TIP Talk!

Thursday September 28, 2017

Facts Don't Persuade Vaccine-Hesitant Parents. What Will?


The facts are all on the side of vaccines. The science has been done many times over, and it clearly shows that vaccines save millions of lives every year. They do not cause autism. Any side effects are uncommon and almost always minor.

Why, then, does it seem so hard to persuade people who are hesitant or skeptical about immunization?

A study published in the journal PLOS ONE over the summer laid out a potentially troubling scenario: It found that three different ways of trying to combat vaccine fears failed to nudge people toward a more positive view of vaccines. Worse: The fact-driven information they were given was actually counter-productive. People said they were even less likely to vaccinate their children than before. Their belief in misinformation about vaccines deepened.

The study, conducted by the University of Edinburgh, divided the subjects into four groups. One group was given a leaflet that used scientific facts to counteract vaccine myths. Another was approached on a more data-driven level, with charts showing the chances of various outcomes for vaccinated and unvaccinated people.

The third approach was more emotional, showing people “pictures of unvaccinated children with measles, mumps, and rubella, along with the description of the symptoms of each disease and a brief warning about the importance of vaccinating one’s own child,” the report said. The fourth group was a control group that was shown unrelated material.

The University of Edinburgh study is just one of several produced over the past several years to raise the all-important question of how to use what we know about vaccines to avoid a backward slide in vaccine acceptance.

The researchers in the Edinburgh study don’t know why all of the approaches backfired, but one concern is that in order to counteract a myth, the myth has to be repeated in some form. That appears in some way to reinforce the myth rather than the correct information.

“Some studies found that repeating myths led to a marked increase in accepting those myths as true,” the authors wrote. “For example, in an unpublished study, participants who read a ‘myths vs. facts’ flyer regarding the flu vaccine subsequently misremembered myths as facts after only 30 minutes.”

Another study, the authors wrote, found that people who read true or false statements about health couldn’t remember which was which after three days. “Even worse, the more they were warned that a statement was false, the more they accepted it as true.”

This puzzling conundrum doesn’t affect just vaccines. Social scientists are trying to get to the bottom of a larger issue about how people process and remember information. One thing is clear: It’s not nearly as simple as learning a fact and taking that fact forward in life.

Some studies have found more promising responses than the Edinburgh research, but one conclusion they tended to reach was that a very science-based, fact-vs-myth conversation was the least effective.

A 2015 study published in the Proceedings of the National Academy of Sciences was among those to find that telling parents their beliefs were wrong, and backing it up with relevant science, didn’t work.

But unlike the Edinburgh scientists, these researchers from UCLA and the University of Illinois-Champaign found that the more emotional approach was effective.

“The final group read materials that described the dangers of measles, mumps and rubella, and explained how a vaccine can prevent these diseases,” according to a statement put out by UCLA. “The materials included photographs of children with these diseases.

“The group also read a paragraph by a mother named Megan Campbell, whose 10-month-old son suffered a life-threatening bout of measles.”

Even among very skeptical parents, support for vaccines increased “substantially” when their emotions were engaged.

But one year before that, a study published in the journal Pediatrics came up with the same frustrating results as the Edinburgh study.

That doesn’t mean the more visceral, emotional approach doesn’t work at all. The UCLA-Illinois study may have put together a more touching presentation for skeptical parents. Obviously, much more research is needed to find the most effective way to communicate potentially life-saving information to parents.

There also are other tactics that have been surprisingly effective. An August study in the Journal of Adolescent Health found that parents were much more likely to go along with HPV vaccination for their preteens when the doctors didn’t over-discuss it. The presumptive approach worked best, researchers found, such as when a doctor said something like, “We give three vaccinations at this checkup, HPV, meningitis and Tdap.” The brief, authoritative language resulted in more kids being vaccinated.

Similarly, a recent report on increased whooping-cough vaccinations during pregnancy concluded that women were much more likely to get the vaccine when their doctors recommended the vaccine as a routine part of prenatal care and offered to provide the shot right then and there.

Earlier this year, a Rutgers study found that people were three times as likely to get a flu shot if their doctors took a proactive role and scheduled the appointment for them instead of recommending that they make an appointment.

Perhaps it will turn out that a more effective way of increasing vaccine acceptance is by persuading doctors to change their tactics, rather than by trying to persuade parents to believe in vaccines.

There is one more way that support grows for vaccines: in the midst of a disease outbreak. After the measles outbreak that originated at Disneyland, a poll showed that parents’ support for vaccines and belief in their benefits increased. That support was the underpinning for California passing one of the strongest vaccination laws in the nation, and vaccination rates for kindergartners are now markedly higher. Similarly, nations in Europe are passing much stricter laws after a deadline measles outbreak there.

But none of us want to reach the point where people are sickened, and children are dying, before more parents are persuaded.



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