Since the 1990s, the number of parents seeking vaccine exemptions for their children has been climbing, pitting public health against influential anti-vaxxers in a proxy messaging war.
But it seems the doctors trying
to persuade the vaccine-hesitant — still a tiny minority of parents —
have mostly been failing: Either their messages are off or the
anti-vaccine campaigns, circulating among sources like conspiracy
theorist Alex Jones, are too powerful to counter.
Now, researchers are borrowing a theory from social psychology (one that also coincidentally helps explain
the rise of Donald Trump) to understand where doctors’ pro-vaccine
campaigns may be going wrong. And they’ve discovered that they’re
probably emphasizing the wrong things in their messages, as they
describe in a study published Monday in the journal Nature Human Behavior.
The paper, led by researchers at Emory University in
Atlanta, was designed to tease out which morals parents who were
hesitant about vaccines held most dear when making personal decisions,
including about vaccinating their kids. The researchers turned to Moral Foundations Theory,
an effort by social and cultural psychologists to chart the moral
values that are common across cultures in guiding decision-making.
Moral Foundations Theory was widely cited in the aftermath
of the election, when the facts alone had trouble explaining the rise
of Trump. The theory involves six moral foundations, or “moral taste
receptors”: care/harm, authority/subversion, loyalty/betrayal,
liberty/oppression, purity/degradation, and fairness/cheating. For
different people, different morals resonate more effectively.
Conservatives are more likely to respond to appeals to authority and
loyalty, for example, while liberals prize fairness.
The Emory authors behind the new paper used a standard
Moral Foundations Theory questionnaire to survey more than 1,000 parents
of children under age 13 who were living in the US, asking them
questions about whether something was right or wrong to suss out their
values, then determine how important those values were in
decision-making. They also asked the parents about
their vaccine beliefs. An independent group of researchers, based at
Loyola University in Chicago, repeated the survey on another group of
American parents.
Parents who are concerned about vaccines prize liberty and purity
Together, they found the morals of purity and liberty
were most associated with vaccine hesitancy, shedding light on what
people who refuse vaccines care about — and what may be holding them
back.
People who value liberty are concerned with individual
freedom and resent others’ dominance over them, while those who value
purity disapprove “of acts that are deemed ‘disgusting’ or ‘unnatural,’”
the researchers wrote. (That squares with the findings of sociologist Jennifer Reich,
who studies the anti-vaccine movement. She’s found vaccine-hesitant
parents tend to favor natural and organic food, for example.)
“This is important because many of our go-to arguments
about herd immunity and keeping your children safe are themed around
values of harm and fairness,” said the Emory study’s lead author, the
epidemiologist Avnika Amin.
Public health campaigns typically seek primarily to
educate on potential harms, reminding parents that getting immunized
helps prevent outbreaks, and protects those who can’t be vaccinated,
like people with allergies to vaccines or very young babies. But those
may not be the values that resonate with vaccine-hesitant parents. The
researchers found that parents who were concerned about vaccinating
their children scored similarly to parents who weren’t when it came to
the morals of harm and fairness.
Anti-vaccine messaging has emphasized purity and liberty, while public health campaigners have been focused on harm and fairness
On the flip side, the paper also helps explain why
anti-vaxxers’ messages may appeal to this group of parents. As the
researchers wrote, “Anti-vaccination websites also often claim that
vaccines contain ‘contaminants’. These concerns may be rooted in the
purity moral foundation, with its emphasis on avoiding anything
disgusting or unnatural. Another frequent message on anti-vaccine
websites is that mandatory vaccination policies violate parental civil
liberties.”
The results suggest that pro-vaccine communications could
be strengthened by taking a page from the anti-vaxx book — and
presenting messages that better align with purity and liberty.
You could increase the salience of disgust associated
with certain diseases, and say vaccines fight those,” said the Emory
study’s senior author, Dr. Saad Omer. “Or you could frame purity
positively — saying vaccines are a very natural product, they work with a
natural system,” he explained. “Messages that talk about liberty, that
the freedom to choose for your child is being taken away if other others
don’t vaccinate, might work.”
This finding is extremely important, considering that over the last three decades, the number of parents who opt out of vaccines for their kids has grown. In one 2009 New England Journal of Medicine paper,
researchers looked at the state-level rates of non-medical exemptions
and found that, between 1991 and 2004, those rates increased from less
than 0.98 percent to about 1.5 percent. According to a recent study,
we’re now hovering above the 2 percent exemption rate, which translates
to thousands more unvaccinated children than just a decade ago.
As I’ve explained,
vaccine refusers are a politically diverse group, but they do have some
things in common. Parents who reject some or all vaccines are more
likely to be white, college-educated, and married, with higher family income.
Both Omer and Amin emphasized that the moral messages
they’ve identified will need to be tested, and that’s what they’re
hoping to work on next. So keep an eye out to see if they’ve truly found
the elusive key to effective vaccine communications.
Seems like everyone's an expert on why parents STOP vaccinating their kids without even asking them why.
ReplyDeleteso why?
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