Despite high COVID vaccine availability, mortality rates in the conservative Permian Basin region of Texas and New Mexico were double the US national average and vaccination rates were low. Research uncovered a barrier to getting vaccinated was not the vaccine itself but the risk of community ostracization. To address this, the “Attack the Virus, Not the Vaccinated” campaign re-established COVID as the real enemy by legitimizing the intimately personal reasons the community had for getting vaccinated. It drove a 73% increase in vaccinations across the region; and it is estimated that communications saved more than 1,600 lives and at least $607m in hospital costs.