It Takes Two to Tango: How the COVID-19 Vaccination Campaign in Israel Was Framed by the Health Ministry vs. the Television News

"During pandemics and disasters, the job of the media is to provide fully transparent, reliable and up-to-date information based on risk communication to enable the public to make informed decisions..."

Framing theory in the field of disaster communication suggests that the public's reaction to a disaster is heavily influenced by how the public interprets the disaster, which in turn is influenced by public relations and media framing. In the context of epidemiological crises that involve politics, a frame defines how an element of rhetoric is packaged so as to encourage certain interpretations and discourage others. In December 2020, the Israeli government announced plans to import the Pfizer pharmaceutical company's coronavirus vaccine as an experimental drug until February 2023, when clinical trials were scheduled to end. Parts of this contract were and still are concealed from the public, yet experts who criticised the government's vaccination policy were deemed "anti-vaxxers". This study focuses on how Israel's two main television news channels (Channel 12 and Channel 13) covered the vaccination campaign compared to how the Ministry of Health (MOH) ran the campaign.

This qualitative study is based on triangulation of online content analyses from three different sources: advertising campaigns, social media posts, and reports on television news channels. The research sample included 252 reports from the newsrooms of Channel 13 (n = 151) and Channel 12 (n = 101), all broadcast between December 1 2020 and November 30 2021. The sample also included posts from Israel MOH Facebook page and advertising campaigns from the Facebook page of the Israel Government Advertising Agency (LAPAM), which constructs advertising campaigns for the MOH (113 items). The study maps different media strategies using infographic charts.

The study found that Israel's vaccination campaign used three primary framing strategies:

1. Positive framing (emphasising the vaccine's advantages and stressing that the vaccine is safe and effective based on cost-benefit calculations and public health perspectives) - 177 news reports and posts on the MOH Facebook page were identified as using positive framing. During the initial weeks of news coverage, the television channels emphasised the advantages of the vaccinations, despite awareness that the vaccine had been developed using a technology that had previously been used only in Pfizer's clinical trials, such that its effectiveness could not be assessed. Concurrently, the newscasts promoted the narrative that the vaccination is effective for all groups in the population, without providing a forum for other experts who opposed the vaccination policy to voice their opinion. Among the reasons for these experts' opposition were that the government's sweeping recommendations to vaccinate the entire population failed to note the absence of long-term and thorough research to follow up on the vaccine's side effects. On September 30 2021, the MOH posted an item about vaccination side effects that received 28,000 reactions from the public, most of which reported side effects not mentioned by the MOH in its post. The MOH responded by deleting some of these posts, claiming they were violent and contained threats against MOH personnel. The public continued to claim that the MOH was not providing a fully transparent picture of the side effects. At the same time this MOH post on side effects appeared, the news continued its positive framing of the booster.
2. Fear appeal strategy (conveying persuasive messages that seek to arouse fear through threats of impending danger or harm) - 145 news reports were identified as using the fear appeal strategy in parallel to MOH posts that used the positive framing strategy. Throughout the vaccination campaign, the newscasts stressed the high morbidity and mortality rates from COVID-19. The study found that when positive framing of vaccinations on the news rises, a parallel rise in the MOH's use of the fear appeal strategy is also apparent. In preparation for the campaign to vaccinate children (August through November 2021), an increasing trend toward using the fear appeal strategy is apparent in the MOH posts. After the MOH published its post about side effects on the MOH Facebook page on September 30, there was a significant rise in the MOH's use of the fear appeal strategy - e.g., the MOH pointed out the negative consequences if citizens do not get the booster and do not vaccinate their children. Per the researchers, any type of "apocalyptic pandemic narrative can be problematic in that the use of intimidation without the empowerment of individual self-efficacy contradicts the extended parallel process model (EPPM)...According to this model, in order for fear-based policies to be effective, policymakers 'must induce a moderate level of fear alongside a higher level of self-efficacy and response efficacy. When the public's fear exceeds its sense of self-efficacy, the message becomes ineffective'..."
3. Attribution of responsibility strategy (blaming the unvaccinated and targeting all those who criticised Israel's generic vaccination policy) - 77 news reports and posts on the MOH Facebook page were identified as assigning negative tags to people who decided for various reasons not to be vaccinated or to professionals who opposed the vaccination policy. This framing found expression in attributing responsibility for spreading the virus to what was referred to as "the group of unvaccinated people in Israel", even though studies had already indicated that both vaccinated and unvaccinated people were infected by the virus and infected others. The television news also used another strategy: publicising vaccination status while differentiating between those who received three doses of the vaccination and those who received one or two doses but did not get the booster. Both the MOH and the media referred to these individuals as being "unvaccinated" or "not fully vaccinated" or whose "vaccination expired". In the researchers' estimation: "These attempts to ostracize and label anyone who criticized the official vaccination policy or refused to be vaccinated as an opponent or an outcast helped create a spiral of silence in society."

In short, the research reveals congruence between the way the MOH framed its vaccination campaign and news coverage of the vaccination issue. In the researchers' assessment, this finding indicates that the newscasts chose to report the "news" according to the values adopted by the MOH, perhaps failing to fulfill its watchdog role of providing the public with complete and balanced information by investigating and cross-checking various sources. "In Israel and in the rest of the world, the media's echoing of official messages helped determine the boundaries of the political discourse on the pandemic....Throughout the entire research period, no news investigations were broadcast that attempted to answer fundamental questions regarding crony capitalism, a situation in which individuals and businesses with political connections and influence are favored. For example, the clandestine contract with Pfizer was never investigated. Moreover, no studies examined conflicts of interest in Israel or elsewhere in the world, for example pharmaceutical company contributions to organizations such as the FDA [Food and Drug Administration]."

The researchers offer the following recommendations:

• The media should check, verify, and validate all information originating from the MOH, and from any other source as well. The media should not report this information without conducting an independent journalistic investigation.
• The media and the MOH should exercise caution in using the fear appeal strategy and the attribution of responsibility strategy, for these strategies may generate a boomerang effect among the public, leading to a lack of trust and a lack of cooperation.

In conclusion: "As the watchdog of democracy, the news should function as a professional and objective source that criticizes government systems if necessary and strives to uncover the truth throughout the crisis. Public trust, which is so essential during such a crisis, can be achieved only if the news channels provide reports and meaningful journalistic investigations that challenge the system. By doing so, they can help fight conflicts of interest that divert management of the crisis from the professional health field to the political-economic arena."