Going against the Herd: Psychological and Cultural Factors Underlying the ‘Vaccination Confidence Gap’

Abstract

By far the most common strategy used in the attempt to modify negative attitudes toward vaccination is to appeal to evidence-based reasoning. We argue, however, that focusing on science comprehension is inconsistent with one of the key facts of cognitive psychology: Humans are biased information processors and often engage in motivated reasoning. On this basis, we hypothesised that negative attitudes can be explained primarily by factors unrelated to the empirical evidence for vaccination; including some shared attitudes that also attract people to complementary and alternative medicine (CAM). In particular, we tested psychosocial factors associated with CAM endorsement in past research; including aspects of spirituality, intuitive (vs analytic) thinking styles, and the personality trait of openness to experience. These relationships were tested in a cross-sectional, stratified CATI survey (N = 1256, 624 Females). Whilst educational level and thinking style did not predict vaccination rejection, psychosocial factors including: preferring CAM to conventional medicine (OR .49, 95% CI .36–.66), endorsement of spirituality as a source of knowledge (OR .83, 95% CI .71–.96), and openness (OR .86, 95% CI .74–.99), all predicted negative attitudes to vaccination. Furthermore, for 9 of the 12 CAMs surveyed, utilisation in the last 12 months was associated with lower levels of vaccination endorsement. From this we suggest that vaccination scepticism appears to be the outcome of a particular cultural and psychological orientation leading to unwillingness to engage with the scientific evidence. Vaccination compliance might be increased either by building general confidence and understanding of evidence-based medicine, or by appealing to features usually associated with CAM, e.g. ‘strengthening your natural resistance to disease’.

Human Values and Attitudes towards Vaccination in Social Media

“…AV seem to trust less the governmental norms, including the President of the Republic (Q5, p-value < 0.001), the national government (Q8, p-value < 0.001), as well as the European Union (Q13, p-value < 0.001). These results are coherent also with the findings of Browne et al [7], unwillingness to trust information delivered by conventional authority sources is a predictor of negative attitudes to vaccination. Further, there seems to be a propensity of the AV cohort to defend the traditional religious and moral values (Q1), p-value = 0.011, and also argue that the newer lifestyles contribute to the decline of our society (Q9), p-value < 0.001.…”

“…Previous research on the determinants of attitude formation towards vaccination suggests that there are broader psychological, political, cultural, or even societal factors that may contribute to negative vaccination attitudes [4,28,39,49]. More specifically, vaccination scepticism has been related to unwillingness to engage with the scientific evidence [7], an alignment with alternative/complementary or holistic health [28], as well as spiritual and religious identities [7,28], anti-authoritarian worldviews [7], conspiracy ideation [25], trust and political attitudes [49].…”

Injecting doubt: responding to the naturopathic anti-vaccination rhetoric

“…38 The relationship is complex, however, as those who are more likely to be attracted to CAM are also the ones most likely to hold negative attitudes toward vaccination. 39 Still, there seems little doubt that healthcare providers can play an important role in how parents and patients approach vaccination. 40 This seems particularly true if naturopaths are involved.…”

Mothers' informational needs when deciding to have their newborn infant vaccinated with BCG. A Mixed‐methods design

“…Communication about vaccines has been increasingly important during the last decades as parents' concerns about vaccines and vaccine safety have increased . Despite campaigns and health authorities' assurance about the safety of vaccines, some parents are still worried about side effects and therefore hesitant to follow the routine childhood vaccination programme . A study on vaccine decision‐making has shown that parents who delayed or refused vaccines were 45% less likely to report that they had the necessary information to make the decision, than parents who followed the vaccination programme .…”

“…On this background, we found it important to explore parents' informational needs when making a decision about vaccination, which was done in the setting of a randomised multicentre trial testing a hypothesis of positive nonspecific effects on the immune system by vaccinating newborns with Bacillus Calmette‐Guerin (BCG). Since side effects are the main concern when parents choose not to accept vaccination , we focused in particular on their informational needs about side effects and furthermore on how they engaged with this information when side effects occurred.…”