Effects of a video-based positive side-effect information framing: An online experiment.

Abstract

Objective: Despite the public health value of vaccines, vaccination uptake rates are stagnating. Expected adverse events following immunization are a major source of concern and play a role in the emergence of vaccine hesitancy. Since nocebo mechanisms are involved in the perception of adverse reactions, positive side-effect communication is warranted. The aim of the present study was to compile a comprehensive communication strategy that minimizes expectations of nocebo effects while respecting the informed consent procedure. Method: In a randomized 2 × 2 between-subject design, 652 participants received information about COVID-19 or influenza vaccination using either standard side-effect messaging or messaging enriched with proven elements of expectation-optimizing framing. A physician presented information online via video. Moderation analyses were conducted to examine effects among particular subpopulations. Expected adverse event ratings following an imagined immunization, cost-benefit ratios of the vaccination, and future vaccination intentions were assessed. Results: Information content ratings were equally high in each group. Positive framing significantly decreased adverse event expectations in the COVID-19 information group and raised the cost-benefit ratio in the influenza condition, indicating higher benefits than cost expectations. Moderation analysis revealed that the framed side-effect communication lowered the expected COVID-19 vaccination uptake willingness in individuals with strong anti-vaccination attitudes. Conclusions: Facing the ongoing coronavirus mass vaccinations, positive information frames have a small but significant impact on vaccination concerns while upholding informed consent. Although intervention trials are still pending, this approach could help decrease vaccine hesitancy by reducing fearful expectations. However, it seems that it should not be used without considering vaccination attitudes.

Frequency of Adverse Events in the Placebo Arms of COVID-19 Vaccine Trials

“…Although nocebo phenomena have been investigated in many contexts involving medication, evidence of their influence in vaccination remains scarce. However, a recent meta-analysis suggested that a significant proportion of placebo recipients in influenza vaccine trials experienced systemic AEs, such as headache or fatigue, owing to nocebo responses …”

Introduction to the special issue on vaccine hesitancy and refusal.

“…Delporte et al (2023) assessed the impacts of optimism and moral appeals on vaccine intention. Bender et al (2023) conducted a four-arm randomized study, with presentation of standard information about vaccine side effects versus enhanced messaging using a positively framed message, each for COVID-19 vaccine and influenza vaccine. This message focused both on the probability of not having a side effect postvaccination and on referring to side effects as signs that the immune system is activating.…”

“…The promotion focus had a stronger association with vaccination intention and uptake than did the prevent focus. This included seeking earlier vaccination (e.g., through trying to get leftover doses when available), in line with the positive framing effects documented by Bender et al (2023).…”

“…The other 11 papers in this special issue present novel research findings across a wide range of aspects of health psychology and vaccination practice. Most of them focus exclusively on COVID-19 (Bogg et al, 2023; Buscemi et al, 2023; Delporte et al, 2023; Eberhardt and Ling, 2023; Husted et al, 2023; Ku et al, 2023; Martin et al, 2023; Preis et al, 2023; Warren et al, 2023), but others concern influenza (Bender et al, 2023; Brumbaugh et al, 2023) and HPV vaccines (Brumbaugh et al, 2023). Six of the research articles (Bogg et al, 2023; Brumbaugh et al, 2023; Buscemi et al, 2023; Martin et al, 2023; Preis et al, 2023; Warren et al, 2023) report on studies conducted in the United States, while two (Eberhardt and Ling, 2023; Husted et al, 2023) were conducted in the United Kingdom, one (Bender et al, 2023) in Germany, one (Delporte et al, 2023) in Belgium, and one (Ku et al, 2023) in South Korea.…”

“…Six of the research articles (Bogg et al, 2023; Brumbaugh et al, 2023; Buscemi et al, 2023; Martin et al, 2023; Preis et al, 2023; Warren et al, 2023) report on studies conducted in the United States, while two (Eberhardt and Ling, 2023; Husted et al, 2023) were conducted in the United Kingdom, one (Bender et al, 2023) in Germany, one (Delporte et al, 2023) in Belgium, and one (Ku et al, 2023) in South Korea. Only one study reported findings from an intervention trial (Bender et al, 2023).…”