Images, Stories of Disease Can Change Attitudes About Vaccines

Beth Skwarecki

August 13, 2015

Reminding people about the dangers of measles, mumps, and rubella can change their feelings about vaccines more than correcting myths about vaccines and autism, according to a study by Zachary Horne, PhD, from the Department of Psychology, University of Illinois at Urbana-Champaign, and colleagues, published online August 3 in the Proceedings of the National Academy of Sciences.

"Someone once asked us, 'isn't this fearmongering?' and we thought, well, it's not really fearmongering if in fact you really ought to be afraid. It's just good advice," Derek Powell, a PhD student in cognitive psychology at the University of California, Los Angeles, and co-lead author of the study, told Medscape Medical News.

Investigators recruited 811 participants through Amazon Mechanical Turk, a work distribution website often used for surveys. On the first day, participants answered questions about vaccine attitudes as well as "distractor" questions about ethical issues such as euthanasia and abortion. On the second day, they were presented with information about vaccines and autism; information about the risks for measles, mumps, and rubella; or a control passage describing the benefits of bird feeding. Afterward, they were asked again about their attitudes toward vaccines. A total of 315 people participated both days and passed "attention check" questions embedded in the survey.

Answers to vaccine attitude questions, such as "The risk of side effects outweighs any protective benefits of vaccines," and "I plan to vaccinate my children," were combined into a score that correlated with participants' answers to whether they had gotten an influenza vaccination for themselves (r = 0.252; P < .001) or whether they had ever refused a vaccination for their children (r = −0.453; P < .001). About half of the participants were parents.

The disease risk intervention included a short true story about a baby who was hospitalized for measles and photos of children with measles, mumps, and rubella. Participants who saw this disease risk information had significantly larger changes in their vaccine attitude scores than those who saw the control passage (P = .003) or a passage explaining that vaccines do not cause autism (P = .017).

As previously reported by Medscape Medical News, a study that tested four different disease interventions to try to change parents' minds about vaccination, including one that aimed to correct misinformation about vaccines and an autism, was not successful. In fact, the autism correction resulted in a "backfire effect," strengthening opposition to vaccines.

However, the current study and the previous one used different populations of participants and had differences in methodology. The new study combined photos and other information into one disease risk intervention, rather than testing them separately as the previous one had done. In addition, Powell and colleagues combined the results of several vaccine attitude questions into a score.

Powell and colleagues suspect that the effect of learning about vaccines may be strongest immediately afterward, which could explain why they did not observe a backfire effect. This also suggests clinicians have a prime opportunity to educate parents or patients immediately before they make a decision about vaccination.

"We've identified the general sort of approach that seems to be effective: highlighting the dangers of diseases and the effectiveness of vaccines as a solution for avoiding that danger. So obviously clinicians would have to make kind of their own judgment what they want to talk to their patients about, but I think [focusing on disease risks] would be an effective way for them to communicate with their patients about vaccines," Powell said.

The authors have disclosed no relevant financial relationships.

Proc Natl Acad Sci. Published online August 3, 2015. Abstract

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