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Using moral foundations in government communication to reduce vaccine hesitancy

ABSTRACT: Having a vaccine available does not necessarily imply that it will be used. Indeed, uptake rates for existing vaccines against infectious diseases have been fluctuating in recent years. Literature suggests that vaccine hesitancy may be grounded in deeply rooted intuitions or values, which can be modelled using Moral Foundations Theory (MFT). We examine the respective prominence of the MFT dimensions in government communication regarding childhood vaccinations and explore its effect on parents’ vaccine hesitancy. We measure the MFT dimension loading of the vaccination information brochures from the Dutch National Institute for Public Health and the Environment (RIVM) between 2011-2019 and connect this information with the electronic national immunisation register to investigate if the use of moral foundations in government communication has a measurable effect on vaccination uptake. We find the largest positive effect for the dimensions Authority/Subversion and Liberty/Oppression and suggestive evidence in favour of a small positive effect for Purity/Degradation. Conversely, Loyalty/Betrayal actually has a negative effect on vaccination rates. For the dimension Harm/Care, we find no significant effect. While Purity/Degradation and Harm/Care appear to be the two most frequently used moral foundations by RIVM, these dimensions have in fact no or only a minor effect on parents’ vaccine hesitancy. Reducing the use of these moral foundations may be the first step towards optimising government communication in this context. Instead, formulations activating the moral foundations Authority/Subversion and Liberty/Oppression appear to have positive effects on vaccination uptake.

SUBMITTER: Heine F

PROVIDER: S-EPMC8577733 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:BackgroundVaccine hesitancy (VH) remains worldwide a reason of concern. Most of the vaccination education strategies followed a "fact-based" approach, based on the assumption that decision making is a rational process, without considering the influence of cognitive biases and heuristics. Our study aimed at identifying factors involved in the parents' vaccination choice to inform and shape communication interventions.MethodsWe conducted an online national survey among parents between November 2020 and April 2021. The questionnaire consisted of 42 items organised in 4 parts: (1) personal information, (2) cognitive biases and risk propension, (3) Analytic Thinking (Cognitive Reflection Test), (4) conspiracy mentality, health literacy, and VH. Exploratory factor analysis was conducted to identify latent variables underlying the 19 items related to the 6 cognitive biases. Factors were categorised in quintiles and the corresponding pseudo-continuous variables used as predictors of the VH. Logistic regression model was applied to assess the association of the VH with factors, conspiracy mentality and risk propension. We adjusted for age, gender, economic status, and education levels.ResultsThe study included 939 parents, 764 women (81.4%), 69.8% had a degree or higher level of education. Considering cognitive biases, four factors explaining 54% of the total variance were identified and characterised as: fear of the side effects of vaccines (scepticism factor); carelessness of the risk and consequences of infections (denial factor); optimistic attitude (optimistic bias factor); preference for natural products (naturalness bias factor). All factors were positively associated to VH (p < 0.001) as were conspiracy mentality (p = 0.007) and risk propension (p = 0.002).ConclusionsThis study confirmed the need to amplify the model used to analyse the VH considering cognitive biases as important factor affecting the parents' decision making. These results may be useful to design personalised communication interventions regarding vaccines and vaccination.

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Using moral foundations in government communication to reduce vaccine hesitancy

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