Vaccine Hesitancy in the COVID-19 Era

By Sapna Suresh

In 1998, a then-credible British scientist named Andrew Wakefield published a seemingly groundbreaking study in the medical journal The Lancet. The article detailed the stories of several children he claimed had received the measles-mumps-rubella (MMR) vaccine, which in turn caused severe inflammation, intestinal leakage, and permitted harmful matter to enter the blood and travel to the brain. According to Wakefield, the consequence of vaccination was that the majority of these children apparently developed Autism Spectrum Disorder (ASD).

Despite evidence of Wakefield’s dubious research methods and the eventual retraction of the article by The Lancet, this study laid the groundwork for the false claim that vaccines are a causal factor in the development of ASD. The myth of the vaccine-autism link has persisted into present day despite numerous studies to the contrary and poses significant challenges for both the current rollout of the COVID-19 vaccine and vaccination efforts more generally.

The reasons for the perpetuation of this myth are numerous: the power of anecdotal evidence and stories, the ability of celebrities with large platforms to widely disseminate the falsehood, the growing tide of anti-government and anti-establishment sentiment within the United States, and an increasing number of individuals favoring alternative over modern medicine. Additional reasons for the persistence of this misinformation in the face of credible correction – known as the continued influence effect – exist on a cognitive level as well.

Research by Bower & Morrow demonstrates that people build mental models around certain topics when first encountering information; these models are then updated as new information becomes relevant. Changes to these models can be made incrementally by incorporating small updates to the existing model, or globally by discarding the old model altogether and re-enacting a new one.

Importantly, when faulty information is retracted and new information only invalidates certain parts of the mental model, people are left with a gap. As a result, they often rely on the original information – even if aware of its retraction or negation – simply because the original information is more coherent. For example, negating a statement (e.g., “this is false” or “this is incorrect”) may create a gap in the mental model because this approach fails to provide an alternative explanation. As a result, people may lose the negative ‘tag’ associated with the memory and revert to their original belief.

Understanding the origins of vaccine misinformation and mechanisms by which it exerts its negative influence is of clear importance during the global vaccination efforts against the novel coronavirus disease. Along with vaccine hesitancy rooted in Wakefield’s work, communities of color have heightened distrust in the medical system due to a long history of medical racism. Social media adds further fuel to the fire by enabling the rapid spread of faulty information.

Thankfully, there are steps that can be taken to address vaccine hesitancies. Global updates to address safety concerns can be enacted by providing factual alternatives to falsehoods. Coherent corrections can be developed by ‘rewriting the narrative’ and accurately describing:

Who was involved?

What happened?

When did it take place?

Where did it take place?

Why did it happen?

Additional steps include framing the message so as to boost retrieval of the retraction rather than the myth, highlighting the trustworthiness of the favored sources to boost credibility, and avoiding repeating the myth itself. Ultimately, global corrections, as opposed to incremental updates, provide a promising route to reframing conceptions of vaccinations without leaving room for coherency concerns.

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Sapna Suresh is a second year PhD student in the School of Communication at Northwestern University. She conducts research on the many ways in which we can persuade people to change their attitudes and behaviors, including through the use of narratives and emotions. Her outreach work includes at a prior internship with Population Media Center, participation in the NPR SciCommers network, and serving as a mentor to Northwestern undergraduates concentrating in health communication.

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