Leadership Lesson – October 2021: Focus on the Movable Middle: Strategies for Overcoming Vaccine Hesitancy

September 29, 2021

Focus on the Movable Middle: Strategies for Overcoming Vaccine Hesitancy

October Leadership Lesson photo








This month’s leadership lesson is from Leighann Sauls, AHS program director for Georgia, Kentucky, North Carolina and Tennessee.

Vaccine hesitancy is a growing challenge. CMS convened a group of leading behavioral science experts from top institutions with expertise across organizational behavior, psychology, healthcare communication and policy and marketing to identify opportunities for improving COVID-19 vaccine uptake among the long-term care facility staff population.

The group provided a model for thinking about vaccine hesitancy among long-term care staff. In this model, there are three groups on the continuum of vaccine hesitancy:

  1. Vaccine acceptors
  2. Movable middle
  3. Vaccine refusers

Understanding your staff as individuals and where they fall across this continuum helps identify interventions for success. As the report suggests, rather than target all staff with a uniform intervention, the focus should be on the those in that fall in the movable middle – those who express varying degrees of hesitancy but are likely to change their minds.

Some successful strategies for the movable middle are:

  • Leverage social influence, communicators and motivational forces to motivate staff
  • Supplement information-based campaigns with peer to peer conversations
  • Mitigate logistical and access barriers

For more details and recommendations, please review the final report – COVID-19 Vaccination Uptake Behavioral Science Task Force: Final Report – February 23, 2021

Additional resources on Vaccine Hesitancy: