Music Videos as Health Promotion: Juvenile’s “Vax That Thang Up” and the Promotion of the COVID-19 Vaccine in the Black Community

Abstract

COVID-19 data reveals that the disease has disproportionately affected the Black community, yet the lowest vaccination rates can be found among this demographic. A myriad of factors can explain this health disparity, but structural barriers such as availability and vaccine apprehension amongst the Black community emerge as two primary reasons. Despite targeted outreach, traditional health campaigns directed at the Black community did not yield results; many argue this was due to the community’s history of medical exploitation and rightful distrust of the medical sector. Instead, the Black community turned to popular culture as a primary means of health information. In turn, Juvenile’s classic song “Back That Thang Up” was repurposed into a vaccine anthem—“Vax That Thang Up.” The PSA, which infuses hip-hop, health promotion, and the power of music videos, sparked controversy and has over 3 million views on YouTube. These considerations serve as the basis of this study, which will interrogate the intersection of health communication and pop culture, in relation to the music video—“Vax That Thang Up.” The researchers will employ the culture-centered approach to unpack how the music video disrupted traditional aspects of health communication campaigns.

The Black Community and COVID-19 as a Health Disparity

As the world entered 2020, a new virus called COVID-19 was detected. Once discovered, the virus quickly spread and caused alarm across the globe. On January 31st, 2020, the World Health Organization (WHO) issued a global health emergency, making COVID-19 only the sixth instance of such a proclamation; but this declaration did not curb the impact of the virus. In March 2020, the WHO officially declared COVID-19 a global pandemic, making it the first pandemic since H1N1 10 years ago (Pan American Health Organization, 2020).

It is undoubtedly true that COVID-19 disrupted the quality of life for virtually every demographic, but certain populations were disproportionately impacted. When discussing COVID-19 and health outcomes, it is imperative to place health behaviors in the appropriate behavioral categories since different acts have different intentions and motivations (Yastica et al., 2020). For example, the rationale for being tested may be vastly different from one’s desire for or intention to get a vaccine. When analyzing COVID-19, health behaviors can be largely categorized as the following: (1) testing, (2) wearing a mask, (3) social distancing, and (4) receiving the vaccine (Knell et al., 2020; Peng et al., 2022). This article will focus exclusively on vaccination within the Black community.

While this article will focus on the health behavior of receiving a vaccine, it is important to note that Black people bore a disproportionate burden of the pandemic. This was true from testing to mortality rates. In other words, COVID-19 has emerged as a stark and sobering health disparity. According to the Centers for Disease Control and Prevention (CDC, 2020), health disparities are “preventable differences in the burden of disease, injury, violence, or opportunities to achieve optimal health that are experienced by socially disadvantaged populations” (p. 1). Additionally, health disparities frequently translate to stark differences in disease incidence, prevalence, and mortality (CDC, 2020). For instance, when analyzing testing rates and new infections, Black-majority counties in the United States had three times the coronavirus infection rate and almost six times the death rate of White-majority counties (Dyer, 2020). Dyer (2020) continues, noting that the Black community accounted for 70% of COVID-19 deaths in some cities, like Milwaukee, but made up less than a quarter of the city’s population. Vasquez-Reyes (2020) further illuminates this disparity with quantitative data; they note that in late 2020, nearly 97.9 out of 100,000 Black Americans have died from COVID-19. This mortality rate is nearly a third higher than Latinos (64.7) and double that of White Americans (46.6) and their Asian counterparts (40.4). Vasquez-Reyes (2020) concludes,

the overrepresentation of African Americans among confirmed COVID-19 cases and the number of deaths underscores the fact that the coronavirus pandemic, far from being an equalizer, is amplifying or even worsening existing social inequalities tied to race, class, and access to the health care system (p. 300).

Even after highly-effective vaccines were introduced, the health disparity continued to exist as the Black community possessed a great deal of vaccine hesitancy (Padamsee et al., 2022). Multiple studies have indicated that the dearth of uptake of vaccines is not indicative of the Black communities’ lack of interest in their health; instead, the low vaccine rates unveil a larger issue—massive structural barriers (Dyer, 2020; Padamsee et al., 2022; Rusoja & Thomas, 2021; Vasquez-Reyes, 2020). In their study, Padamsee et al. (2022) note that the obstacles of access and hesitancy were the main barriers to receiving a vaccination. They write,

Access barriers, such as distant vaccine sites, lack of transportation, and inflexible work hours, impede the use of vaccines, especially within vulnerable communities. Vaccine hesitancy, defined as delay in acceptance or refusal of vaccines despite availability, has been a challenge to infectious disease control over the past 2 decades (p. 1).

Medical Racism and Vaccine Hesitancy in the Black Community

Black people in America have a complex and troubled history with the domestic medical industry as many advancements have been built on the deliberate and, often, veiled exploitation of Black bodies. Many negative historical examples continue to frame how Black people in America view medicine and treatments. For instance, the legacy of the now-infamous Tuskegee study cannot be overstated, as Black Americans still fear being treated as test subjects for unapproved treatments (Elliot, 2021). Elliott (2021) writes,

The Syphilis study also looms large in collective memory. People in this nearly all-Black community are skeptical when the government says to take a shot. They felt that the government wanted to inject something in their bodies, and they were going to eventually die from that (p. 2).

Multiple scholarly articles reinforce this notion that the fallout of the Tuskegee study can still be felt decades later (Dyer, 2020; Padamsee et al., 2022; Poteat et al., 2020; Rusoja & Thomas, 2021). While the legacy of Tuskegee is of the utmost importance, it is also important to note that multiple historical atrocities laid the foundation for medical apprehension in the Black community. In her book Medical Apartheid: The Dark History of Medical Experimentation on Black Americans from Colonial Times author Washington (2008) notes that gynecology and other forms of contemporary medicine were all started by unethical procedures against the enslaved people, where they were not only void of bodily autonomy, but also anesthesia.

Unfortunately, the mistrust of the Black community continues today, and physicians rarely lessen Black patient concerns. In fact, physicians and other direct caregivers frequently employ racist stereotypes and tropes that subconsciously guide their recommendations and procedures. Simply, Anti-Black racism continues to plague the healthcare system, and as a result, Black Americans receive inadequate care. It is important to isolate how medical racism has subtly shaped previous interactions because those provide the foundation for how the Black community perceives the vaccine. For instance, one study found that compared to White patients, Black patients are less likely to receive pain medications, and if they do receive them, it is in lower doses with no refills (Hoffman et al., 2016). The authors surveyed 222 White medical students/residents about the biological differences between White and Black patients; the results of their study were astounding. Forty percent of first-year medical students and one in four residents believed Black patients have thicker skin than White patients (Hoffman et al., 2016). Additionally, 40% of students believed Black patients’ blood coagulates more quickly, and 20% believed Black patients had less sensitive nerve endings, and in turn, felt less pain.

When taken together, historical and contemporary examples highlight how the Black community has been largely marginalized when analyzing health outcomes, and the COVID-19 vaccine followed this trend. Similar to the response to other disease outbreaks, stakeholders scrambled to develop health communication campaigns that would increase vaccination rates and hopefully, in turn, drastically decrease rates of COVID-19 in the Black community.

Traditional Health Campaigns: An Overview of Social Marketing

This article argues that pop culture was used to circumvent the Anti-Blackness often found in traditional health communication campaigns. However, to understand how disruption occurred, it is imperative to first break down the core principles of social marketing, a popular form of health communication campaigns. Social marketing, or the implementation of traditional marketing techniques for positive behavior change to promote social good, is widely used to combat a myriad of health issues (Ramirez et al., 2017). While social marketing focuses on individual behavior change, the purpose of a campaign must also benefit society in some way (social good); on the other hand, traditional marketing focuses on maximizing profits (Lee & Kotler, 2020). From large-scale national campaigns to local flyers, social marketing uses visual and verbal rhetoric to produce behavior change about a particular health condition.

Social marketers often utilize audience segmentation and the four Ps: price, place, product, and promotion (Olawepo et al., 2018). Promotion is often the most visible of the four Ps used in social marketing (Olawepo et al., 2018). Promotion refers to how a message is constructed and where the campaign message is presented. Promotional materials could include television, short films, print, social media, and websites (Olawepo et al., 2018). Our analysis will highlight how pop culture served as a primary promotional tool of health information as it relates to the COVID-19 vaccine in the Black community. Second, Lee & Kotler (2020) contend price is more than a monetary cost; instead, price includes any and all sacrifices and barriers one has to overcome to achieve the desired behavior (COVID-19 vaccine). For COVID-19, this could be literal barriers, including the cost of transportation or concerns of receiving an insurance bill, but it could also be something dire—much of the Black community feared the vaccine would cost them their life (Morgan, 2022).

Third, place refers to the location of the desired behavior, known as action outlets, whereas the final P, product refers to the action itself; action outlets require one to understand where and when the target market will perform the desired behavior. For the COVID-19 vaccine, the product is universal as the song and accompanying music video functioned as a public service announcement (PSA) designed to get the Black community to receive the vaccination (product); however, place refers to all of the physical locations one could actually receive the COVID-19 vaccine.

Black Community Consumption of Pop Culture: A Vehicle for Behavior Change

Notwithstanding that only 12.4% of the population in the United States identifies as Black or African American (Jones et al., 2021), the societal-wide fascination with Black pop culture is unmistakable. More than 30 years ago, MacDonald (1992) underscored the power of Black American culture in fashioning popular culture within the United States. Today, that influence remains. Nielsen (2015, 2018) underscores the influence of Black culture in shaping pop culture, raising awareness of social justice issues, and transcending race to resonate among various demographic groups. Almost three-quarters of non-Hispanic Whites and two-thirds of Hispanics are of the view that African Americans play a major role in shaping the mainstream culture in the United States (Nielsen, 2017). Such data points to the fact that people within the Black community are simultaneously the drivers of pop culture, as well as the largest consumers. Moreover, as Nielsen (2020) highlights, between 2011 and 2020, smartphone ownership grew fastest among African Americans and this demographic group spends the most time using these devices.

Music

Black consumers’ over-indexing in the digital space extends to music with more than 80% using their smartphone as the primary device to access content. Fifty-two percent take advantage of audio streaming services, compared to 40% of Whites (Nielsen, 2018). Notwithstanding their embracing of new communication technologies, Black consumers continue to tune into the radio with 92% listening to the radio every week (Nielsen, 2018). Further, the Black community gravitates to genres of music that have long been an integral part of the culture such as R&B/hip-hop (Nielsen 2014). Perhaps, due to the increased levels at which Black consumers listen to and spend money on music, the popularity of these genres has increased in recent years (Nielsen, 2018). In 2017, R&B/hip-hop became the “most consumed genre,” ousting rock from the top spot (Nielsen, 2018, p. 32).

The Intersection: Pop Culture and Health in the Black Community

Black audiences’ media consumption outpaces that of all other groups (Nielsen, 2021). With their media usage exceeding that of the general population, it is not surprising that “African Americans are more likely than [Whites] to be among the first to set new trends and to consider themselves on the cutting edge” (P. Miller & Kemp, 2015, p. 14). Despite shaping habits of the wider population, historical factors that have impeded the adoption of certain new products cannot be ignored. A history of discrimination, in particular, medical discrimination against this demographic group, has carried over into the 21st century and fueled present-day distrust in the government, healthcare system—and by extension, the COVID-19 vaccine. As Aggarwal (2021) points out, “Many public campaigns aim to convince Americans of vaccine safety by touting experimental data, but such initiatives overlook the distrust that lies at the core of Black vaccine hesitancy” (para. 13). Having recognized the “suspicion, distrust, and cynicism that is deeply embedded in [Black] collective memory” (J. C. Williams, 2017a, para. 16), it is imperative that research explore alternative sources of information on the COVID-19 vaccine that was directed toward the Black community. This article seeks to address this area by examining how “Vax That Thang Up” served as a vehicle to engage Black people and promote COVID-19 vaccination.

Culture-Centered Approach to Health Promotion

Clearly, culture is crucial to the Black community, thus, a culture-centered approach (CCA) is ideal for the current analysis. The CCA contends structural inequalities are intertwined with communicative and health inequities (Dutta, 2018). As highlighted above, previous research reinforces the notion that disproportionate rates of COVID-19 in the Black community were driven by structural inequities rooted in racism as opposed to individual factors (Egede & Walker, 2020; Holden et al., 2022; Keshavan, 2020). Holden et al. (2022) note that structural racism continues to drive social, economic, and community factors, including, transportation barriers, employment opportunities, and lack of access to healthcare, that create poor overall population health for the Black community. Under CCA, if one desires to mitigate a health disparity, one must also account for and address systemic inequities.

Furthermore, CCA analyzes how communication operates at the intersection of culture, structure, and agency (Dutta, 2018). First, according to Dutta (2018), culture “reflects the shared values, practices, and meanings that are negotiated in communities” (p. 241). Culture refers to how communities make meanings. For example, as mentioned above, medical trauma and exploitation are cultural components embedded in the Black community in the United States and the medical industry, especially pharmaceutical companies. Throughout this analysis, the authors will isolate important cultural components and augment how they were uniquely situated to urge the Black community to be vaccinated. Second, structure refers to systems in place that increase or decrease resources, rules, and assumptions within a community (Dutta, 2018). Third, agency refers to the degree to which an individual and/or community can enact daily choices while interacting with structures.

In this case, the researchers argue that pop culture was used as a tool to increase agency for the Black community. Dutta (2018) writes, “whereas agency is communicatively expressed, the process of communication draws upon cultural meanings, and is located in its relationship to structures” (p. 241). Simply, CCA provides the lens for understanding how cultural meanings, especially when embedded in health and disease, are co-constructed by communities and this construction is largely shaped by interactions with structures and one’s perceived level of agency. CCA also allows marginalized communities to co-create narratives that often push back against the dominant discourse and/or the silencing by mainstream structures; under CCA, communities often create and circulate their own structures of knowledge production (Dutta, 2018).

CCA warns against traditional health communication campaigns that utilize a top-down approach. As stated above, through dialog, knowledge surrounding the vaccine is co-created in community spaces as opposed to being isolated in the ivory tower or labs. Moreover, Dutta (2018) argues CCA is more than formative research that can be used to guide message construction. Proper use of CCA shifts decision-making possibilities to the hands of the community. CCA can, and should, be used in every step of social marketing campaigns, from message construction to evaluation. In their study that utilized focus groups to understand vaccine hesitancy amongst African Americans in the Deep South, Zhang et al. (2022) found that the trusted messengers of health information are not doctors or health officials; instead, they are members who already have trust and rapport in the community. This finding aligns with previous research (Bogart et al., 2021). For some, other community leaders, such as athletes, are best designed to circulate information related to the vaccine. Similar to Bogart et al. (2021), Zhang et al. (2022) write, “participants suggested to reach out to the target population through social events, behavioral economics, storytelling, and media strategies” (p. 3).

Multimodal Analysis: A Form of Critical Discourse Analysis

Health campaigns are notoriously difficult to evaluate (Clarke et al., 2019). Outcome evaluations require resources, time, and other expertise that frequently lag behind innovation. Moreover, as previously highlighted, the Black community has a rightful distrust of traditional health campaigns. Thus, this article is not analyzing the impact of or exposure to “Vax That Thang Up”; instead, the authors will apply CCA to the four Ps of social marketing and deconstruct how culture was augmented and used as a tool to promote the COVID-19 vaccine in Black America. In order to anchor our analysis, especially as it relates to promotional messaging, we will isolate aspects of multimodal critical discourse analysis.

Before unpacking multimodal analysis, it is important to first provide an overview of critical discourse analysis overall. Critical discourse analysis “speaks to and, perhaps, intervenes in, social or political issues, controversies in the world” (Gee, 2017, p. 9). When one interacts with health and illness, they are not merely dealing with a biological and/or physiological difference of their bodies, their new “reality” is often shaped by a myriad of factors including the discourse and language used to communicate about the condition (Brookes & Hunt, 2021). Discourse analysis prompts one to analyze the socio-cultural and political context in which communication and language occur, and it also provides the foundation for understanding how dominant ideologies are subtly reinforced (Lupton, 2010). Previous research indicates that while underutilized, critical discourse analysis is a fruitful methodology when one wants “to lay bare the ideological dimensions of lay health belief, and the dissemination of health information in the entertainment/mass media” (Lupton, 2010, p. 147).

Multimodal critical discourse analysis stems from the fields of media, cultural, and film studies. Music videos contain a vast amount of acoustic, lyrical, and visual content that is able to be consumed in a relatively short period of time (Pandeya et al., 2021). As a type of critical discourse analysis, multimodal analysis provides the framework to analyze other aspects of an artifact in addition to the language used. The multimodal approach to the critical discourse originally arose from the field of semiotics, and thus, multimodal analysis can be conceived as the process in which the product of one or more semiotic modes is “articulated and interpreted” at the same time (van Leeuwen, 2007). In other words, multimodal analysis is best equipped to analyze how multiple modes of communication, especially visual and verbal, exist at the same time.

Overview and Analysis of the Artifact

“Vax That Thang Up” Music Video PSA

Previous research highlights the power of music as it relates to the experience of Black people in the United States; from identity construction to racial liberation in the 1960s to debates over contemporary feminism, the influence of music videos is well-researched (Morant, 2010; Myrie et al., 2021; S. Williams, 2017b). For example, Beyoncé’s visual album, which was initially released as exclusively music videos, Lemonade, was incredibly popular and prompted important conversations over Black feminism and neoliberalism (Olutola, 2018). Additionally, Childish Gambino’s This is America ushered in conversations on race and racialized experiences to a new audience (Simmons, 2018). It is possible for music to be simultaneously entertaining and a critical tool that promotes equity and social change. Juvenile’s transformation of “Back That Thang (A$$) Up” to the pro-vaccine anthem “Vax That Thang Up” illuminates this duality as it shows how culture can be harnessed as opposed to ignored.

Released in 1999 by Juvenile and members of Cash Money Records, “Back That Thang (A$$) Up”—often referred to as “Back That Azz Up” and “Back That Thang Up”—is now part of the Black music canon and was listed as one of the 500 greatest songs of all time (Rolling Stone, 2021). The song has such reach that in a failed outreach attempt, Democratic Party presidential primary candidate Tom Steyer invited Juvenile to perform the song before the 2020 primaries in South Carolina (Thomas, 2020). The song is influential and has remained relevant for more than 20 years for multiple reasons. On one hand, originating in New Orleans, it was the nation’s introduction to a new sound of music, a unique lexicon, and a new style of rapping (Weingarten, 2020). It represented a shift in pop culture. Acknowledging the cultural impact of “Back That Thang Up,” and Cash Money’s other hits, their original phrase “bling-bling” was added to the Oxford dictionary in 2003 (Tawa, 2003). Moreover, Tinsley (2019) notes the song “shifted the course of Down South hip-hop. Juvenile’s third solo project is drenched in New Orleans drawl, flavor, dialect and, at times, aggression, and became the highest-selling album of 1999 with more than 4 million copies sold” (p. 1). Tinsley (2019) also notes that for Black millennials, in particular, the song represents nostalgia and prompts moments of communal memories that are almost exclusively positive. Tinsley (2019) concludes, “‘Back That Azz Up’ is as important to the culture as The Gap Band’s ‘Outstanding.’ As timelessly nostalgic as ‘Fire and Desire.’ As passion-triggering as Marvin Gaye’s ‘Let’s Get It On’” (p. 1).

With a better understanding of the original, one can now unpack how “Vax That Thang Up” was used as a vehicle to promote the COVID-19 vaccine. For the analysis, isolating the “P” of promotion yields fruitful information, especially since the promotion in the PSA was purposely constructed to decrease the sense of price for Black people, while simultaneously increasing the agency of the community. This section will first analyze the who and where of “Vax That Thang Up,” before using multimodal analysis to analyze the lyrics and visual elements of the remake, turned PSA.

Analysis

The making of the PSA

“Vax That Thang Up” featured three artists, two of the original, Juvenile and Mannie Fresh, but also included Mia X (Blistein, 2021). This decision was important because not only was it the first time a woman had been featured on the track, but also because Mia X is from a competing record label in Louisiana, No Limit Records. By coming together, the previous rivals imply the importance of the vaccine—the two labels had never collaborated before, but coming together for the community was critical (Blistein, 2021). When asked about the decision to do the remake, Juvenile stated, “I just wanted to do something positive for my people and to stand in the front to show that I’m willing to sacrifice” (Vaughn, 2021, p. 1). In addition to this, of special significance is the fact that all of the rappers were Black and from the Deep South; both of these factors have been known social determinants of health that increase rates of COVID-19. The researchers argue that having Black artists from the Deep South increases connection with the audience and the sense of agency as the messengers share a similar background to those disproportionately impacted. In this instance, the region is an example of culture, and the PSA illuminated the importance of the message being drafted and disseminated by a member of the culture.

Also, when analyzing who developed the promotion, it is important to understand that this was completed in conjunction with BLK, a dating app created for Black singles, not in collaboration with the government. S. L. Miller (2021) notes that the partnership was developed to create a “non-pushy” way to educate Black youth on the vaccine. The innovative approach worked as “Vax That Thang Up” became a trending topic on Twitter and has amassed around 3.3 million views, as of June 2022 (S. L. Miller, 2021). Lastly, before continuing to analyze the specific language, one must note that the medium of a music video is one that is relatively short, can be repeated, and consumed on one’s own time. The PSA, therefore, consists of the music video, not just the song.

Discourse Analysis: The Language of Promotion

Opening verse

The music video can be found on YouTube on BLK’s, the largest dating app for Black singles, channel. The initial 7 seconds feature the original song’s infamous “beat drop,” the moment where the silence is broken and the twerking anthem comes in; in fact, the first 7 seconds of the video still features twerking, a dancing act that empowers Black women and provides agency over their body (Halliday, 2020). At around 10 seconds listeners hear the first clear departure from the original as Juvenile raps, “But before you find a date yeah, you gotta wait yeah, Gotta go vaccinate yeah, get it straight yeah.” In this stanza, Juvenile frames the vaccination as critical to dating, using a potential romantic connection as the main motivation for seeking a vaccine. It is important to note the lyrics are vastly different than the original which reads, “You claiming you want a b*tch, yeah, that ain’t shit, yeah, The n*gga with the money, yeah, don’t act funny, yeah.”

The original was met with much ridicule surrounding the misogynist and explicit lyrics, but these have all been purposely altered to fit the rhetoric of being vaccinated. For example, the original chorus features the lyrics “girl, you look good, won’t you back that thang up.” However, “Vax That Thang Up” alters the language as Mia X, the only woman on the track, raps, “girl you looks good, won’t you vax that thang up.” In this alteration, becoming vaccinated is not perceived as a chore, but instead, it is a tool of female empowerment and linked to one’s physical attractiveness.

Chorus

Further analysis of the chorus unveils more insights into the power of culture in health promotion. Like other songs, the chorus repeats, and in turn, the primary message of “vaxxing that thang up” is consistently reinforced. The chorus also features a specific call out to men as Juvenile raps “You’s a handsome young brother, won’t you vax that thang up.” In this line, the term “brother” is used to signify community in the same way it is colloquially used within the Black community. Similar to the frequent use of the “head nod,” to say hello, the word “brother” is often used within circles of Black men to show solidarity and support (Dennis, 2021). In 2014, Former President Barack Obama’s foundation, launched My Brother’s Keeper, an initiative specifically designed to ensure all young men of color can maximize their potential. Because of the cultural connections, “brother” signifies that one may need to act not out of their own concern, but out of concern for their “brothers,” and other community members. Previous research has shown that for the Black community, familial-based messaging is an effective strategy in promoting the vaccine (Francis et al., 2021).

The chorus continues, “Date in real life you need to vax that thang up.” Here, the messaging of getting vaccinated to date is reinforced; framing the purpose of the vaccine as a means to enter back into dating and romance is a unique choice that is explored further in the discussion. This promotional language was purposeful, and centered on the Black community’s cultural value of freedom and dating; this is a vastly different framing than traditional health campaigns. The PSA did not just account for culture, but was able to give a unique cultural framing for the community. The chorus concludes, “Feeling freaky all night you need to vax that thang up.” Again, the vaccine is promoted as a means for the Black community to experience sexual freedom and liberation. There is a dearth of literature dedicated to sex positivity in the Black community (Alexander, 2019), but “Vax That Thang Up” utilizes a sex-positive frame to promote the vaccine.

Second verse

After the chorus, the artist switches to Mannie Fresh, and instead of rapping, “I know you can’t stand it, dick bandit,” he now states, “I know you can’t stand it. No holding hands chick. But when we get the shot, we gonna be romancing. Girl you can be the queen. After quarantine.” This reinvention completely transforms the original lyrics; the initial lyrics were largely focused on sexual conquests, but lyrics like “no holding hands chick,” indicates that the PSA is about ensuring COVID-19 social distancing guidelines were followed. It is important to note that these messages are from the Black community to the Black community, and in turn, the artists highlight the communal act of quarantining. The music video frames quarantining as a communal responsibility that the Black community should adhere to; it is only after one receives the vaccine that romancing can happen. Moreover, in the phrase above, “quarantine” is not framed in a negative light, instead, the rappers indicate that one can leave quarantine as a “queen.” This reshapes quarantine from a nuisance to a process of growth, where one can imagine themselves as royalty.

Toward the end of the verse, Mannie raps, “Internet date yeah, I’m the mate yeah, Download the app shorty you ain’t got to wait yeah.” In this verse, Mannie subtly recommends that internet dating is the only way to connect until one receives the vaccine. In addition to this, the lyric “download the app,” reinforces the importance that this was a partnership with a technology app focused on dating, not a government campaign or even an app focused on health promotion. As previously articulated, the Black community utilizes smartphones extensively and this campaign capitalized on this cultural asset.

Concluding verse

Toward the end of the music video, the chorus is heard again, but with a slight variation from above. The chorus concludes, “Acting foolishly you need to vax that thang up, Herd immunity when you vax that thing up.” Previous lines have centered around empowerment, but this line indicates a slight shift with the use of the word “foolishly,” which implies irresponsible behavior. However, this immediately shifts as one gets the opportunity to help achieve herd immunity, a known goal of the COVID-19 vaccine (Randolph & Barreiro, 2020). Again, it is worth underscoring that this follows the language of collectivism as opposed to one of individual liberty.

Visual analysis

Since this article takes a multimodal approach, it is imperative to isolate the visual elements as well. First, the video is filled with aspects of Black joy and bliss; one can observe dozens of individuals dancing, convening, and enjoying each other’s company after they have lined up for and received the vaccine. A long line indicates a high demand for the vaccine, and helps normalize the health behavior. The video implies that the freedom and peace of mind showcased in the video can be achieved only after one is vaccinated.

In other words, the communal joy, twerking, and bliss highlighted in the video are not achievable in a world where Black people are not vaccinated. In the video, there are even examples of people dancing in face masks and shields, but it is clear that this is not the same level of protection as the vaccine. While the video is able to show examples of Black prosperity during the pandemic, it is important to note that many Black people perished as a direct result of not receiving the vaccine and/or not having access to it. The video does not provide any negative visual elements of the Black experience related to COVID-19.

Second, many hip-hop videos feature the act of “making it rain,” or the act of throwing one-dollar bills to dancers (Hunter, 2011). The PSA took this popular act and completely reimagined it. Instead of throwing dollar bills, Juvenile and others proudly flash vaccine cards, passing them out and propelling them into the air. Finally, throughout the video, many individuals are seen engaging with BLK the app, where they find a match for their date. However, there are multiple instances where friends signal that they cannot meet yet because they have not received their vaccine. The music video shows a woman matching with a man on the app, but they do not meet in person until the end of the video; it is implied that they have both received the vaccine.

Discussion

“Vax That Thang Up” represents a huge departure from traditional health campaigns, but it also illuminates the power of culture and augmented agency within the Black community. To better understand the impact of the analysis, a discussion is warranted.

First, for “Vaxx That Thang Up,” it is critical to recognize that the partnership was completed in the absence of the government. As stated in the literature review, there is a collective memory and cultural apprehension related to Anti-Blackness and the history of American medicine. “Vax That Thang Up” was done in spite of government intervention, not because of it. Because it was an organic partnership between a Black-centered dating app and a Black New Orleans hip-hop bounce artist, the PSA was able to be unapologetically Black and connect to their intended audience. Under CCA, this would be an example of how culture was harnessed to increase communal agency. It is one thing for a politician and doctor to promote the vaccine, but those may not be the culture’s most important and/or influential messengers. As America continues to reckon with the toll of racial health disparities, it is imperative to always analyze how culture can be used as a benefit as opposed to a barrier. With more than 3 million views, the PSA clearly highlighted the power of an unorthodox approach to promoting the vaccine.

Second, when one analyzes the language of the music video, very little promotion was rooted in shame or negativity; instead, the music video purposely tied the vaccine to personal agency. The vaccine was critical to people’s sexual and romantic freedom; the community has the ability to liberate itself. However, the desire to become vaccinated does not automatically translate to receiving the vaccine, especially in the Deep South, the region where the video was filmed. While it does increase agency, the PSA conflates locus of control and self-efficacy with vaccine availability. In other words, much of the PSA centered on the P or promotion, but did not account for the lack of place and/or product availability even though the South had a lack of vaccination sites in Black communities well into the pandemic (McMinn et al., 2021).

Third, like many health-related PSAs, further analysis unveils an interesting paradox—the video did an impeccable job of promoting the vaccine, but did not necessarily adhere to or promote other COVID-19-related measures. If one analyzes the actions and spacing of the video, social distancing and masks are largely absent. The vaccine was one mitigation measure, but COVID-19 is best mitigated through a multi-pronged approach—social distancing, masks, and vaccines. Moreover, analysis of the lyrics reveals that the main vaccine promotional strategy was framed around dating and sexual pleasure. For instance, the end of the song features the lyrics “if you wanna get sticky and hot. . . . go get the shot.” Using sexual empowerment as a vaccine message strategy is not inherently flawed, but in this instance, it may be subjected to the same critiques as the original song—“Back That A$$ Up.” Also, it is vital to acknowledge that this PSA was developed and circulated before the onslaught of variants and other issues that increased susceptibility. Subsequent research has since revealed that the vaccine did not shield people from contracting COVID-19; instead, the vaccine lessens the severity of the symptoms. Thus, in turn, it is possible for one to be vaccinated, go on a date via BLK, and still contract COVID-19. This element was virtually absent in the PSA.

Limitations and Future Research

For the purpose of this research, the researchers systematically and strategically chose one artifact for analysis. However, additional pieces of content remain available for analysis. To this end, it would be fruitful if future studies examined the ways in which other music videos—as well as other forms of popular culture—specifically those targeting the Black community, incorporated topics related to COVID-19 and vaccination into their videos. Also, researchers were not able to include images of the campaign in the article due to copyright rules.

The field of health communication would benefit from additional studies that examine the culture of health within other communities of color, as well as other health-related subject matters. While the current study focuses on COVID-19 vaccination in the Black community due to the low rates, an analysis of the use of pop culture to target other racial minority groups would also be useful. Finally, more research is needed to understand the power of music videos in relation to health; music videos are designed to be consumed quickly, but also offer ample opportunity for visual and verbal cues to exist at the same time.

Conclusion

Based on years of exploitation and subpar direct care, the Black community has a large distrust of traditional health campaigns, and this apprehension extended to the COVID-19 vaccine. Applying Dutta’s (2018) CCA to health communication, researchers analyzed how Juvenile’s “Vax That Thang Up” was able to harness culture and augment agency for the Black community; in turn, traditional notions of Anti-Blackness were circumvented and empowerment became a key message.

Author Biographies

Deion S. Hawkins, Ph.D., serves as an Assistant Professor of Argumentation & Advocacy and the Director of Debate at Emerson College. Dr. Hawkins is an expert in social marketing campaigns and Critical Race Theory (CRT); his research is situated at the intersection of race, communication, culture, and health.

Sharifa Simon-Roberts (PhD) is an Assistant Professor of Intercultural Communication and Civic Engagement in the Communication Studies Department at Emerson College. Her scholarly interests center on communication, new media, culture, and identity, especially as these issues affect marginalized communities.