Building Confidence in Vaccines and Reducing Vaccine Hesitancy: How Vaccine Messaging Helps to Improve Vaccine Uptake in Hesitant Portions of the Population.
Researchers
Background Info
People base their vaccination decisions on a variety of factors, including the perceived risk of contracting the disease, trust in the vaccine safety and the health care system that produced it, degree of protection produced by the vaccine, and the personal costs of obtaining it. Following these judgments, some individuals get vaccinated, some do not, and a large portion of the population remains ambivalent. This project asks how vaccine messaging help to improve vaccine uptake in hesitant portions of the population.
Problem
Vaccine hesitancy is the phrase used to describe individuals who refuse vaccines or delay vaccination despite availability, effectiveness, and safety. The number of people who are vaccine hesitant varies across regions, communities, countries, and continents, as well as diseases. With the introduction of new vaccines, such as COVID-19, hesitancy is often high due to unfamiliarity and uncertainty.
Health messaging is an important means of building confidence in vaccines and reducing vaccine hesitancy. Vaccine-promoting messages usually focus effectiveness and safety. For example, messages may emphasize the degree to which vaccination benefits individuals or others, and how un-vaccinated individuals are at higher risk of infection, hospitalization and death, and how unvaccinated persons may harm others by contributing to transmission of the disease. The CDC and other health authorities have observed that a one-size-fits-all strategy for pro-vaccine communication often backfires. What is needed instead is the development of messages that are tailored to different groups based on their needs, wants, and identities.
Goals
The main goal of this project is to develop confidence-building vaccine messages that are adapted to distinct groups of vaccine-hesitant individuals. The design and implementation of such messages requires three things. First, a thorough understanding of the nature of the problem to be solved—that is, why are certain populations vaccine-hesitant? Second, how does the target audience conceive of the issue? Finally, the proposed solution—how can we create messaging that successfully encourages vaccine-hesitant individuals to get vaccinated? Audience research into responses to SARS-CoV-2 vaccine is scarce due to the relatively new technologies of the vaccine development (mRNA) and the uncertainty involved with the novelty of the virus itself. Our project leverages the theoretical framework of the integrated behavior model to characterize different audience segments and match messages to their profiles.
Progress
Funding
Shen, L., MacGeorge, E. L., Dillard, J. P., Boni, M. (2022). Developing tailored message strategies to build vaccine confidence based on profiles of individuals hesitant to receive vaccines for COVID-19 and influenza. Merck Investigator Studies Program. ($212,000. Funded)
Shen, L., Dillard, J. P., MacGeorge, E., & Block, R. (2023). Building COVID-19 and flu vaccine confidence with interventions that match undergraduates’ psychological profiles. Proposal submitted to the Centers for Disease Control and Prevention. ($1,465,180 requested. Approved for funding by CDC, but not funded due to subsequent Congressional cuts to CDC)
Findings
Shen, L., & Lee, D. (2023). Predicting COVID-19 and influenza vaccination confidence and uptake in the United States. Vaccines, 11, 1-17.
Abstract. This study investigates and compares the predictors of COVID-19 and influenza vaccination confidence and uptake in the U.S. Vaccine hesitancy is defined as the reluctance or refusal (i.e., less than 100% behavioral intention) to vaccinate despite the availability of effective and safe vaccines. Vaccine hesitancy is a major obstacle in the fight against infectious diseases such as COVID-19 and influenza. Predictors of vaccination intention are identified using the reasoned action approach and the integrated behavioral model. Data from two national samples (N = 1131 for COVID-19 and N = 1126 for influenza) were collected from U.S. Qualtrics panels. Tobit regression models were estimated to predict percentage increases in vaccination intention (i.e., confidence) and the probability of vaccination uptake (i.e., intention reaching 100%). The results provided evidence for the reasoned approach and the IBM model and showed that the predictors followed different patterns for COVID-19 and influenza. The implications for intervention strategies and message designs were discussed.
Shen, L. (2024). Toward multidimensional message tailoring to address COVID-19 and influenza vaccine-hesitancy: A latent profile approach. Health Communication, 39(13), 3380-3391.
Abstract. Vaccines remain the best strategy as the COVID-19 pandemic enters into later stages and governments begin to shed pandemic-control measures. Vaccine hesitancy continues to be a major obstacle in efforts to end the pandemic. This study reports formative evaluation research that adopted a multidimensional approach using latent profile analysis to audience segmentation and message targeting. Within the framework of the integrated behavioral model, data were collected from a US national survey to explore the dimensions in which vaccine-confident vs. -hesitant individuals differed significantly across the topics of COVID-19 and influenza. Latent profile analyses were performed to identify subgroups and establish measurement invariance between COVID-19 and influenza vaccines. Matching message strategies were proposed for the distinctive characteristics of the subgroups for both topics and to be tested in future research.
Dillard, J. P., & Shen, L. (2024). Pro-vaccination flu and COVID-19 messages: Evidence of congenial targeted and spillover effects. COVID, 4(3), 363-377.
Abstract. Given the plentitude of messages in the public arena that promote vaccination against different diseases or raise the possibility of vaccine mandates, we asked whether message effects in one disease domain might spill over into other domains. Our experiment exposed individuals (N = 1755) recruited from an opt-in online panel (Qualtrics) on influenza or COVID-19 pro-vaccination messages then measured intentions to vaccinate for each disease and intentions to support a vaccine mandate for each disease. Messages that targeted flu (vs. COVID-19) exhibited stronger effects on intentions to vaccinate for corresponding (vs. noncorresponding) disease. We observed positive spillover from intention to vaccinate against one disease to intention to vaccinate against the other disease, as well as from vaccination intention type to support for corresponding and noncorresponding vaccine mandates. Although pro-vaccination flu and COVID-19 messages have multiple effects, those effects are congenial. The results adjudicate differences in spillover theory and suggest synergistic effects between pro-vaccination campaigns.