Message framing effect on vaccine hesitancy

Measles outbreaks are becoming a real headache in the US. We know the reason: Low measles vaccination coverage!

Parents fear to jab their babies with vaccines due to the vaccine’s adverse effects.

How do healthcare workers deal with this dilemma?: Persuading parents to jab their children.

Loss-framed messages and gain-framed messages

We can find two types of vaccine-related public health messages: Loss-framed and gain-framed.

Loss-framed messages highlight what we lose if we do not take the vaccine; on the other hand, gain-framed messages highlight what we gain if we take the vaccine.

Because of my enthusiasm about the effect of message framing on behaviour, I searched for systematic reviews, meta-analyses, and research papers about this topic.

A systematic review

In this short journey, I found a systematic review published in 2018 by Marcela A. Penţa and Adriana Băban under the title of “Message Framing in Vaccine Communication: A Systematic Review of Published Literature”. Of the 34 studies reviewed, they found only two studies that addressed my topic of interest. Most studies have addressed messages related to Human Papillomavirus (HPV) vaccination.

The two studies were:

  1. Abhyankar, P., O’Connor, D. B., & Lawton, R. (2008). The role of message framing in promoting MMR vaccination: Evidence of a loss-frame advantage. Psychology, Health & Medicine, 13, 1–16.
  2. Hendrix, K. S., Finnell, S. M. E., Zimet, G. D., Sturm, L. A., Lane, K. A., & Downs, S. M. (2014). Vaccine message framing and parents’ intent to immunize their infants for MMR. Pediatrics, 134, e675–e683.

Just in case, if I missed studies related to this topic but not cited here, I invite interested readers to write to this blog regarding your findings.

About the Hendrix et al., study (2014) 

I will begin with the Hendrix et al., (2014) study. It was an online survey. They randomly assigned 802 parents with infants aged less than 12 months into four groups; each group received only one message type.  The message types were as follows:

Message type 1: The standard CDC vaccine statement

Message type 2: The above CDC message and information emphasizing MMR vaccine’s benefit to the child

The “benefit to the infant” message: The message was this:

“The MMR vaccine protects your child from getting the diseases measles, mumps, or rubella or the complications caused by these diseases. After receiving this vaccine, your child will not miss school activities due to these illnesses and will be able to play with friends during an outbreak”.

Message type 3: The CDC message and information emphasizing MMR’s benefit to the society

The “benefit to the society” message: The message was this:

“The MMR vaccine prevents your child from spreading measles, mumps, or rubella to those who cannot get the shot. Such people include infants, 1-year-old who are too young for the shot, the elderly who have outgrown their immunity, and someone with an immune system that does not respond to shots, such as some patients with cancer during therapy”.

Message type 4: The CDC message and information emphasizing MMR vaccine’s benefit both to the child and society

The parents’ willingness to give MMR vaccine to the child was assessed on a scale from 0 (very unlikely to give) to 100 (very likely to give).

Their findings

They found when compared to the intention (mean = 86.3) of the group who received the CDC standard statement, the intention of the group (mean = 91.6) who received an information leaflet highlighting the benefit to the baby was significantly higher (SD =16.9; P=0.01). The intention of the other group who received information highlighting both types of benefits – to the baby as well as the society – was also higher than the former but slightly lower (90.8); however, the result also became statistically significant (SD=18.2; P=0.03).

As a result, they conclude that emphasizing benefits to the society does not add any value; however, they further conclude that it does not interfere with the “benefits to the child” message.

Although the increase in intentions was modest when highlighting benefits to the child, it impacts hugely in terms of millions of populations.

Author: Prasantha De Silva

A specialist in Community Medicine board-certified in Sri Lanka and a research analyst in Canada

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