Thursday, October 04, 2012

The Hazy World of Vaccine Messaging

After almost 3 years now of complete absorption into issues related to vaccination, it's no surprise that I continue to be fascinated and dumbfounded by the complexity of the rhetorical situation that occurs when a doctor must convince a new parent (or even an old one) that vaccines are the right course of action for protecting a child. The issue has been researched and studied and battled for hundreds of years, and as much as vaccines may be an "answer" to the scourge of small pox, polio, and measles, no "answer" has yet emerged that guarantees that vaccines will be accepted by the people they are intended to protect. I'm fascinated and in some ways encouraged that, in this case, a scientific discovery comes along quicker than a rhetorical one.

On Twitter (my new, sole connection to the outside world since I started writing my dissertation) today another piece of yet more confusing information about vaccine messaging rolled across my feed. This article in Scientific American reports on a study published in Health Psychology about the role that pro-vaccine messages play in convincing parents of vaccine efficacy and safety. 

The article states, in what seems like a completely counter-intuitive conclusion, that after participants were told to "imagine parenting an 8-month-old" (maybe a problematic scenario; I'd have to read the study to understand this, but couldn't they just have gotten participants who actually were parents of 8-month-olds?) and were told about a serious disease that the doctor wanted the parent to vaccinate against: "Those who were told there was no evidence for risk [from the vaccine] reported greater concern about vaccination and less intention to vaccinate their child than those who read the moderate messaging. The effect intensified when the messaging came from a perceived untrustworthy source, like a pharma company."

The conclusion the article draws is that a harder sell for the vaccine might produce the opposite effect, and so therefore a softer sell may be more effective. 

I have two thoughts: first, I have a lot of questions about the population/participants here, and I really wish I had time to find this study and give it a closer look. To imagine you're the parent of a baby, and then to imagine being told about a disease, and then to imagine how you might react to different ways of "selling" the vaccine constitutes a lot of imaginative leaps. I don't want to extrapolate too much on that without reading the full study, but I am really curious why they didn't ask actual parents of 8-month-olds. I also wonder whether they had a doctor, pediatrician, or a researcher present this scenario. Here, I'm thinking ethos: did the person seem concerned, did the person seem like an advocate for children, or did he/she seem disinterested? That could have played a role in how the "parent" interacted with the person delivering the information relative to disease perception and need for vaccination. 

Second, I don't think this is about hard/soft sells. I think the believability, in this case, has to be tied to trust in some way. Does anyone really think that any medical treatment comes with absolutely no risk? We are so engrossed in a culture and scientific reality now that knows about and accepts side effects as an expected part of any treatment, that it would strike me as suspect if someone told me that there were no risks rather than just some risks. 

In my Literature, Medicine, and Culture class a few weeks ago, we looked at commercials for Ambien, one from 2000 or 2001 and another from 2012. The list of side effects in the 2012 commercial takes up more airtime than the actual description of what the drug is supposed to help, and the list ranges from mild side-effects to ridiculous things (that have by now been well-publicized) like hallucinations and sleep walking. 

This expectation of risk may not stop us from being surprised or annoyed when we take a medication and it makes us sick in ways we weren't anticipating, but at the outset, I think I would feel lied to if a doctor told me there was absolutely no risk as a result from treatment, and that is particularly true with parents and vaccines. Even people who are pro-vaccine know that there are risks associated with the vaccination, even though they are rare when severe. 

So, again, I don't think this has to do with the "hardness" or "softness" of the information as presented. My sense is that it has more to do with believability, trust, and the logos at work here. If the participant feels liked to or deceived by being told that the vaccine carries no risks, then that person may be less likely to trust the related recommendation. But, if the speaker acknowledges the side effects and risks, then the appeal matches the expectation of risk, and the person feels leveled with, spoken to honestly. 

The inherent persuasiveness trust, even if risks are involved, may be more convincing than the imaginary notion of a risk-free world, or even a risk-free treatment.

1 comment:

Starling said...

I think you're exactly right about ethos & trust being at the heart of this study, rather than hard vs. soft selling of the message. Risk communication is always a trust-building (and trust reliant) enterprise. When there's even the slightest breach in that trust, it's understandable that participant audiences are going to distrust the source of that breach.

I think, to a certain extent, there might be a "psychic numbing" element going on, too. Slovic talks about numbers being less persuasive than stories in risk comm. Parents have access to numerous narratives (whether validated or not) about children damaged by vaccines, but whenever the scientific community responds, it's with numbers. You can't "fight" stories with narratives. You have to develop counternarratives. (Also, can I just say how odd it is to think of the possibility of scientific info as counternarrative?)