How Do We Get America Vaccinated?

To Get to Herd Immunity, We Need to Take a Psychobehavioral Approach, Tackle People’s Barriers and Get Local

The U.S. is facing the greatest public health challenge of a generation: getting at least 70% of the population vaccinated against COVID-19, even though demand has dropped considerably in recent weeks. How can we do it?

It starts with answering three key questions:


is or isn’t likely to get the vaccine?


are they likely/not likely to get the vaccine?


do we respond?


Looking at Demographics Isn’t Enough

Looking at Demographics Isn’t Enough

Segmentation is the practice of dividing a population into approachable groups in order to create more personalized interventions. Traditionally in public health, segmentation has focused on demographic traits such as gender, geography, race, party and income.

The circles displayed show the demographic breakdowns of respondents to a survey of U.S. adults about the COVID-19 vaccine conducted by Surgo Ventures.

The problem: Demographic targeting helps identify the who. However, it doesn’t help answer the why and the how.

Note: January 2021 survey sample consisted of 2,747 U.S. adults. * Includes those who prefer to self-describe or not to answer

Mouseover to see number of people for each group

Looking at Demographics Isn’t Enough

Previous studies of COVID-19 vaccine confidence have focused on demographic groups—finding that women, rural residents, Black individuals, Republicans, lower-income individuals and essential workers tend to express lower likelihood of vaccine uptake.

But people are more complicated than their gender, race, political party, or where they live. Targeting solely based on demographics misses the underlying barriers shaping a person’s intention—barriers that are malleable and multidimensional.

Note: January 2021 survey sample consisted of 2,747 U.S. adults. * Includes those who prefer to self-describe or not to answer

Mouseover to see number of people for each group

We Need to Target People’s Barriers and Beliefs

Psychobehavioral segmentation instead divides people into groups based on their barriers and beliefs—those things that influence why they express reluctance to get vaccinated.

In a recent survey of U.S. adults, Surgo Ventures identified five psychobehavioral personas for the COVID-19 vaccine. As you can see, each segment includes at least some of every demographic included in the survey.

Mouseover to see number of people for each group

The Five Vaccine Personas in the U.S.

Our survey found that 39% of Americans are highly likely to get the vaccine, with the remaining 60% falling into four less likely segments, with a variety of concerns and barriers shaping their likelihood.

On one end of the vaccine likelihood spectrum we have The Enthusiasts, who are ready and willing to get the vaccine, and on the other end we have The COVID Skeptics who are guided by misinformation and unlikely to get vaccinated.

These Personas Differ in their Likelihood of Getting Vaccinated

Each of these personas express different likelihood of getting vaccinated on a scale up to 10.

Three of these segments (labeled "The Persuadable") can likely be convinced to take the vaccine, due to barriers they have that we believe can be overcome with the right interventions.

Tackling Barriers = Reaching Herd Immunity Faster

...But it all depends on how well we address key perceptual and structural barriers that affect their intention to get vaccinated.

We must prioritize these barriers to vaccination. Without doing so, we’re in danger of not reaching herd immunity.

Mouseover to explore barrier info of each personas

Customized Solutions for Each Persona

Here is a roadmap for the types of interventions we can use to address the real or perceived barriers for each vaccine persona.

We will also need to get local. Because people’s lived experiences are so critical, each intervention should be developed with a person’s own localized context in mind.

Mouseover to explore intervention examples of each personas

Identifying Segments and Implementing Local Solutions

How do we use our segmentation approach in local communities?

With the help of machine learning, we start with an online tool that easily identifies a person's vaccine persona, with more than 90% accuracy.

Using the tool in their own communities allows local decision-makers, health care professionals, and community health organizations to easily identify the vaccine personas they must persuade, using targeted, evidence-based solutions to do so.

How the Segments Shift over Time

Behaviors and motives can change. Similarly, people can move within the personas as their attitudes toward the vaccine, reasons for hesitancy, and barriers to uptake shift over time.

How the Segments Shift over Time

Here’s how the composition of the vaccine personas had shifted between surveys that were administered in January 2021 and March 2021 by Surgo Ventures.

The greatest movement was among the Watchful and the Cost-Anxious. The System Distrusters and the COVID Skeptics were largely unchanged, remaining unconvinced about getting the vaccine.

The Time to Act is Now

We must act now to reach a minimum threshold of 70% vaccinated in the U.S.

To do so, we must not only prioritize “the Persuadable” and focus on dismantling the barriers that stand in their way. We must also convince at least some proportion of the COVID Skeptics. Not easy, but not impossible if we work in a targeted way!

Together, we can build greater COVID-19 vaccine confidence. Chances are, we all know people in our communities who fit these personas. It’s important that everyone— not just the health care professionals or the policymakers— work together and do their part to build greater vaccine acceptance in the U.S.

Identify a
Vaccine Persona

Do you know someone who is unsure about getting the COVID-19 vaccine? If so, knowing their barriers and beliefs can help you understand how to start a conversation with them.

How Surgo Uses Psychobehavioral Segmentation in Our Other Work