Going with the Grain of Cognition: Applying Insights from Psychology to Build Support for Childhood Vaccination

Abstract

Childhood vaccination is widely considered to be one of the most successful public health interventions. Yet, the effective delivery of vaccination depends upon public willingness to vaccinate. Recently, many countries have faced problems with vaccine hesitancy, where a growing number of parents perceive vaccination to be unsafe or unnecessary, leading some to delay or refuse vaccines for their children. Effective intervention strategies for countering this problem are currently sorely lacking, however. Here, we propose that this may be because existing strategies are grounded more in intuition than insights from psychology. Consequently, such strategies are sometimes at variance with basic psychological principles and assumptions. By going against the grain of cognition, such strategies potentially run the risk of undermining persuasive efforts to reduce vaccine hesitancy. We demonstrate this by drawing on key insights from cognitive and social psychology to show how various known features of human psychology can lead many intuitively appealing intervention strategies to backfire, yielding unintended and undesirable repercussions. We conclude with a summary of potential avenues of investigation that may be more effective in addressing vaccine hesitancy. Our key message is that intervention strategies must be crafted that go with the grain of cognition by incorporating key insights from the psychological sciences.

Vaccine Rejection and Hesitancy: A Review and Call to Action

“…There are many different subpopulations of individuals with divergent reasons for not vaccinating or delaying vaccines [ 27 ]. This may be due to a variety of factors, including (1) complacency (low-risk perceptions of vaccine-preventable diseases), (2) lack of convenient access to vaccine services, (3) or lack of confidence in vaccines due to concerns about safety and other vaccine issues [ 25 , 28 ].…”

“…As noted previously, one impulse many scientists may have is to simply educate the public. Known as the “information deficit model” of science communication, this model assumes that the public is merely uneducated or undereducated about vaccines, and that providing additional factual information will fill this knowledge gap and lead people toward vaccinating [ 28 ]. Unfortunately, information alone has not been shown to increase vaccine confidence among hesitant parents [ 9 , 37 ].…”

The second information revolution: digitalization brings opportunities and concerns for public health

“…For example, challenging incorrect anti-vaccine beliefs held by those who believe that the pharmaceutical industry manipulates data is not made easy by a few high profile cases where they have been shown to do so. Some responses could perversely ‘backfire’, 44 paradoxically, increasing the propensity for some people to believe the false message 45 , 46 . It may be more effective not to engage with the details but instead appeal to values.…”

Information wars: tackling the threat from disinformation on vaccines

“…Those responsible for vaccination programmes must ensure they have a detailed understanding of knowledge and beliefs in their populations14 and employ much more sophisticated messages, recognising that many traditional ones can backfire and reduce the likelihood that those already sceptical will support vaccination 15. They should draw on a growing body of research, some in related fields such as climate change,16 on confronting disinformation.…”