
reporting system solely for The Ad Council.
    The Ad Council is drawing on Bully Pulpit and PGP's learnings about 
what messages best resonate and is extending these counter-messages by 
tapping our own network of influencers, alongside additional 
communications to hesitant audiences through both paid and earned 
media.

EVALUATION & INITIAL RESULTS:
    As with all Ad Council efforts, we are applying a rigorous, data-
driven approach to measuring performance and impact. Our goal is to 
continually understand the effectiveness of our vaccine work by 
increasing confidence in COVID-19 vaccinations through education and 
how that translates into action.
    Specifically, we have defined KPIs and measurement strategies via 
established and new partnerships with industry leaders in data and 
insights, as well as solutions unique to the Ad Council. These include:

   Comprehensive tracking of support across all earned and 
        donated media channels

   Shifts in attitudes and behaviors via a monthly, national 
        survey

   Engagement on our website and all social platforms

   Significant ground game efforts (e-mail outreach, events, 
        influencer programs).

    All results ladder up to the ultimate outcome of vaccination uptake 
as measured through survey-based shifts in behaviors, CDC data on 
number of vaccinations and how exposure to our work influences both.
    We are using customized platforms/tools to view real-time results 
(data visualizations, scorecards, modeling), which will be continually 
optimized throughout the ``It's Up to You'' initiative. Some key 
highlights on our work to date:

   Since launch (February 25), media support and related 
        publicity is currently valued at $65M, which is twice as much 
        as an average campaign receives annually.

   Our TV and digital partnerships have a 26 percent reach so 
        far across all audiences.

   11.4M engagements with our social and search ads.

   330K views of targeted events within the Black, Faith and 
        Hispanic communities,

   Collectively, our efforts have driven over 2M sessions to 
        GetVaccineAnswers.org with nearly 2 out of 3 users who were 
        surveyed reporting feeling more confident about getting 
        vaccinated.

    As people learn more, we're seeing attitudes across the country 
shift. National polls by the Ad Council/Ipsos, NORC Center for Public 
Affairs Research, Kaiser Family Foundation, and others have registered 
significant improvements in Americans' intent to get vaccinated, 
including among Black Americans, over the past two months. As we 
collect more data, we will be conducting analyses to help determine the 
role of the Ad Council-COVID Collaborative campaign in ongoing 
improvements in Americans' vaccination intent and vaccination rates.
    Thank you for the opportunity to lend the Ad Council's voice to 
this important hearing. We appreciate this subcommittee's attention to 
what will surely be the largest, most consequential national education 
effort of our time. By working together to educate and inform the 
American public, we will soon be on the path to recovery and renewal.
                                 ______
                                 
                               APPENDIX A
 Ad Council-COVID Collaborative's COVID-19 Vaccine Education campaign: 
                   Research & Media Planning partners
Been There Done That:
Who are they: Creative agency that draws on expertise from community of 
leading Chief Strategy and Chief Creative Officers.

What they did: Provided message frames for testing (Note: These frames 
were informed by the Ad Council's deep dive on existing research on 
vaccine hesitancy from academia, CDC, NGOs, and pharma companies).

Output: Creation of 9 messaging territories rooted in existing insights 
to put into testing.
Dentsu Health:
Who are they: A leading global agency in health communications and 
media strategy.

What they did: Provided audience insights and media insights to help 
drive campaign strategy and media outreach.

Output: Audience insights and media planning recommendations.
IBM Watson Advertising Accelerator:
Who are they: Uses advanced AI technology to ``learn'' the optimal mix 
of creative/messaging approaches which resonate with key target 
audiences.

What they did: Conducted targeted in-market testing of messaging and 
creative (digital ads), leveraging their AI-powered platform to 
optimize results based on key call-to-actions by each audience.

Output: Data-driven insights on the most effective language and message 
framings for specific audiences.
Ipsos:
Who are they: Global leader in public opinion and market research.

What they did: In December 2020, fielded large quantitative survey 
(general population with Black and Latinx oversamples) to understand 
COVID vaccine mindsets, testing messaging territories and conducting 
in-depth audience segmentation/profiling. Continuing to field ongoing, 
quantitative survey to measure attitudes and behaviors around the COVID 
vaccines, as well as recognition of campaign creative

Output: Deep understanding of the ``vaccine hesitant'' adults in terms 
of demographics, psychographics, and areas of opportunity, with 
specific message framings. Continual tracking of issue attitudes, 
behaviors, and vaccine hesitancy over time
The Public Good Projects:
Who are they: Public health nonprofit composed of experts in public 
health, media, and marketing.

What they did: Social listening and access to their sophisticated 
monitoring and combatting of online vaccine misinformation.

Output: Real-time insights on vaccine misinformation as well as trusted 
online messengers to help inform testing and creative development.
Ahzul:
Who are they: BIPOC-owned market research and strategic agency.

What they did: Conducted qualitative interviews with Black, Latinx, 
young adult and general public (skew rural) vaccine hesitant Americans 
to understand knowledge, motivators, barriers, and mindsets (and to 
expose a variety of messaging territories for feedback).

Output: Culturally-nuanced insights on how message territories are 
received by these communities, which has informed/will inform creative 
development and outreach.
Feedback Loop:
Who are they: Agile research platform to glean audience insights and 
test messaging ideas.

What they did: Multiple survey-based messaging tests of various target 
audiences.

Output: Quick-turnaround surveys throughout the planning phase.
Facebook:
Who are they: The world's largest social media platform.

What they did: In-market messaging research of Ad Council/Facebook 
advertising, including test/control `lift' studies, to help optimize 
early campaign messaging.

Output: Data-driven learning on promising messaging framing and copy.
IBM Watson Advertising Accelerator:
Who are they: Uses advanced AI technology to ``learn'' the optimal mix 
of creative/messaging approaches which resonate with key target 
audiences.

What they did: Conducted targeted in-market testing of messaging and 
creative (digital ads), leveraging their AI-powered platform to 
optimize results based on key call-to-actions by each audience.

Output: Data-driven insights on the most effective language and message 
framings for specific audiences.

    Finally, our testing phase was informed by a diverse group of 
leading experts from members of the COVID Collaborative's Vaccine 
Scientific Advisory Committee:

   Lenora Johnson, DrPH, MPH, Director, Science policy, 
        Engagement, Education and Communications, National Heart, Lung, 
        and Blood Institute (NHLBI) at NIH

   Regina Davis-Moss, PhD, MPH, MCHES, Associate Executive 
        Director, Health Policy and Practice, American Public Health 
        Association

   Erica DeWald, Director of Advocacy, Vaccinate Your Family

   Katie Greene, MPP, Visiting Policy Associate, Duke-Margolis 
        Center for Health Policy

   Tene Hamilton Franklyn, Vice President, Health Equity & 
        Stakeholder Engagement, Health Leads

   Joyce Liu, Senior Policy Associate, Veng Group (on behalf of 
        Asian & Pacific Islander American Health Forum)

   Jen Morales, MPA, Director of Public Relations and 
        Marketing, Infectious Disease Society of America

   Rick Wade, Senior Vice President, Strategic Alliances & 
        Outreach, U.S. Chamber of Commerce

   Alexandre White, PhD, Assistant Professor Johns Hopkins 
        University, Department of Sociology and Department of the 
        History of Medicine
                                 ______
                                 
                       Prepared Statement of AHIP
    AHIP thanks the Subcommittee for holding this hearing to examine 
the ways public and private institutions can partner to promote vaccine 
safety and COVID-19 health-related information to encourage Americans 
in underserved areas to get vaccinated. We share your commitment to 
ensuring that Americans get vaccinated as quickly and equitably as 
possible.
    AHIP is the national association whose members provide coverage for 
health care and related services to hundreds of millions of Americans 
every day. Through these offerings, we improve and protect the health 
and financial security of consumers, families, businesses, communities 
and the Nation. We are committed to market-based solutions and public-
private partnerships that improve affordability, value, access, and 
well-being for consumers.
    The COVID-19 pandemic has caused extraordinary suffering and 
economic upheaval across the country and around the world. AHIP members 
have seen first-hand the complications and consequences of the COVID-19 
public health crisis and are working hard to ensure that all Americans, 
regardless of the type of health insurance they have, get the care they 
need to fight the pandemic and to stay well through these challenging 
times. The industry, in collaboration with providers, policymakers at 
the state and Federal levels, and other stakeholders, has taken 
decisive actions to respond to the crisis. Health insurance providers 
have waived cost-sharing for COVID-19 testing and treatment to ensure 
patients can access needed care and that cost is not a barrier and made 
significant investments in telehealth and community-based services to 
assure that social barriers such as lack of transportation don't create 
insurmountable barriers to care.
    Health insurance providers are a trusted source of information for 
the people they serve. As COVID-19 vaccinations ramp up and supplies 
expand, overcoming vaccine hesitancy and ensuring equitable 
distribution is going to be critical. To that end, health insurance 
providers are working with national, state, and local leaders to help 
every American access vaccines. This includes efforts to raise public 
awareness, particularly within communities of color and vulnerable 
populations, about the safety and effectiveness of COVID vaccines and 
working with policymakers, providers and other stakeholders in local 
communities to improve equity in distribution and vaccine uptake. 
Insurance providers work to ensure the availability of culturally and 
linguistically appropriate content that is tailored to resonate with 
underserved communities and meet people where they are regarding 
vaccine information.
Vaccine Community Connectors: Commitment to Helping Underserved 
        Communities
    In March 2021, health insurance providers, led by AHIP and Blue 
Cross Blue Shield Association (BCBSA), committed to supporting a new 
effort to promote health equity by removing barriers to vaccinations 
for 2 million Americans most at risk of COVID-19 as quickly as 
possible.
    The Vaccine Community Connectors pilot initiative aims to enable 
the vaccination of 2 million seniors age 65+ in America's most at-risk, 
vulnerable, and underserved communities--such as communities whose 
residents are primarily African American or Hispanic. Insurance 
providers are focusing on their members and the communities they serve. 
They are working to reach this important goal quickly, depending upon 
the increasing availability of vaccine supply. Since our March 
announcement, this initiative has already expanded to focus on the 
needs of other vulnerable populations such as Medicaid enrollees.
    Improving health equity means setting important goals, removing 
barriers to better care, and meeting people where they are. As vaccine 
supplies expand and registrations become available, insurance providers 
are using combined expertise, data, and insights to:

   Identify seniors 65+ who are vulnerable to COVID-19 and who 
        live in areas where vaccination rates are most inequitable.

   Work with partners in the community to educate seniors on 
        the safety, efficacy, and value of COVID-19 vaccines.

   Contact those seniors who are eligible to get a vaccine 
        through multiple channels to facilitate vaccine registration 
        and appointment scheduling; answer questions about vaccines; 
        help them understand when, where, and how they can receive 
        vaccines and remind them about any required second doses; 
        coordinate services to help overcome barriers that may stand 
        between a person and getting vaccinated, including 
        transportation.

   Work with federal, state, and local leaders to deliver 
        vaccines to underserved communities and closely collaborate 
        with other vaccination partners, such as pharmacies.

   Track progress to ensure that those who need vaccinations 
        most are receiving them.

    Health insurance providers are using their data and analytics 
capabilities combining what they know about the people and communities 
they serve with government sources such as the Social Vulnerability 
Index--to help identify the 25 percent most vulnerable communities and 
to improve the accuracy and efficiency in the effort. By tailoring the 
outreach approach to each community, health insurance providers are 
better able to best meet unique community needs. For example, some 
communities may best be served by mobile clinics, language assistance, 
or a combination of interventions while others will benefit from health 
insurance providers who partner directly with ride share services to 
provide transportation to vaccine appointments at no cost to the 
member.
    But barriers to effectively improving vaccine rates in 
disadvantaged communities remain. The biggest drivers of inequitable 
vaccination rates in these communities include: lack of health 
infrastructure/access to vaccine; lack of data access to determine who 
has and has not been vaccinated to date; and burdensome scheduling. 
Health plans are actively partnering with provider organization and 
state and local leaders to break down these barriers. For example, 
Governor JB Pritzker and the Illinois Department of Public Health along 
with the health plans operating Illinois and supported by AHIP, BCBSA, 
Illinois Association of Medicaid Health Plans, and Illinois Life and 
Health Insurance Council, recently announced that Illinois will launch 
a Vaccine Community Connectors Program in the state to reduce COVID-19 
vaccination disparities.\1\ Participating health plans will execute on 
all of the commitments of the Vaccine Community Connectors program 
described above and the State of Illinois has:
---------------------------------------------------------------------------
    \1\ https://www2.illinois.gov/Pages/news-item.aspx?ReleaseID=23036

   Reserved weekly appointment slots at mass vaccination sites 
---------------------------------------------------------------------------
        for the plans to schedule vulnerable seniors;

   Provided health plans with links to the state's mass 
        vaccination site scheduling system to schedule members;

   Provided weekly access to data/analytics to support plan 
        outreach and identify target ZIP codes where seniors have not 
        been vaccinated; and

   As available, respond to requests for state mobile teams.

    This Illinois pilot demonstrates the critical importance of strong 
partnerships between the public sector and private market to address 
the needs of the people we both serve. Across the country, health 
insurance providers will rely on existing relationships with government 
and provider partners, their ability to build strong networks within 
communities and among community leaders, and make connections across 
the health care system to provide access for America's most vulnerable 
seniors.
Health Insurance Providers in Action
    Health insurance providers have increasingly focused their COVID-19 
actions to improve vaccine acceptance and access. Below are several 
examples of how AHIP member organizations are promoting quick, safe, 
and equitable vaccinations:

   Blue Shield of California launched ``Get it,'' an 
        advertising campaign to encourage all Californians to get 
        vaccinated--and protected--from COVID-19. Blue Shield of 
        California produced television and radio commercials in English 
        and Spanish, which aired in media markets across the state, 
        especially in communities most impacted by COVID-19.\2\
---------------------------------------------------------------------------
    \2\ https://news.blueshieldca.com/2021/02/22/blue-shield-of-
california-encourages-californians-to-get-vaccinated-for-covid-19

   Centene Corporation and several members of the Pro Football 
        Hall of Fame family are partnering to increase education and 
        awareness of COVID-19 vaccines through a series of new public 
        service announcements (PSA), to air nationally on television 
        networks and digital platforms. The PSAs will focus on 
        communities of color.\3\
---------------------------------------------------------------------------
    \3\ https://centene.gcs-web.com/news-releases/news-release-details/
centene-and-pro-football-hall-fame-team-tackle-concerns-over

   Health Net is sharing content on its social media tool kit 
        across channels to promote the Vaccinate All 58 social media 
        campaign in California. Health Net is using the opportunity to 
        let its members know that the vaccine is safe and effective.\4\
---------------------------------------------------------------------------
    \4\ https://www.facebook.com/HealthNetInc/photos/a.197141806989580/
3555098077860586/?type=3&theater

   SCAN Health Plan is offering members access to SCAN 
        TeleTalks, a series of large-scale conference calls addressing 
        the COVID-19 vaccine.\5\
---------------------------------------------------------------------------
    \5\ https://www.scanhealthplan.com/members/coronavirus-vaccine
---------------------------------------------------------------------------
Support for the Ad Council's National COVID-19 Vaccine Education Effort
    To further encourage equitable uptake, insurance providers leverage 
their role as trusted messengers of health information for their 
members. To help build trust across the country, AHIP contributed to 
the work of the Ad Council on a national communications effort to 
increase confidence in vaccination against COVID-19. Developed in 
partnership with the COVID Collaborative, the initiative will reach key 
audiences across the country through research-driven creative 
campaigns, strategic media placements, community outreach and trusted 
messenger engagement--representing one of the largest public education 
efforts in history.\6\
---------------------------------------------------------------------------
    \6\ https://www.prnewswire.com/news-releases/leading-corporations-
and-foundations-come-together-to-support-national-covid-19-vaccine-
education-effort-from-the-ad-council-and-covid-collaborative-
301206697.html
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    A critical part of the strategy includes developing coalitions and 
partnerships with leading non-profit, public health, civil rights, 
faith-based and community organizations. In light of systemic 
inequities that contribute to mistrust of vaccines among communities of 
color, special attention will be given to developing content tailored 
to reach and resonate with the Black and Hispanic communities, in 
alignment with the Vaccine Community Connector program.
    The campaign has been created in close partnership with the U.S. 
Department of Health and Human Services and the Centers for Disease 
Control and Prevention. AHIP joins dozens of other partners in the 
work, including Bank of America, Facebook, General Motors, Google and 
YouTube, World Wrestling Entertainment, the American Heart Association, 
and JPMorgan Chase.
Barriers to Promoting Information About the COVID-19 Vaccine
    While great strides have been made in increasing the supply of the 
COVID-19 vaccines, as described above, challenges still remain to the 
effective execution of these efforts to assure Americans are 
vaccinated.
    The biggest challenge health insurance providers face is knowing 
who has already been vaccinated. Because many people are being 
vaccinated in public health settings that do not submit invoices to 
health insurers, health insurance providers do not have complete 
records of the vaccinations of the people they serve. Despite the fact 
that health insurance providers are subject to HIPAA and routinely 
possess and protect health care information, they rarely are provided 
access Immunization Information Systems (IIS), which are independently 
run by states and jurisdictions. This incomplete information can result 
in fragmented care with the potential for confusion down the road (for 
instance, should individuals need booster shots to match the original 
dose or experience an adverse reaction).
    Universal access to state and local IIS's would help health 
insurance providers to more effectively reach the most vulnerable 
people who have not yet been vaccinated and provide them with important 
information about follow up care and treatment. Specifically, better 
information would allow health plans to identify which of their members 
in higher-risk groups and in the most vulnerable communities still need 
access to vaccines. Health plans can use the data to better target 
efforts to provide education and awareness, social media campaigns, and 
outbound calls to alert their members of when vaccines are available, 
how to schedule appointments, and when to get a second shot if it is 
needed.
    Vaccine misinformation and disinformation also remains a challenge. 
Health insurance providers are working to educate people who may be 
skeptical or fearful about the vaccines, inform them about the benefits 
of immunization and the potential dangers associated with COVID-19, and 
answer their questions.
    Although inconsistent state distribution and patient eligibility 
information have caused confusion, we are hopefully making our way past 
this issue. With increasing supply of vaccines, health plans stand 
ready to work across the health care system and with the public sector 
to get Americans vaccinated so that we can reach community immunity and 
get back to the moments we miss.
Conclusion
    Everyone deserves a fair and just opportunity to be as healthy as 
possible, especially as the Nation grapples with the COVID-19 crisis. 
We thank the members of the Subcommittee for your dedication to improve 
health equity through promoting reliable COVID-19 vaccine information. 
We look forward to working with Congress and the Administration to 
promote equity and improve health outcomes for all Americans.
                                 ______
                                 
     Prepared Statement of Carmen Scurato, Senior Policy Counsel; 
          Jessica J. Gonzalez, Co-CEO, Free Press Action Fund
    Chairman Lujan, Ranking Member Thune, and esteemed members of the 
subcommittee, thank you for accepting our written testimony for the 
record.
    Last week's hearing explored how we can try to ensure that people 
have accurate information about the coronavirus vaccine as we race to 
end the pandemic. Ensuring access to quality news and information about 
vaccine safety and COVID-19 related health information is urgent. Yet 
pandemic disinformation continues to flourish over social media and 
broadcast media too. Much has been made about Big Tech platforms' role 
in fueling the spread of vaccine disinformation, but sadly, they're not 
alone. Broadcasters also have spread false, unverified and misleading 
information about the vaccine and the pandemic. In addition to queries 
into Big Tech's role in spreading disinformation, we encourage the 
subcommittee to explore whether broadcasters have consistently served 
the public interest with accurate, timely, local news and information 
about the pandemic and the vaccine, and whether any broadcasters have 
violated the FCC's broadcast hoax rule by amplifying inaccurate claims 
about this public health emergency.
    What pivots are needed to ensure that everyone receives their 
``shot of truth'' on vaccine safety? What will accountability look like 
for media entities that exacerbate the public health crisis by 
spreading false information about it? As the subcommittee considers 
these questions, we suggest that it address three key challenges: (1) 
disinformation targeting and/or disproportionately impacting people of 
color; (2) disinformation flowing over Big Tech; and (3) disinformation 
over traditional media.
(1) Mitigating disinformation is critical to advancing public health 
        and safety for all and especially for communities of color.
    As researchers at Harvard's Shorenstein Center have explained, 
disinformation disrupts our access to timely, relevant, and accurate 
information.\1\ Indeed, the World Health Organization (``WHO'') itself 
has recognized that what it calls the ``infodemic'' presents a major 
barrier to combatting the pandemic. In a joint statement with the 
United Nations and international aid organizations, the WHO explained:
---------------------------------------------------------------------------
    \1\ See Letter from Joan Donavan et al., Technology and Social 
Change Team, Harvard Kennedy School, Shorenstein Center on Media, 
Politics and Public Policy, to Irene Khan, Special Rapporteur on the 
promotion and protection of the right to freedom of opinion and 
expression, United Nations (Feb. 15, 2021), https://
mediamanipulation.org/sites/default/files/2021-02/
Donovan%20et%20al%20TaSC%20Comment%20-%20FINAL.pdf.

        The Coronavirus disease (COVID-19) is the first pandemic in 
        history in which technology and social media are being used on 
        a massive scale to keep people safe, informed, productive and 
        connected. At the same time, the technology we rely on to keep 
        connected and informed is enabling and amplifying an infodemic 
        that continues to undermine the global response and jeopardizes 
---------------------------------------------------------------------------
        measures to control the pandemic.

        An infodemic is an overabundance of information, both online 
        and offline. It includes deliberate attempts to disseminate 
        wrong information to undermine the public health response and 
        advance alternative agendas of groups or individuals. Mis-and 
        disinformation can be harmful to people's physical and mental 
        health; increase stigmatization; threaten precious health 
        gains; and lead to poor observance of public health measures, 
        thus reducing their effectiveness and endangering countries' 
        ability to stop the pandemic.\2\
---------------------------------------------------------------------------
    \2\ See Joint Statement by WHO, UN, UNICEF, UNDP, UNESCO, UNAIDS, 
ITU, UN Global Pulse, and IFRC, Managing the COVID-19 infodemic: 
Promoting healthy behaviours and mitigating the harm from 
misinformation and disinformation (Sept. 2020), https://www.who.int/
news/item/23-09-2020-managing-the-covid-19-infodemic-promoting-healthy-
behaviours-and-mitigating-the-harm-from-misinformation-and-
disinformation.

    Many of the countless COVID-19 disinformation campaigns woven with 
conspiracy theories, half-truths, and lies are surgically designed to 
target Black, Latinx, AAPI, Indigenous, and other communities of color. 
More generally the flood of disinformation has spurred the 
politicization of various community safety regulations, like mask-
wearing and social distancing. This has weakened our communal response 
to the pandemic, where we continue to observe massive infection and 
death rates, disproportionately affecting communities of color.
    Both online platforms and broadcasters have shirked responsibility 
and accountability for their roles in spreading dangerous 
disinformation. Policymakers must examine how this entire corporate 
media ecosystem works in concert to distort facts and spread deadly 
lies. Understanding how disinformation is disseminated across the media 
landscape is critical to achieving the goals outlined for the hearing, 
of providing truthful and accurate information about the pandemic and 
encouraging people to get vaccinated.
(2) Big Tech has failed to adequately rein in pandemic disinformation, 
        especially in non-English languages.
    Big Tech's hate-and-lie-for-profit business model has built 
algorithmic systems that prop up lies and recommend groups for people, 
amplifying and recommending content that often steers people toward 
conspiracy theories and false information about COVID, vaccines, and a 
wide range of other important topics like the election. Predominant 
vaccine disinformation remains up on several platforms, with phony 
claims that vaccines cause dire side effects (including but not limited 
to cancer and infertility) and that they include a microchip tracker. 
Online platforms have every incentive to maximize profit by keeping 
people engaged, and have chosen time after time to leave up hateful and 
deceitful content that spurs enragement and keeps people glued to their 
screens instead of promptly taking down such wild disinformation. For 
instance, even in the face of massive public pressure campaigns--such 
as the Stop Hate For Profit campaign that Free Press helped organize 
last year, and which resulted in more than 1,100 advertisers pausing 
advertising on Facebook in July in protest of rampant hate and 
disinformation on the site--hate and disinformation continue to 
flourish on Facebook.
    Although most online platforms have updated their policies to 
address COVID-19 related mis-and disinformation, their enforcement 
efforts have been lackluster across the board, and especially in 
languages other than English.\3\ Recent studies have revealed how a 
small group of accounts are responsible for the majority of Covid-
related disinformation spread across social media platforms.\4\ And in 
the absence of a more comprehensive approach to remove disinformation 
instead of amplifying it, COVID vaccine conspiracies have continued to 
spread far and wide on their sites. People of color, women, religious 
minorities and others have repeatedly and outspokenly called for better 
content moderation to tamp down hate and lies. That is why Change the 
Terms--a coalition of more than 60 leading racial justice, civil 
rights, human rights and digital rights groups, co-led by Free Press--
has been calling on platforms to adopt comprehensive model policies to 
disrupt hate and disinformation on their sites.\5\ To date, not one 
social media company has adopted those policies in full.
---------------------------------------------------------------------------
    \3\ There are daily instances of Spanish-language COVID-19 
misinformation traveling across online platforms and closed messaging 
apps over the last several months. For example, one such post listing 
false vaccine side effects such as infertility and cancer was shared on 
Telegram and in several Facebook groups, such as ``Cree en Cristo'' and 
``LOS ULTIMOS DIAS Y SENALES DEL FIN.'' Another article from a site 
called Abre Los Ojos claimed that 200 German scientists came out in 
opposition to the COVID-19 vaccine was also shared on both Telegram and 
Facebook. And a video from a prominent physician claimed that 
``mandatory vaccinations'' are deemed ``genetic experiments.''
    \4\ See ``The Disinformation Dozen: Why Platforms Must Act on 
Twelve Leading Online Anti-Vaxxers,'' Center for Countering Digital 
Hate (Mar. 2021), https://www.counterhate.com/disinformationdozen; 
David Klepper, Farnoush Amiri & Beatrice Dupuy, ``The superspreaders 
behind top COVID conspiracy theories,'' AP News (Feb. 15, 2021), 
https://apnews.com/article/conspiracy-theories-iran-only-on-ap-media-
misinformation-bfca6d5b236a29d61c4dd38702495ffe.
    \5\ See generally ``Recommended Internet Company Corporate Policies 
And Terms of Service To Reduce Hateful Activities,'' Change the Terms, 
https://assets.website-files.com/5bba6f4828dfc
3686095bf6b/
5bd0e36186e28d35874f0909_Recommended%20Internet%20Company%20Corporate
%20Policies%20%20Terms%20of%20Service_final-10-24.pdf (last visited 
Apr. 14, 2021).
---------------------------------------------------------------------------
    Facebook, as the largest online platform on earth, merits special 
attention. A recent poll from Voto Latino and Media Matters found that 
misinformation around COVID-19 plays a critical role in vaccine 
hesitancy among the Latinx community, where 51 percent of Latinx 
respondents said they would not get vaccinated, with the number rising 
to 67 percent in Spanish-speaking households.\6\ Additionally, based on 
the sample of respondents, the poll found that ``[t]he main source of 
this information is Facebook: 49 percent say this is where they saw the 
material. The second most common source of this information is local 
news (39 percent).'' \7\
---------------------------------------------------------------------------
    \6\ See ``LADL: Nationwide Poll on COVID Vaccine,'' Voto Latino & 
Media Matters for America (Apr. 21, 2021), https://votolatino.org/
media/press-releases/polloncovid/.
    \7\ See id.
---------------------------------------------------------------------------
    Free Press has worked with the National Hispanic Media Coalition 
and the Center for American Progress to confront Facebook about rampant 
Spanish-language disinformation across the many platforms it owns. 
Together, our groups surfaced dozens of examples of Spanish-language 
content that should have triggered immediate removal from Facebook--in 
some instances we saw that the English version of the comment was 
removed, while almost identical content remained up in Spanish.\8\ In 
mid-March of this year, after Facebook's repeated failure to solve this 
problem, we launched #YaBastaFacebook,\9\ a campaign to combat Spanish-
language disinformation. We demanded that Facebook:
---------------------------------------------------------------------------
    \8\ See generally Jessica Cobian, Carmen Scurato & Brenda Castillo, 
Opinion, ``Facebook and the Disinformation Targeting Latinx 
Communities,'' Colorlines (Mar. 19, 2021), https://www.colorlines.com/
articles/op-ed-facebook-and-disinformation-targeting-latinx-
communities.
    \9\ See Spanish Language Disinformation Action Plan--
#YaBastaFacebook, Real Facebook Oversight Board (Mar. 16, 2021), 
https://rfob.medium.com/spanish-language-disinformation-action-plan-
yabastafacebook-29e905c885eb.

  1.  Hire an executive in the United States to oversee Spanish-
---------------------------------------------------------------------------
        language content moderation

  2.  Share how many Spanish-language content moderators it employs, 
        and what training they receive; and

  3.  Clarify why its translation algorithms consistently fail to 
        capture the nuance in Spanish-language, literally losing 
        dangerous and explicit vaccine lies in translation.
To date, Facebook has failed to respond to these requests.
    Social media platforms have demonstrated, both through insufficient 
action and outright inaction in many instances, that self-regulation 
alone will not be enough to curtail dangerous disinformation online. We 
are encouraged that Congress is gathering information about the spread 
of disinformation and considering steps to regulate or ban abusive data 
practices and discriminatory targeting.
(3) Some traditional media outlets, including broadcasters, have also 
        played a significant role in spreading disinformation about the 
        COVID-19 vaccine.
    Mega-media conglomerates like Fox News\10\ and Sinclair Broadcast 
Group,\11\ as well as cable channels like One America News Network,\12\ 
are also regular purveyors of COVID-19 disinformation. In the past year 
they have all spread dangerous conspiracies about the pandemic and 
vaccines. And as the Voto Latino/Media Matters poll seems to indicate, 
vaccine disinformation is prominent over broadcast media and results in 
vaccine hesitancy.\13\
---------------------------------------------------------------------------
    \10\ See Media Matters for America, Fox News, https://
www.mediamatters.org/search?search=
Fox+News (last visited Apr. 22, 2021).
    \11\ See Media Matters for America, Sinclair Broadcast Group, 
https://www.mediamatters.org/search?search=Sinclair+Broadcast+Group 
(last visited Apr. 22, 2021).
    \12\ See Media Matters for America, One America News Network, 
https://www.media
matters.org/search?search=OAN (last visited Apr. 22, 2021).
    \13\ ``LADL: Nationwide Poll on COVID Vaccine,'' Voto Latino & 
Media Matters for America (Apr. 21, 2021), https://votolatino.org/
media/press-releases/polloncovid/.
---------------------------------------------------------------------------
    We urge this subcommittee to grapple with the serious challenges 
presented by mainstream media outlets propping up pandemic lies too. 
For instance, what responsibility do broadcasters have to serve the 
public interest by providing accurate information during an emergency 
situation, like this pandemic? What can broadcasters do to ensure that 
they provide the public with reliable and truthful information about 
vaccines and other measures to prevent the spread of COVID-19? As we 
move forward, should the FCC issue guidance to broadcasters on their 
role to stop broadcasting hoaxes about the pandemic during this time of 
national emergency? Should cable subscribers have a choice about 
whether to subsidize Fox News' pandemic lies?
    Free Press raised some of these questions over a year ago in an 
Emergency Petition for Inquiry\14\ to the FCC, requesting that the 
agency launch an investigation into the broadcast of false information 
about COVID-19, disinformation about public health measures and 
untested ``cures'' and home remedies.\15\ We observed that myriad radio 
and television broadcasters were airing false and misleading 
information about COVID-19, and that such content was being aired 
without the necessary context or disclaimers\16\ contemplated by the 
FCC's broadcast hoax rule.\17\
---------------------------------------------------------------------------
    \14\ See Free Press Emergency Petition for Inquiry Into Broadcast 
of False Information on COVID-19 (filed Mar. 26, 2020), https://
www.freepress.net/sites/default/files/2020-03/
free_press_petition_for_inquiry_to_fcc_re_broadcast_misinformation.pdf.
    \15\ See Theresa Waldrop, Dave Alsup & Eliott C. McLaughlin, 
``Fearing coronavirus, Arizona man dies after taking a form of 
chloroquine used to treat aquariums,'' CNN (Mar. 25, 2019), https://
www.cnn.com/2020/03/23/health/arizona-coronavirus-chloroquine-death/
index.html.
    \16\ At the time of our Emergency Petition for Inquiry, television 
and radio stations across the country were airing context-less coverage 
of former President Donald Trump's press conferences where he propped 
up fake cures and falsely claimed that ``like a miracle'' the virus 
would ``just disappear.'' See, e.g., Parker Molloy, ``Why can't 
mainstream media stop echoing Trump's coronavirus misinformation?'', 
Media Matters for America (Mar. 15, 2020), https://www.
mediamatters.org/coronavirus-covid-19/why-cant-mainstream-media-stop-
echoing-trumps-corona
virus-misinformation; David Leonhardt, ``Complete List of Trump's 
Attempts to Play Down Coronavirus,'' N.Y. Times (Mar. 15, 2020), 
https://www.nytimes.com/2020/03/15/opinion/trump-coronavirus.html; 
Daniel Dale and Tara Subramaniam, ``Trump made 33 false claims about 
the coronavirus crisis in the first two weeks of March,'' CNN (Mar. 22, 
2020), https://www.cnn.com/2020/03/22/politics/fact-check-trump-
coronavirus-false-claims-march/index.
html.
    \17\ When the Commission adopted in 1992 its rule against broadcast 
hoaxes, it weighed the public interest obligations of its licensees 
against their First Amendment rights and concluded that ``the 
government has a compelling interest in preventing substantial public 
harm, such as the substantial diversion of police and emergency 
resources from their duties,'' further noting that ``the First 
Amendment does not preclude civil liability for broadcasts that create 
a foreseeable risk of personal injury.'' Amendment of Part 73 Regarding 
Broadcast Hoaxes, MM Docket No. 91-314, Report and Order, 7 FCC Rcd 
4106,  10-11 (1992), https://docs.fcc.gov/public/attachments/FCC-92-
208A1.pdf.
---------------------------------------------------------------------------
    The FCC's broadcast hoax rule requires that broadcasters not air 
``false information concerning a crime or catastrophe if: (a) The 
licensee knows this information is false; (b) It is foreseeable that 
broadcast of the information will cause substantial harm, and; (c) 
Broadcast of the information does in fact directly cause substantial 
public harm.'' \18\ Nonetheless, in the throes of the pandemic, the 
Trump-era FCC denied our emergency petition and declined to issue 
guidance on how broadcast disinformation may run afoul of the broadcast 
hoax rule.\19\ Unsurprisingly then, pandemic disinformation endures in 
broadcast radio and television. For example, Sinclair Broadcast Group 
recently aired a segment attacking lockdowns and downplaying the 
lethality of COVID-19,\20\ while radio hosts state they are hesitant to 
take the vaccine and promote anti-vaccine misinformation.\21\ Just as 
they have when it comes to social media, we encourage members of this 
subcommittee to interrogate: the role that broadcasters played and 
continue to play in airing information about COVID-19, whether their 
actions are adhering to their mandate to serve the public interest, and 
what the FCC can do to stop the spread of deadly disinformation.
---------------------------------------------------------------------------
    \18\ 47 C.F.R. Sec. 73.1217.
    \19\ See ``FCC Defends 1st Amendment and Denies Petition filed by 
Free Press,'' (Apr. 6, 2020), https://www.fcc.gov/document/fcc-defends-
1st-amendment-and-denies-petition-filed-free-press.
    \20\ See Zachary Pleat, ``Sinclair's Full Measure attacks lockdowns 
while downplaying the lethality of COVID-19 and promoting a strategy of 
widespread infection,'' Media Matters for America (Feb. 9, 2021), 
https://www.mediamatters.org/coronavirus-covid-19/sinclairs-full-
measure-attacks-lockdowns-while-downplaying-lethality-covid-19. The 
segment aired on a show called ``Full Measure with Sharyl Attkisson'' 
which according to the show's website broadcast to 43 million 
households in 79 markets on 162 Sinclair Broadcast Group stations.
    \21\ See Alex Walker, ``Some states are confronting vaccine 
hesitancy. These local radio hosts aren't helping,'' Media Matters for 
America (Mar. 23, 2021), https://www.mediamatters.org/coronavirus-
covid-19/some-states-are-confronting-vaccine-hesitancy-these-local-
radio-hosts-arent.
---------------------------------------------------------------------------
Conclusion
    Free Press Action looks forward to working with this subcommittee 
to evaluate whether and how traditional and social media platforms are 
disseminating accurate vaccine safety and COVID-health-related 
information, and to recommend any appropriate interventions to ensure 
that all Americans have trustworthy vaccine information. Thank you.
                                 ______
                                 
            Prepared Statement of Media Matters for America
    Dear Chairman Ben Ray Lujan and Ranking Member John Thune, and 
Members of the Committee,

    Media Matters for America is a 501(c3) media watchdog and research 
information center. We work daily to document how misinformation and 
disinformation spread within the U.S. media and online.
    The COVID-19 pandemic has been catastrophic for American citizens, 
killing upward of half a million people. The COVID-19 vaccines, which 
have been called the key to achieving herd immunity, have become 
targets of bad actors who aim to spread dangerous and misleading 
misinformation to devalue and undermine their effectiveness.\1\
---------------------------------------------------------------------------
    \1\ University of Missouri Health Care, ``COVID-19 Vaccine Key to 
Reaching `Herd Immunity,'' September 21, 2020, https://
www.muhealth.org/our-stories/covid-19-vaccine-key-reaching-herd-
immunity
---------------------------------------------------------------------------
    The right-wing media have been a pivotal force in pushing the lie 
that COVID-19 vaccines do not work or are dangerous. The leading 
misinformer has been Fox News, which spent 2020 recklessly minimizing 
the pandemic as it took the lives of hundreds of thousands of 
Americans.\2\ The network spent months putting the health of millions 
of Americans at risk thanks to the symbiotic relationship between Fox 
and the Trump White House.\3\
---------------------------------------------------------------------------
    \2\ Matt Gertz, Media Matters for America, ``Misinformer of the 
Year: Fox News,'' December 30, 2020, https://www.mediamatters.org/fox-
news/misinformer-year-fox-news
    \3\ Ibid.
---------------------------------------------------------------------------
    Fox News promoted coronavirus misinformation an estimated 13,551 
times on its weekday programs from February to December 2020.\4\ The 
network's hosts and guests also promoted unproven treatments like 
hydroxychloroquine nearly 300 times during a two-week span and ran at 
least 1,001 segments that undermined coronavirus health measures over a 
three-month period in 2020.\5\ \6\
---------------------------------------------------------------------------
    \4\ Ibid.
    \5\ Lis Power and Rob Savillo, Media Matters for America, ``Fox 
News has promoted hydroxychloroquine nearly 300 times in a two-week 
period,'' April 7, 2020, https://www.media
matters.org/fox-news/fox-news-has-promoted-hydroxychloroquine-nearly-
300-times-two-week-period
    \6\ Matt Gertz, Media Matters for America, ``Misinformer of the 
Year: Fox News,'' December 30, 2020, https://www.mediamatters.org/fox-
news/misinformer-year-fox-news
---------------------------------------------------------------------------
    The key purveyors of this misinformation include Fox News prime-
time hosts Laura Ingraham and Tucker Carlson, who have repeatedly 
questioned vaccine effectiveness throughout their development and 
rollout, in addition to hosting guests with reputations for being 
stringent vaccination opponents. Carlson and the guests on his 
programs, Tucker Carlson Tonight and Tucker Carlson Today, have 
repeatedly cast doubt on vaccine efficacy--to the point that Dr. 
Anthony Fauci, President Joe Biden's chief medical adviser, has said 
Carlson's comments amount to a ``crazy conspiracy theory.'' \7\ As 
recently as April 13, Carlson claimed that the COVID vaccine ``doesn't 
work and they're simply not telling you that.'' \8\
---------------------------------------------------------------------------
    \7\ Media Matters Staff, Media Matters for America, ``Dr. Fauci on 
Tucker Carlson's vaccine comments: `That's just a typical crazy 
conspiracy theory,' '' April 14, 2021, https://www.media
matters.org/coronavirus-covid-19/dr-fauci-tucker-carlsons-vaccine-
comments-thats-just-typical-crazy-conspiracy
    \8\ Media Matters Staff, Media Matters for America, ``Tucker 
Carlson speculates the COVID vaccine `doesn't work and they're simply 
not telling you that,' '' April 13, 2021, https://www.mediamatters.org/
fox-news/tucker-carlson-speculates-covid-vaccine-doesnt-work-and-
theyre-simply-not-telling-you
---------------------------------------------------------------------------
    Carlson, as well as frequent Fox guest Alex Berenson--whom The 
Atlantic dubbed ``The Pandemic's Wrongest Man'' and various other 
right-wing figures across platforms also jumped on the temporary pause 
in distribution in the Johnson & Johnson vaccine after six recipients 
experienced rare blot clots.\9\ \10\ The pause was initiated partly to 
make sure health care providers were prepared to treat this 
condition.\11\ But Carlson took it as an opportunity to claim that the 
vaccine was more dangerous than previously thought and possibly even 
ineffective.\12\ Berenson suggested other vaccination campaigns (Pfizer 
and Moderna) also be halted.\13\
---------------------------------------------------------------------------
    \9\ Derek Thompson, The Atlantic, ``The Pandemic's Wrongest Man,'' 
April 1, 2021, https://www.theatlantic.com/ideas/archive/2021/04/
pandemics-wrongest-man/618475/
    \10\ Alex Walker, Media Matters for America, ``Johnson & Johnson 
vaccine pause fuels anti-vax rhetoric from right-wing media,'' April 
14, 2021, https://www.mediamatters.org/coronavirus-covid-19/johnson-
johnson-vaccine-pause-fuels-anti-vax-rhetoric-right-wing-media
    \11\ Carolyn Y. Johnson, Laurie McGinley, Lena H. Sun, and 
Christopher Rowland, The Washington Post, ``FDA, CDC call for pause in 
use of Johnson & Johnson vaccine after `extremely rare' cases of blood 
clots,'' April 13, 2021, https://www.washingtonpost.com/health/2021/04/
13/johnson-and-johnson-vaccine-blood-clots/
    \12\ Alex Walker, Media Matters for America, ``Johnson & Johnson 
vaccine pause fuels anti-vax rhetoric from right-wing media,'' April 
14, 2021, https://www.mediamatters.org/coronavirus-covid-19/johnson-
johnson-vaccine-pause-fuels-anti-vax-rhetoric-right-wing-media
    \13\ Alex Berenson, Twitter, April 13, 2021, https://twitter.com/
AlexBerenson/status/138193
2310426189829?s=20
---------------------------------------------------------------------------
    Fox News is not the only force spreading COVID-19 misinformation. 
This misinformation often originates and is spread throughout social 
media via right-wing political pundits and activists, including right-
wing ministry Daystar Television, MyPillow CEO Mike Lindell, and former 
Donald Trump adviser Steve Bannon.\14\ \15\ \16\ \17\ Despite 
continuing insistence from the social media platforms that they have 
COVID-19 misinformation under control, misinformation is found on 
almost every platform, including but not limited to TikTok, Instagram, 
Facebook, and Twitter.\18\ \19\ \20\ \21\
---------------------------------------------------------------------------
    \14\ Timothy Johnson, Media Matters for America, ``Anti-vaccine 
ministry uses Facebook to promote dangerous COVID-19 and vaccine 
falsehoods to millions followers,'' March 18, 2021, https://
www.mediamatters.org/facebook/anti-vaccine-ministry-uses-facebook-
promote-dangerous
-covid-19-and-vaccine-falsehoods
    \15\ Media Matters Staff, Media Matters for America, ``My Pillow 
CEO Mike Lindell refers to the COVID-19 vaccine as the `mark of the 
beast,' '' March 11, 2021, https://www.media
matters.org/steve-bannon/my-pillow-ceo-mike-lindell-refers-covid-19-
vaccine-mark-beast
    \16\ Rhea Bhatnagar, Media Matters for America, ``Right-wing 
media's focus on abortion may stop people from getting vaccines,'' 
March 9, 2021, https://www.mediamatters.org/coronavirus-covid-19/right-
wing-medias-focus-abortion-may-stop-people-getting-vaccines
    \17\ Media Matters Staff, Media Matters for America, ``Steve Bannon 
says coronavirus vaccines are `not technically vaccines' but 
`experimental gene therapies,' '' March 15, 2021, https://
www.mediamatters.org/steve-bannon/steve-bannon-says-coronavirus-
vaccines-are-not-technically-vaccines-experimental-gene
    \18\ Olivia Little and Chloe Simon, Media Matters for America, 
``TikTok's massive COVID-19 and vaccine misinformation failure,'' March 
12, 2021, https://www.mediamatters.org/tiktok/tiktoks-massive-covid-19-
and-vaccine-misinformation-failure
    \19\ Spencer Silva, Media Matters for America, ``Vaccine 
misinformation still runs wild on Instagram,'' March 23, 2021, https://
www.mediamatters.org/coronavirus-covid-19/vaccine-misinformation-still-
runs-wild-instagram
    \20\ Timothy Johnson, Media Matters for America, ``Right-wing 
ministry continues to use Facebook to dispense deadly COVID-19 and 
vaccine misinformation to millions of followers,'' March 29, 2021, 
https://www.mediamatters.org/coronavirus-covid-19/right-wing-ministry-
continues-use-facebook-dispense-deadly-covid-19-and
    \21\ Kayla Gogarty, Media Matters for America, ``Fake `vaccination 
exemption' cards are being promoted on Twitter, despite its policy 
against COVID-19 vaccine misinformation,'' March 8, 2021, https://
www.mediamatters.org/twitter/fake-vaccination-exemption-cards-are-
being-promoted-twitter-despite-its-policy-against
---------------------------------------------------------------------------
    In particular, video streaming site YouTube has been a breeding 
ground for COVID-19 and vaccine conspiracy theories throughout the 
pandemic. In February, a video from a conspiracy theory-filled series 
titled Planet Lockdown gained over 20 million views between Facebook 
and YouTube. The video features Catherine Austin Fitts, a former 
assistant secretary of housing and urban development under President 
George H.W. Bush and an anti-vaxxer, who makes the false accusation 
that the COVID vaccine will modify a recipient's DNA and make them 
infertile.\22\ \23\
---------------------------------------------------------------------------
    \22\ Alex Kaplan, Media Matters for America, ``YouTube and Facebook 
allowed another COVID-19 conspiracy theory video to go viral,'' 
February 8, 2021, https://www.mediamatters.org/coronavirus-covid-19/
youtube-and-facebook-allowed-another-covid-19-conspiracy-theory-video-
go-viral
    \23\ Beatrice Dupuy, Associated Press, ``No evidence that COVID-19 
vaccine results in sterilization,'' December 8, 2020, https://
apnews.com/article/fact-checking-afs:Content:9856420671
---------------------------------------------------------------------------
    Facebook is also notorious for profiting from and enabling the 
spread of dangerous COVID misinformation--as well as fomenting anti-
lockdown, anti-vaccine forces. Right-leaning Facebook pages have 
contributed to the spread of COVID-19 misinformation. Media Matters 
found at least 7,300 Facebook posts from right-leaning pages with 
keywords related to COVID-19 and vaccine misinformation between June 1, 
2020, and February 28, 2021. As COVID-19 vaccines were granted 
emergency use authorization between December 1, 2020, and February 28, 
2021, there were at least 1,900 Facebook posts from right-leaning pages 
with keywords related to COVID-19 and vaccine misinformation.
    In April 2020, Facebook announced that ``events that defy 
government's guidance on social distancing'' wouldn't be allowed on 
Facebook. Facebook's actions came after the creation of more than 100 
state-specific Facebook groups to protest stay-at-home orders across 
the country.\24\ These groups and affiliated Facebook pages organized 
at least 49 different events.\25\ Through the course of the pandemic, 
Facebook has repeatedly allowed its users to organize in opposition of 
public health measures aimed at curbing the spread of the virus.
---------------------------------------------------------------------------
    \24\ Brandy Zadrozny, NBC News, ``Facebook removes some events 
calling for protests of stay-at-home orders,'' April 20, 2020, https://
www.nbcnews.com/tech/tech-news/facebook-removes-some-events-calling-
protests-stay-home-orders-n1187811
    \25\ Kayla Gogarty, Media Matters for America, ``Facebook says it 
removed events violating stay-at-home orders. But, it hasn't removed 
them,'' April 22, 2020, https://www.media
matters.org/coronavirus-covid-19/facebook-says-it-removed-events-
violating-stay-home-orders-it-hasnt-removed
---------------------------------------------------------------------------
    In addition, Facebook has been slow to curb the spread of dangerous 
medical misinformation targeting COVID-19 vaccines. For instance, Media 
Matters also discovered an anti-vaccine Facebook group and a network of 
17 state-specific groups spreading harmful coronavirus conspiracy 
theories and misinformation.\26\ This misinformation included false 
claims that COVID-19 is no different from the flu and that wearing 
masks increases the chances of getting the virus.
---------------------------------------------------------------------------
    \26\ Kayla Gogarty, Media Matters for America, ``A network of anti-
vaccine Facebook groups is a hotbed for coronavirus conspiracy theories 
and medical misinformation,'' May 11, 2020, https://
www.mediamatters.org/coronavirus-covid-19/network-anti-vaccine-
facebook-groups-hotbed-coronavirus-conspiracy-theories
---------------------------------------------------------------------------
    These misinformation narratives also often circulate on fringe or 
far-right extremist platforms including Telegram, 4chan, Gab, and 
Patriots.win. These platforms have less stringent moderation than their 
mainstream counterparts, allowing misinformation regarding vaccines to 
spread unchallenged. This makes the Internet dangerous territory for 
anyone in search of factual information pertaining to the pandemic and 
the corresponding vaccines.
            Sincerely,
                                             Media Matters for America.
                                 ______
                                 
     Prepared Statement of Tara Kirk Sell, PhD, MA, Senior Scholar;
     Marc Trotochaud, MSPH, Senior Analyst; Divya Hosangadi, MSPH,
    Senior Analyst; Ellie Smith, MSPH, Graduate Research Assistant;
                Johns Hopkins Center for Health Security
            Johns Hopkins Bloomberg School of Public Health
    Chairman Lujan, Ranking Member Thune, and members of the committee:

    Thank you for inviting us to provide written testimony to the 
committee on the problem of communicating trusted vaccine information. 
This is a critical component of ending the COVID-19 pandemic and 
returning to normalcy. Our testimony will focus on ways to improve 
communication around COVID-19 vaccines and ways to combat health-
related misinformation and disinformation during the COVID-19 pandemic 
and future public health emergencies. The topic of this hearing is 
critical, and we commend the subcommittee for taking this on. The 
timing is also important. As we now attempt to reach every eligible 
American 16 years or older with a vaccine, we know that even the most 
effective vaccine cannot work if people, misled by rumor and 
falsehoods, are too afraid to take it.
    Our group is made up of researchers experienced in risk 
communication and analysis of misinformation and disinformation. The 
opinions expressed herein are our own and do not necessarily reflect 
the views of the Johns Hopkins University. Dr. Tara Kirk Sell is an 
Assistant Professor in the Department of Environmental Health and 
Engineering at the Johns Hopkins Bloomberg School of Public Health and 
is a Senior Scholar at the Johns Hopkins Center for Health Security. 
Marc Trotochaud and Divya Hosangadi are Research Associates in the 
Department of Environmental Health and Engineering at the Johns Hopkins 
Bloomberg School of Public Health and Senior Analysts at the Johns 
Hopkins Center for Health Security. Ellie Smith is a Graduate Research 
Assistant at the Johns Hopkins Center for Health Security. The Center 
for Health Security's mission is to protect people's health from major 
epidemics and disasters and build resilience. We study the 
organizations, systems, and tools needed to prepare and respond to 
these events.
    Our testimony is founded on expertise gained through extensive 
research on pandemic preparedness and public health risk communication. 
We believe the problem of health-related misinformation and 
disinformation and the need for clear, consistent communication that 
encourages COVID-19 vaccination have been provided by hearing 
witnesses. Therefore, in this testimony we focus on practical solutions 
that may help to improve communication about vaccination and reduce 
health-related misinformation and disinformation. Additional research 
into these topics is important. There is still a great amount to be 
learned about COVID-19 vaccine hesitancy and misinformation that will 
help our country to improve the response to both COVID-19 and future 
threats.
Risk communication needs
    The communication landscape around the COVID-19 pandemic and 
multiple COVID-19 vaccines is dynamic and the information needs of 
communities across the country are broad and multifaceted. Messaging 
around vaccines and vaccination must appeal to a range of populations 
with different needs, concerns, and barriers to getting a vaccine. 
Recent polling from Pew Research Center and the Kaiser Family 
Foundation suggests that COVID-19 vaccine hesitancy may stem from a 
lack of confidence and trust around the vaccine and the development 
process.i,ii Though the COVID-19 
vaccination campaign has received high levels of support from large 
portions of the country, with many valuing the demonstrated benefits of 
vaccination, it is likely that this initial response will dwindle, 
requiring active communication to encourage further vaccination of the 
U.S. population. Parts of the country are already facing a decline in 
interest in and rates of vaccination, leading to challenges in meeting 
adequate population coverage and increasing the risk of wasted 
vaccines.iii
---------------------------------------------------------------------------
    \i\ Cary Funk and Alec Tyson, ``Growing Share of Americans Say They 
Plan To Get a COVID-19 Vaccine--or Already Have,'' Pew Research Center 
Science & Society. April 6, 202. Available at: https://
www.pewresearch.org/science/2021/03/05/growing-share-of-americans-say-
they-plan
-to-get-a-covid-19-vaccine-or-already-have/.
    \ii\ Lunna Lopes Liz Hamel, ``KFF COVID-19 Vaccine Monitor: March 
2021,'' KFF, March 30, 2021. Available at: https://www.kff.org/
coronavirus-covid-19/poll-finding/kff-covid-19-vaccine-monitor-march-
2021/.
    \iii\ Bracey Harris and Nigel Chiwaya, ``States See Rise in Unused 
Vaccines as Demand Flattens, Shifting Focus to Hesitancy,'' NBCNews.com 
(NBCUniversal News Group, April 17, 2021), https://www.nbcnews.com/
news/us-news/states-see-rise-unused-vaccines-demand-flattens-shifting-
focus-hesitancy-n1264346.
---------------------------------------------------------------------------
    Effective risk communication about COVID-19 vaccines should be a 
tailored and iterative process. The first step in addressing vaccine 
hesitancy is to identify the groups of people within the country who 
are experiencing vaccine hesitancy. Recent polling suggests that the 
gap between White Americans and Black Americans is closing but that 
there is still room for improvement, along with focused attention to 
Hispanic populations, rural populations, White Evangelicals, and 
Republicans.i,ii Crafting communication messages for those 
who are already enthusiastic about getting the vaccine or those who 
adamantly object to the COVID-19 vaccine is not an efficient pathway 
toward reaching desired levels of vaccination coverage. Instead, 
focusing on those who may be open to vaccination but are undecided or 
face barriers to accessing a vaccine is critical. Additional 
information on the unique barriers and hesitations of different 
communities can be better understood through activities like polling 
and reporting from on-the-ground stakeholders and working with local 
communities. Local groups within communities can interface most 
effectively to identify those who may be vaccine hesitant. Prioritizing 
work to tap into, and support, these ongoing efforts will provide 
frameworks for future communication and avoid duplicative efforts.
    Existing broad communication campaigns have sought to provide 
information on common vaccine misconceptions. These campaigns have 
included trusted messengers, increasing the chances of overcoming 
uncertainty around COVID-19 vaccines. Additionally, multiple efforts 
from the Federal government and partners have designed public service 
announcements, using celebrities or well-known public figures to raise 
awareness of the 
vaccine.iv,v,vi 
While there is value in large-scale communication campaigns, it is 
important to continue to support other, more local or community-
specific organizations to do this outreach and communication work. 
Community organizations are better equipped to work with local 
populations due to time already invested in the community, longstanding 
relationships that increase trust, and their commitment to providing 
lasting support within the community. The American Rescue Plan has 
taken several substantive steps to provide funding for public health 
communication. The bill supports the CDC's communication effort around 
the COVID-19 vaccine and outreach activities through community health 
organizations. Additional funding has been allocated for local health 
departments, which could be used to support vaccine communication 
efforts.
---------------------------------------------------------------------------
    \iv\ ``COVID-19 Vaccination Communication Toolkit for Health 
Systems and Clinics,'' Centers for Disease Control and Prevention 
(Centers for Disease Control and Prevention, December 21, 2020), 
https://www.cdc.gov/vaccines/covid-19/health-systems-communication-
toolkit.html.
    \v\ ``COVID-19 Vaccine Education Initiative,'' Ad Council Org, 
accessed April 19, 2021, https://www.adcouncil.org/covid-vaccine.
    \vi\ Paul LeBlanc, ``Biden and Obama Urge Americans to Get 
Vaccinated in Star-Studded Television Special,'' CNN (Cable News 
Network, April 19, 2021), https://www.cnn.com/2021/04/18/politics/
biden-obama-covid-vaccine-roll-up-your-sleeves/index.html.
---------------------------------------------------------------------------
    An ongoing effort led by the Johns Hopkins Center for Health 
Security and Texas State University's Department of Anthropology is one 
example of a research collaborative working on a national plan to 
address these COVID-19 vaccination concerns in local populations across 
the country. The CommuniVax coalition\1\ (https://www.communivax.org/) 
has brought together a multidisciplinary team of researchers and a 
network of local partners conducting rapid ethnographic research to 
inform policy on an equitable and effective COVID-19 vaccination 
campaign. The project's first action plan compiled evidence-based 
advice on how local and state jurisdictions could ensure that their 
vaccination effort does not leave parts of the population behind. The 
group is scheduled to produce two additional reports, one sharing 
insights from community research of seven local teams working across 
the United States and the other on longitudinal pathways for a more 
equitable public health system. This, and similar efforts across the 
country, provide guidance for a Federal communication strategy around 
COVID-19 vaccine hesitancy. Although more resource and time-intensive 
than large-scale communication campaigns, tailored communication 
efforts and working with communities will provide significant benefits 
through better vaccine uptake in the populations that need it the most.
---------------------------------------------------------------------------
    \1\ Disclosure: The CommuniVax Coalition is funded by the Chan 
Zuckerberg Initiative, which was cofounded by the founder and CEO of 
Facebook. Author MT currently works on and DH previously worked on this 
research project. This testimony is independent work of the authors.
---------------------------------------------------------------------------
    Below, are several approaches to consider when working to address 
vaccine hesitancy:

    Elevate the voices of trusted partners

   Support and fund collaborative approaches to vaccine 
        communication through cooperation with faith-based and 
        community-based organizations. Work with local organizations to 
        amplify vaccine information through trusted sources and key 
        messengers.

   Establish connections between public health organizations 
        and news media members serving local communities to highlight 
        the benefits of COVID-19 vaccination. These trusted voices may 
        be the main source of news in local communities.

    Establish systems to gather information from communities

   Support systems that allow feedback from community members 
        and trusted community partners to influence vaccination 
        processes. Communication is a two-way process; community voices 
        and concerns should have a meaningful impact on vaccine 
        delivery.

   Consider concerns and hesitations as valuable feedback on 
        communication needs in the community. Although some concerns 
        may be unsupported by science, these reflect areas where 
        additional information and/or efforts to communicate through 
        shared values and beliefs are critical. Communication should be 
        inclusive of people at different stages of their decision-
        making process.

    Eliminate barriers to vaccination

   Ensure vaccination sites and timing of vaccination 
        appointments are easily accessible and feasible for the local 
        community. In many instances, lack of accessibility may be more 
        of a barrier than hesitancy.

   Streamline pathways for registration and preparation for 
        COVID-19 vaccination. The vaccination scheduling system has 
        been viewed as hard to manage and arduous for some. Support 
        systems that allow everyone to access the vaccine.

    Support local public health

   Ensure that local health departments have the support and 
        funding to translate educational materials into all prevalent 
        languages used in their jurisdiction.

   Establish and fund action plans that include long-term 
        improvements to the delivery of public health services for a 
        community. When other essential health services are lacking in 
        a community, vaccination is less of a priority.

    Above all, communication planners, as well as the public, should 
communicate and understand that changes to recommendations and 
approaches are likely as the COVID-19 vaccination campaign continues in 
the U.S. Unforeseen challenges with vaccine administration, 
particularly current emerging questions around rare adverse events, 
have complicated the communication landscape around certain vaccine 
products. Additionally, COVID-19 vaccine development and use may shift 
or evolve amid changing epidemic situations. Preparing and testing 
messages ahead of time will allow for a timely response at particularly 
critical moments.
Solutions for health-related misinformation and disinformation
    The COVID-19 pandemic has shown that health-related misinformation 
and disinformation can dangerously undermine the response to a public 
health crisis. In terms of vaccine hesitancy, research has shown that 
misinformation can lead to measurable declines in intent to receive a 
COVID-19 vaccine.vii Polling shows that approximately 20 
percent--30 percent of U.S. adults do not plan to receive the COVID-19 
vaccine.i,ii While it is the right of every individual to 
choose whether to receive a vaccine, every effort must be made to 
address concerns and barriers that limit vaccine uptake--particularly 
those caused by rumors or false information.
---------------------------------------------------------------------------
    \vii\ Sahil Loomba et al., ``Measuring the Impact of COVID-19 
Vaccine Misinformation on Vaccination Intent in the UK and USA,'' 
Nature Human Behavior (Nature Publishing Group, February 5, 2021), 
https://www.nature.com/articles/s41562-021-01056-1.
---------------------------------------------------------------------------
    Unfortunately, there are no easy solutions to the problem of 
health-related misinformation and disinformation. No U.S. agency is 
tasked with leading a unified response, constitutional concerns with 
restricting free speech limit some potential interventions, and 
solutions require cooperation across a range of stakeholders. Great 
attention has been paid to the need for social media companies to act 
in responsible ways. Technological solutions are indeed necessary, but 
not sufficient, in the battle against health-related misinformation.
    It is time for the United States to address the problem of health-
related misinformation and disinformation through a national strategy. 
Such a strategy will facilitate a more unified and effective response 
to misleading information during the COVID-19 pandemic and future 
public health emergencies. The National Security Council should be 
responsible for developing and overseeing a U.S. strategy for 
preventing and responding to health-related misinformation and 
disinformation in public health emergencies, drawing on existing 
Federal agency efforts, expertise, and implementation capabilities.
    Additionally, effective management of health-related misinformation 
and disinformation would benefit from the establishment of a neutral, 
nonpartisan, and expert authority in the health communication landscape 
that would take the form of a standing nonpartisan cross-disciplinary 
expert commission--including social media companies, communication 
specialists, public health experts, and bioethicists--to propose 
standards. A detailed explanation of such a proposed strategy are 
included here: https://www.centerforhealthsecurity.org/our-work/
publications/national-priorities-to-combat-misinformation-and-
disinformation-for-covid-19. We provide a summary below.
    The priorities that should guide the development of a national 
strategy are:

  1)  Intervene against false and damaging content as well as the 
        sources propagating it

     Establish a multiagency national security response 
            effort that prioritizes management of public health 
            disinformation, from both domestic and international 
            sources, as a national security issue in order to prevent 
            disinformation campaigns and educate the public on their 
            use.

     Establish a national nonpartisan commission that 
            provides neutral evidence-based guidance and 
            recommendations in order to improve the health 
            communication landscape in ways that limit misleading 
            information and ensure accountability for and 
            identification of sources of misleading information.

     Encourage active, transparent, nonpartisan 
            intervention from social media and news media companies to 
            identify and remove, control the spread of, and curtail 
            generators of false information.

  2)  Promote and ensure the abundant presence and dissemination of 
        factual information

     Prioritize public health risk communication at the 
            federal, state, and local levels in public health 
            departments and academic research communities by including 
            training and resources on specific messaging and by 
            increasing staffing, funding, and research support.

     Increase coordination between public health experts 
            and sources of public information, including social media 
            platforms and news media to increase the dissemination of 
            accurate information through multiple channels.

  3)  Increase the public's resilience to misinformation and 
        disinformation

     Safeguard and promote health and digital literacy 
            through multiple sources including schools, community 
            organizations, social media, news media, and others to help 
            information consumers choose responsible sources of 
            information and increase their awareness of disinformation 
            tactics and approaches.

     Improve resources for public verification of 
            questionable content through the development of a robust 
            fact-checking infrastructure with support, training, and 
            guiding principles for fact-checking organizations.

  4)  Ensure a whole-of-nation response through multisector and 
        multiagency collaboration

     Ensure multisector collaboration in the development of 
            a national strategy to combat public health misinformation 
            through collective planning with social media, news media, 
            government, national security officials, public health 
            officials, scientists, the public, and others.

     Increase coordination across the range of government 
            stakeholders and conduct a cross-governmental analysis of 
            efforts and responsibilities for managing health-related 
            misinformation and disinformation in order to streamline 
            and organize efforts. Key U.S. agencies include the 
            Department of Defense, Department of Health and Human 
            Services, and Department of Homeland Security as well as 
            intelligence agencies such as the Federal Bureau of 
            Investigation, the National Security Agency, and the 
            Central Intelligence Agency.
Conclusion
    This hearing recognizes a critical component in increasing 
vaccination rates across the U.S.--effective communication. We have 
highlighted several key priorities to increase the capacity of public 
health and other communicators to provide effective risk communication 
to local communities. At the same time, the problem of health-related 
misinformation and disinformation must be dealt with through a more 
unified national strategy. We share great optimism that the problem of 
vaccine hesitancy is a tractable and approachable problem and thank the 
committee for its commitment to engaging in solutions-based approaches 
to make meaningful change.

                                [all]