Health

Measles is on the march again – but scare tactics won’t improve vaccination rates | Andre Spicer


In the past, hundreds of people died from measles each year. That all changed during the 1960s, when the government introduced a routine vaccination programme. By the 1990s there were only thousands of cases of measles each year, and very few deaths.

Just when it appeared the disease had been conquered, a scientific paper appeared linking the vaccine to autism. The now discredited paper received widespread coverage in the media, fuelling a resurgence of an anti-vaccination movement that had been popular in the 19th century.

These anti-vaxxers took to social media, mobilised celebrities, stoked suspicion about experts, and played on concerns about state intrusions into our personal lives. The movement seemed to succeed. More people now think vaccination is harmful, and fewer children are being vaccinated. The upshot is half a million children in the UK missed their measles vaccination between 2010 and 2017, and in 2018 there were a record number of deaths from measles.

As infection and death rates climb, health experts are struggling to work out how to get people to vaccinate their children. Many hoped that publicising the facts would help. For instance, a recent report by the Royal Society for Public Health suggested more factual information and better education about the benefits of vaccinations could be key. Others think we need to focus efforts on stopping “fake news” about vaccinations. For instance, Matt Hancock, the minister for health and social care, favours forcing social media sites such as Facebook to remove anti-vaccination content.

Educating parents seems to have some impact. For instance, one randomised control trial in Colorado found that parents who were given rich information about the benefits of vaccines before their baby was born were more likely to have them immunised. Banning “fake news” about vaccinations also seems to work. One study found that Facebook’s 2016 fake news ban led to a 75% drop in erroneous anti-vaccination messages.

More facts, better education and less fake news are a start. But such strategies alone are unlikely to break through social media bubbles. One study of 2.6 million Facebook users found that anti-vaxxers and pro-vaxxers tend to gravitate towards others who share their views. By sharing information with other like-minded people, they created echo-chambers where their views are rarely challenged. Researchers who have looked inside the anti-vaxxer echo chamber have found high levels of distrust towards the government and medical industry, a shared sense of paranoia and conspiracy, and common stories about big government and big business versus individual faith and belief.

Even if scientific information about vaccination finds its way to people who are suspicious of immunisation, it’s likely to be overlooked because of the way it is presented. Information about vaccination often focuses on the harm that not immunising children can do and its unfairness to other people. Such messages are unlikely to connect with people who are suspicious of vaccinations because they don’t speak to their values. They are much more likely to notice messages which play up themes of purity and liberty.

In the unlikely case that a message about the safety of immunisation should be absorbed by an anti-vaxxer, there’s a high likelihood it will backfire. One study found that giving people with anti-vaccination attitudes scientifically valid information did not change their beliefs or behaviours. In fact, seven days after receiving the information, they had stronger anti-vaccination beliefs and had become less likely to vaccinate their children.

There are big barriers to get through to people who are hesitant to vaccinate their children, but it is possible. Recent research has identified a range of strategies that work. Parents who are sitting on the fence might just a need a strong recommendation from their family doctor. Those who have rejected vaccination in the past need to be invited to ask their doctor questions first. Once they have had such a conversation, they become more likely to take steps toward vaccinating their children. We also need to rely less on facts and figures about the benefits of immunisation and more on evocative stories. Most people find stories more accessible, and such accounts are more likely to change their minds and more likely to inspire action. Finally, public authorities can encourage people to vaccinate their children by making entry to schools and use of other public services dependent on being vaccinated. Although the tactic sounds heavy-handed, the historical evidence suggests it tends to work.

André Spicer is professor of organisational behaviour at the Cass Business School at City, University of London. He is the author of the book Business Bullshit



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