In an ad shown to people Facebook thinks are college-educated conservatives in Oklahoma, coronavirus vaccination is touted as “trusted by the U.S. military … and by our Greatest Generation.”
At least 35 government agencies, nonprofit entities, corporations and public figures have purchased ads with different pro-vaccination messages, each set to reach — and hopefully persuade — Americans based on characteristics such as political affiliation, cultural identity and hobbies, a Washington Post analysis of Facebook ad data has found.
The practice, known as microtargeted advertising, is one of the Internet’s biggest boogeymen and has long been criticized as invasive, discriminatory and divisive. But the ad technique — in which marketers use tech companies’ data to show certain messages only to people with specific interests or traits — has also become an important tool in the battle to boost vaccination rates across the United States.
It’s unclear how effective the ad campaigns have been at encouraging vaccine holdouts to change their minds. Many of the ad campaigns ran through the spring and summer, as vaccination rates sagged across the country. Health authorities are newly hopeful that the full approval Monday of Pfizer’s vaccine by the Food and Drug Administration will convince more Americans to roll up their sleeves.
But public health officials say the widespread use of microtargeting reflects the recognition that groups with different values, motivations and personal tastes require more than a one-size-fits-all approach amid the country’s polarized political debates.
“We’re in this unique moment for public health messaging where we can see what people are really looking for … and meet them where they are,” said Tina Hoff at the Kaiser Family Foundation, a health nonprofit that targeted ads for one video series to Facebook users interested in African American culture and Ebony and Essence magazines. The videos featured Black doctors and nurses answering questions about the vaccine.
“When you’ve got limited resources and want to be as efficient as you can be,” Hoff said, “you go straight to the folks who have the greatest need.”
Health groups also have paid for ads that show up on sites popular with conservatives. On Breitbart, the far-right news blog that has called refusing coronavirus vaccination a “perfectly reasonable choice,” one ad called the vaccine a “shot to restore our freedoms,” alongside a photo of children walking into school.
Candace DeMatteis, the policy director at the Partnership to Fight Infectious Disease, said the nonprofit had designed the ad seen on Breitbart to meet conservatives “where they are, both in geography and the media they consume.”
“We have focused our messaging in areas where it’s needed most,” she said.
Federal, state and local health departments are paying for the ads alongside more traditional billboard, bus stop and TV ads in the hope that they can help turn the tide on the pandemic amid the delta variant’s surge. The United States is averaging about 140,000 new coronavirus cases a day, and roughly 70 percent of the country’s adults has received at least one dose of a vaccine. Facebook said in a statement that it has given more than $30 million this year in free advertising to governments and other groups for covid-related campaigns, including promoting the vaccine.
Unlike traditional ads, microtargeted campaigns zero in on groups with low vaccination rates, such as Republicans. Only 56 percent of that group said they are vaccinated or plan to be immediately, compared to 89 percent of Democrats and 67 percent of independents, a KFF poll last month found.
The Oklahoma Alliance for Healthy Families, a public health nonprofit, targeted its Greatest Generation pro-vaccine ad in March to college-educated Facebook users likely to engage with conservative political content, The Post’s analysis shows.
“Doctors have done their part,” the ad says. “It’s time to do ours — for our country … for each other.”
Jacqueline McDaniel, the group’s executive director, said the campaign was focused on conservatives who might be persuaded by its themes of patriotism and getting back to normal. “If we picked folks with more of a liberal view, they would’ve been more likely to be vaccinated, anyway,” she said.
Public health groups have used various tactics to reach the unvaccinated across a crowded Internet. KFF, Hoff said, also has used broad-level location data to send pro-vaccine ads to people in Zip codes with low vaccination rates, and to people who ask covid-related questions on Google. Officials also have paid online influencers to promote the vaccine to their fans: “I joined the Pfizer club,” one blogger wrote in an Instagram post in April sponsored by Colorado’s public health authorities.
One of microtargeted advertising’s big strengths is its cost and efficiency, said Hoff, who leads KFF’s social impact media team. She remembers 20 years ago when teaching young Black audiences about HIV meant paying for pricey 30-second TV ads on BET and MTV — all while hoping viewers would pay attention during commercial breaks.
Today, instead of spending a fortune on a single ad for a nationwide broadcast blitz, the nonprofit is devoting its resources to pro-vaccination campaigns like “The Conversation,” which features more than 100 question-and-answer videos with varying lengths, topics and audiences, each of which can then be rolled out in a more focused way online.
The group’s videos in English and Spanish, including “Why not wait to get the coronavirus vaccine?,” have been watched for 30 seconds or longer on Facebook and YouTube more than 25 million times, she said.
Microtargeted advertising has often been criticized for dividing people based on their personal backgrounds or beliefs, and Rep. Anna G. Eshoo (D-Calif.) last year introduced a bill that would ban political microtargeting for fear it could further fracture “our open democratic debate.”
After Russia-linked trolls used Facebook ads microtargeted by race and politics in an attempt to furtively spread dissension during the 2016 presidential election, federal regulators and lawmakers warned that the tool was a “potent weapon for spreading disinformation and sowing discord.” Democrats have fretted over President Donald Trump’s use of the technique in his campaigns, for instance, when he showed messages last year about unchecked violent crime to battleground-state suburban moms.
Google banned political campaigns from using most forms of targeting in 2019, though Facebook has continued to allow it. Facebook declined to say how small of a group one could target using the company’s ad tools; in previous years, the minimum audience size was 100 people.
Some fear microtargeting could also be used to undercut the vaccines. Though Facebook has rules against anti-vaccine content, some recent ads have made misleading claims: One ad from the two-month-old group Positive Freedom Alliance said government data on adverse side effects undercuts the narrative that the vaccines are safe and effective. Facebook said the ad was taken down after questions from The Post. The group didn’t respond to a Facebook message seeking comment.
Facebook doesn’t publicly disclose advertisers’ targeting choices. It does, however, give users a brief explanation of why they were shown a particular ad. Volunteers have shared many of those explanations with the NYU Cybersecurity for Democracy project, which collects them in its Ad Observatory database that The Post used for this analysis (and which Facebook has pushed to shut down).
The database offers a glimpse of how groups have crafted different pro-vaccine messages, depending on whom they’re talking to. Facebook users interested in the Catholic Church, for instance, were shown an ad from Ready to Vaccinate featuring the pope calling vaccination “the moral choice.” Arnold Schwarzenegger, the former California governor and “Terminator” star, targeted a video ad showing himself getting vaccinated (“Come with me if you want to live!”) to Facebook users interested in bodybuilding or physical exercise.
Facebook doesn’t offer the ability to target ads based on race or ethnicity. But public health authorities, like many corporate advertisers, often selected categories that they expected would include the audience they want to reach.
The U.S. Department of Health and Human Services targeted ads to Facebook users interested in “Native American culture” that featured a woman wearing a mask decorated with Native American symbols and a pledge to “do my part for all our people.” And Arkansas’ Department of Health targeted ads featuring Matt Dillion, the owner of popular barbershops around Little Rock, to Facebook users interested in hip-hop, gospel music and Black comedy.
Early research into these newer advertising methods’ effectiveness offer some encouraging signs. In June, the health nonprofit Public Good Projects analyzed how people responded to influencers popular with Black and Hispanic audiences when they pushed their followers to get flu shots. Though older large-scale campaigns were typically flooded with anti-vaccine trolls, the researchers found that the targeted effort received an overwhelmingly positive response and reached millions of people they might otherwise have missed.
Joe Smyser, the group’s chief executive, said public health officials are only now starting to catch on to how a more modern approach could lead to major changes in a life-or-death matter. Some public health attempts to increase vaccination rates for the coronavirus — and before that, the flu — have resorted mostly to “shotgun-blasting messages we know are not very effective.”
In the past, “one person in a public health organization was permitted to speak to reporters and the public, and the framing was one of risk mitigation, not engagement, and it was not a conversation — it was carefully selected talking points in front of an American flag,” he said.
“We’ve been using these traditional advertising techniques forever,” he added, and the country’s immunization rates for the coronavirus and the flu aren’t “anywhere close to the levels we want. We need to make sure people are seeing the things that will resonate with them. Every dollar needs to count.”