Vaccination Hesitation in the COVID-19 Era – NPHR Blog


by Sapna Suresh

In 1998, a then credible British scientist named Andrew Wakefield published a seemingly groundbreaking study in the medical journal the hand. The article detailed the stories of several children who claimed to have received the measles-mumps-rubella (MMR) vaccine, which in turn caused severe inflammation, intestinal discharge, and allowed harmful substances to enter the blood and travel to to the brain. According to Wakefield, the consequence of the vaccination was that most of these children apparently developed autism spectrum disorder (ASD).

Despite the evidence of the dubious research methods of Wakefield and the possible withdrawal of the article by the hand, this study set the stage for the false claim that vaccines are a causal factor in the development of ASD. The myth of the vaccine-autism link has persisted to this day despite it numerous studies quite the opposite and poses significant challenges to both the current launch of the COVID-19 vaccine and vaccination efforts more generally.

The reasons for the perpetuation of this myth are numerous: the power of evidence and anecdotal stories, the ability of celebrities with big platforms to spread the lie widely, the growing wave of anti-government and anti-establishment sentiments in the United States, and a growing number of individuals who prefer alternative medicine over modern medicine. Additional reasons for this misinformation persisting in the face of a credible correction – known as the continuing influence effect – also exist on a cognitive level.

Search for Bower & Morrow demonstrates that people build mental models around certain topics when they first encounter information; These models are then updated as new information becomes relevant. Changes to these models can be made incrementally by incorporating small updates to the existing model or globally by discarding the old model altogether and recreating a new one.

Importantly, when incorrect information is withdrawn and new information only invalidates parts of the mental model, people are left with a void. As a result, they often rely on original information – even if aware of its retraction or denial – simply because the original information is more coherent. For example, denying a statement (for example, “this is false” or “this is incorrect”) can create a gap in the mental model because this approach fails to provide an alternative explanation. As a result, people can lose the negative “tag” associated with memory and return to their original belief.

Understanding the origins of vaccine misinformation and the mechanisms by which it exerts its negative influence is of clear importance during global vaccination efforts against the novel coronavirus disease. Coupled with vaccine hesitation rooted in Wakefield’s work, communities of color have increased distrust of the medical system due to a long history of medical racism. Social media adds further fuel to the fire by allowing for the rapid dissemination of misinformation.

Thankfully, there are steps that can be taken to address vaccination hesitations. Global updates to address security concerns can be implemented by providing factual alternatives to untruths. Consistent fixes can be developed by “rewriting the narrative” and accurately describing:

Who was involved?

What happened?

When did it happen?

Where did it happen?

Why did it happen?

Further steps include framing the message in a way that increases the recovery of the retraction rather than the myth, highlighting the trustworthiness of preferred sources to increase credibility, and avoid repeating the myth itself. Ultimately, global fixes, as opposed to incremental updates, provide a promising path to reformulate vaccination concepts without leaving room for consistency issues.

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Sapna Suresh is a second-year PhD student at Northwestern University’s School of Communication. It conducts research on the many ways we can persuade people to change their attitudes and behaviors, including through the use of narratives and emotions. Her outreach work includes a previous internship at the Population Media Center, participation in the NPR SciCommers network, and service as a mentor for Northwestern college students focused on health communication.


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