This is the second in an eight-article series on “Restoring Trust in Public Health: Lessons from COVID-19.” Four years of the Biden-Harris administration has left Americans rightly skeptical of public health institutions. This series highlights key findings from several congressional oversight reports, including the final report of the U.S. House Select Committee on the Coronavirus Pandemic, and offers lessons for Congress and the new administration on ways to restore trust in public health.
Based on extensive investigations and sworn testimony, the House Energy and Commerce Subcommittee on Oversight exposed how the Biden-Harris administration used a $900 million public relations campaign to influence how Americans understood and responded to the administration’s COVID-19 policies.
The public relations campaign became a tool for flawed narratives. Despite the administration’s promises to “follow the science,” the evidence clearly showed that the administration prioritized managing people’s perceptions over public transparency.
The October 2024 subcommittee report also unveiled a textbook example of how federal officials used taxpayer dollars to engage platforms like Facebook, Twitter, Instagram, and Google to advance their policy agenda. The report proved that these public officials relied upon selective data to shape public opinion that was not, in fact, supported by the existing scientific evidence.
For its “We Can Do This” campaign, the Department of Health and Human Services contracted with Fors Marsh Group, a firm that specializes in behavior change research and strategy, to “sell” its COVID-19 policies to the general public.
The Biden administration’s taxpayer-financed media strategy honed in on a segment called the “movable middle”—vaccine-hesitant individuals considered the most open and potentially responsive audience to target for influence. This group also included those who had not committed to getting vaccinated but still trusted government officials’ information on the effectiveness of the vaccines.
The “movable middle” target changed as vaccine uptake data evolved, with Fors Marsh Group continuously tailoring its approach to match changing demographics and levels of vaccine hesitancy.
Fors Marsh Group used demographic data, like age, ethnicity, parenting status, and geographic information, to tailor its messaging. This data enabled segmentation of the target audience at a very specific level. the messaging firm used public opinion surveys to monitor and track key information on vaccine hesitant parents.
According to the report, the firm “proactively proposed including the following elements in survey tools: monitoring of parental vaccine hesitancy, parental reporting of eligible child vaccine uptake, and booster uptake.”
Digital behavior, including frequent online content consumption, was layered on top of these demographics. The firm then conducted both quantitative (e.g., content relevance) and qualitative (e.g., frequency of exposure) analyses to select ideal media channels with which to reach audiences.
Using this information, it created detailed “personas” to capture how target audiences perceived the COVID-19 pandemic. These “personas” were informed by geographic and behavioral segmentation tools. To further enhance targeting, Fors Marsh Group employed “journey mapping,” a “simulated day-in-the-life analysis … to track vaccine-hesitant individuals’ interactions with media, organizations, and trusted messengers.” These tactics were aimed at identifying messages that would resonate most strongly.
The firm also conducted opinion surveys to track parental attitudes on vaccines, including hesitancy and booster uptake for eligible children. The tracking extended to monitor shifts in these attitudes over time, adapting messages accordingly.
To counter what it deemed as “misinformation” about COVID-19 vaccines, the Biden-Harris administration turned to social media “to decrease vaccine skepticism and correct misinformation.” Google search trends and social listening tools on the topic informed the administration’s actions, enabling the rapid creation of tailored ads on platforms like Facebook, Twitter, and YouTube. Fors Marsh Group’s calendar aligned paid media efforts with key holidays and events like the Lunar New Year for Chinese Americans and spring break ads for parents to maximize impact.
The administration pursued this aggressive PR campaign despite the Food and Drug Administration’s own determination on COVID-19 vaccine effectiveness. When the FDA issued an emergency use authorization for the Pfizer-BioNTech vaccine on Dec. 11, 2020, it explicitly stated that it could not affirm that the vaccine could prevent COVID-19 transmission: “At this time, data are not available to make a determination about how long the vaccine will provide protection, nor is there evidence that the vaccine prevents transmission of SARS-CoV-2 from person to person.”
The FDA repeated this message in issuing its emergency use authorizations for the Moderna vaccine on Dec. 18, 2020, and the Janssen vaccine on Feb. 27, 2021.
Nonetheless, in March 2021, Centers for Disease Control and Prevention Director Dr. Rochelle Walensky declared that vaccinated persons “do not carry” the virus. In September 2021, falsely insisting that the pandemic was a “pandemic of the unvaccinated,” President Joe Biden announced a series of unprecedented federal vaccine mandates that would have affected an estimated 100 million Americans.
Remarkably, in the teeth of mounting evidence, including the personal experiences of millions of Americans, the administration’s continuous messaging overstated vaccine effectiveness. It was not until January 2022 that the United States Supreme Court halted most of the mandates.
Leveraging Big Tech’s vast influence, the federal officials went far beyond conventional public health outreach. Rather, they pressured and deployed Big Tech to amplify selective messaging while sidelining scientifically valid alternative perspectives.
Big Tech actively censored views critical of administration policy from private citizens and even other public officials. This became clear when, on July 4, 2023, in Missouri v. Biden, a federal court held that the Biden administration colluded with and coerced social media platforms to censor dissenting viewpoints on COVID-19—“a massive attack” in an apparent violation of the First Amendment.
This was later confirmed when, on Aug. 26, 2024, Meta CEO Mark Zuckerberg wrote a letter to Congress in which he stated: “In 2021, senior officials from the Biden administration, including the White House, repeatedly pressured our teams for months to censor certain COVID-19 content, including humor and satire, and expressed a lot of frustration when we didn’t agree.”
Tactics traditionally used in consumer marketing—such as tracking daily behaviors, mapping moments of vulnerability, and targeting cultural touchpoints—were employed to shape public opinion in ways that blurred the line between simple communication and public manipulation.
During his confirmation hearings earlier this month, Robert F. Kennedy Jr., the new secretary of the Department of Health and Human Services expressed his strong commitment to full and complete transparency, open discourse, and scientifically valid communications with the public. Kennedy’s public promise directly accords with the key recommendations of the House subcommittee report.
On Jan. 20, 2025, President Donald Trump signed an executive order to prevent federal officials from abridging or censoring the constitutionally protected speech of all Americans. This order is a good start, but working with Congress, additional actions could be taken to protect medical and scientific debate so that there is full and fair exploration of scientifically based information.
Meanwhile, as the House subcommittee also recommends, the Centers for Disease Control and Prevention and other federal agencies should be prohibited from making claims about vaccines that do “not reflect” the FDA approved label. No future presidential administration should attempt to manipulate scientific evidence or silence scientific dissent. The president and the Congress can work together to prevent a repeat of the dreadful experience Americans endured over the past four years. To prepare the public to cope with the next national medical emergency, they must restore trust in public health.