Vaccines: building confidence and tackling mistrust
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Vaccines: building confidence and tackling mistrust
The ability to be vaccinated against infectious diseases is a wonder of the modern world, yet mistrust in vaccines is an ongoing issue that is a real threat to public health. Dr Constance Blomgren, Dr Karen Cook and Dr Stella George of Athabasca University, in Canada, are addressing this issue by engaging with young people to build vaccine confidence. They have co-developed an open educational resource animation that explores how to approach concerns and misconceptions around vaccines.
Glossary
Bias — a skewed perception or opinion of something or someone that is inaccurate or prejudiced
Disinformation — false information deliberately intended to mislead
Malinformation — information based on fact but removed from its original context in order to mislead
Misinformation — false or inaccurate information
Vaccine — a substance that promotes immunity to a particular pathogen
Vaccine confidence — the belief that vaccines work, are safe and are part of a trustworthy medical system
The development of vaccinations has fundamentally changed society’s relationship with infectious disease. Many illnesses that used to affect millions of people, such as polio and diphtheria, are almost unheard-of in countries with strong vaccination rates, while smallpox, previously one of the world’s deadliest diseases, has disappeared altogether. It is estimated that global vaccination efforts have saved 154 million lives over the past 50 years, including over 100 million infants.1
Despite these advances, recent years have seen a surge of mistrust in vaccines, with some saying that they are unnecessary, dangerous or not scientifically proven. These are all examples of untrue information – but such untruths can have profound effects on public health. If people do not get vaccinated, they put themselves and those around them at greater risk of catching dangerous infectious diseases, so building public confidence in vaccines is essential.
Dr Constance (Connie) Blomgren, Dr Karen Cook and Dr Stella George from Athabasca University are on a mission to increase vaccine confidence in Canadian teenagers. Working alongside a cohort of high-school students, an immigrant youth organisation and many others, the team has created an educational animation that could help to improve vaccine confidence in Canadian teenagers, and in people all over the world.
What is vaccine confidence?
Vaccine confidence is the belief that vaccines are a safe, effective and legitimate form of medicine. Doubts about these factors can influence a person’s confidence in vaccines, which may lead them to decide against getting vaccinated and encourage others to follow suit. “Many factors influence vaccine decision-making,” says Karen. “Cultural, social and political factors all play a part, as well as the characteristics of individuals and their groups, and the specifics around particular vaccines themselves.”
There is a lot of misleading information about vaccines, despite the underlying science being well-established. “Even though we have a good scientific understanding about vaccines, the advice on which vaccines are best does change, which can be confusing,” says Karen. “Science is always progressing, and changes to best practice can create uncertainty, but health advice should be based on the most recent science.”
Why is it important to build vaccine confidence?
Over the last few years, many people have taken an interest in how vaccines work, but there are still many misconceptions. “Generally, people want to know more about vaccines, especially new ones, like we saw with COVID-19,” says Karen. “People want to understand their safety, effectiveness and the processes in place to authorise and approve their development.” Ensuring that people have access to accurate information that answers their questions and concerns is essential.
Getting vaccinated is an individual choice, but it is also often a social responsibility. “Because many diseases are contagious, an individual’s choices easily affect the health of others,” explains Karen. “Luckily, vaccines prevent the spread of many diseases.” This means that, by getting a vaccine, you are not only protecting yourself from disease but potentially protecting those around you too. This concept is called herd immunity: as more people in a community become vaccinated, every member of that community, whether vaccinated or unvaccinated, becomes safer as the disease has less chance to spread.
What factors affect our decision-making
As humans, most of our decisions are not based on facts alone. A lot of the decisions we make are influenced by emotions, opinions or instincts. For a critical topic like vaccines, however, it is important that we look past any potential biases and make decisions as rationally as possible.
Biases are certain inclinations that can influence our decision-making and lead us towards misguided conclusions. A few important biases that might affect your approach to vaccines are:
False consensus bias: the tendency to assume that those around us, such as friends and family, have the same beliefs as us. For instance, if we oppose vaccines due to prior beliefs, we might think that most other people in our community think the same way.
Optimism bias: the tendency to overestimate the possibility of positive outcomes and underestimate the possibility of negative outcomes. For example, we might not get vaccinated because we assume that we are never going to encounter the diseases that vaccines protect us from, potentially endangering our communities.
Present bias: the tendency to value the present more than the future. Factors such as inconvenience or fear of needles can convince us not to get a vaccine in the present moment, even though this could have grave consequences for our future health.
Anchoring bias: the tendency to put more weight on information gained early on in a decision-making process. For instance, someone might convince us to be skeptical about a vaccine before we have given it much thought. Even though subsequent information demonstrates its safety and effectiveness, it can be hard to shake that initial scepticism.
Authority bias: the tendency to trust the opinion of an authority figure over others. For example, a politician or religious leader may speak against vaccines, but they do not have specialist knowledge on the subject.
“Everyone is subject to biases, and understanding them can help when facing difficult decisions,” says Connie. “Factors such as culture, religion, age and personal beliefs can all affect our decision-making.” Connie recommends writing out the fact-based pros and cons of either option when making a decision about whether or not receive a vaccination.
Building vaccine confidence
Reference
https://doi.org/10.33424/FUTURUM528
Typically, information about vaccines and vaccination targets adults, but the team felt that this misses a critical demographic. Our teenage years are when we tend to form many of our beliefs. Once these beliefs are established, they can be hard to change. “Teenagers are the parents of the future, so young people’s perspectives on vaccination choices will influence future generations,” says Karen. It is critical that teens receive scientifically accurate information about vaccines, which is why the team has created a range of resources for young people.
1www.who.int/news/item/24-04-2024-global-immunization-efforts-have-saved-at-least-154-million-lives-over-the-past-50-years
Dr Constance Blomgren
Associate Professor and Program Director for the Masters of Education in Open, Digital and Distance Education, Faculty of Humanities and Social Sciences, Athabasca University, Canada
Dr Karen Cook
Adjunct Associate Professor, Faculty of Health Disciplines, Athabasca University, Canada
Dr Stella George
Associate Professor, Computer Science and Information Systems, Faculty of Science and Technology, Athabasca University, Canada
Fields of research: Vaccine confidence, science literacy, open education, health literacy, youth health
Research project: Creating a bespoke animation with youth participation that encourages young people to think critically and scientifically about vaccine decision-making
Funders: Promoscience Canada, funded by Canadian Tri-Council: NSERC; CIHR; SSHRC
Evaluating the information you read
There is a lot of misleading information out there, and much of it is caused by poor interpretations of science, unreliable sources, or malicious attempts to spread untruths. Connie helps us break down the different types of misleading information that might lead us astray:
Misinformation
“Misinformation is untrue or semi-truthful content presented as, and believed to be, fact,” explains Connie. “Rumours, ill-informed opinions, insults and pranks are examples of misinformation.”
Below is an example of misinformation, stemming from a misunderstanding of science:
Because vaccines sometimes involve the injection of a weakened pathogen, some people say that a vaccine can give you the disease that they are trying to protect you from.
Disinformation
“Disinformation is false information deliberately intended to manipulate, harm, or mislead people,” says Connie. “Propaganda and conspiracy theories are examples of disinformation.”
Below is an example of disinformation in the form of a conspiracy theory – it is demonstrably false and likely created and spread to fuel certain political agendas:
When the COVID-19 vaccine was developed, some people said that powerful people had included a microchip in the vaccine for global surveillance.
Malinformation
“Malinformation originates with true information that is changed or exaggerated in a way that misleads and potentially causes harm,” says Connie. “Examples include quoting information out of context, or only partially.”
Below is an example of malinformation:
Very occasionally, certain vaccines can cause serious side-effects. Some people will only communicate about these side-effects to scare people, while omitting the fact that it happens very rarely. The risk of catching the disease in question if not vaccinated is far higher than the risk of developing side-effects.
The Five-in-five
The Five-in-five2 is a framework that can help you evaluate the information that you read:
Read like a scientist:
Is the information based on facts and evidence?
Could there be bias in the information?
Look for a consensus on agreed facts:
Do most people agree about the facts and evidence included?
Does the information include links to see examples of consensus?
Find original sources:
Is it possible to find the origin of the facts included, such as a scientific paper?
Does the information given match with the sources?
Examine if sources are high quality and specialised:
Is the information based on specific facts, rather than vague information or generalisations?
Are the sources specialised in the same area as the information given?
Evaluate the author’s expertise:
Is the author qualified?
Do they have a good track record of giving reliable information?
Is the information up-to-date?
Identifying false information is not always easy, which is why the Five-in-five is useful. “If a source of information doesn’t pass all five steps, then it may not be reliable,” says Connie. “If this is the case, look for other information that passes all five steps.”
2Johnson, M. (2022). Reality Check: Getting the Goods on Science and Health [MediaSmarts]. https://mediasmarts.ca/teacher-resources/reality-check-getting-goods-science-health
Creating the animation
Collaborating with young people
Focusing on young people’s perspectives, Connie, Karen and Stella have created a range of resources to provide accurate information about vaccines. “The resources are shareable via digital spaces, such as social media, and communal spaces, such as school and community groups,” says Stella.
One such resource is a unique animation about vaccine confidence, co-created with young people from the Canadian province of Alberta. This project included collaborations with students from the Vista Virtual School, as well as members of a community development organisation called Sinkunia, which helps young African immigrants get accustomed to life in Canada. Given that teenagers were the intended target audience of the animation, it was important to co-create and include their perspectives, to ensure that the animation spoke directly to their needs and concerns.
First, the team co-produced the script and the storyboard, using a variety of online technologies to allow real-time, virtual participation from young people. Once participants had agreed on the story and the structure, professional animators brought their vision to life. An online tool called SyncSketch enabled young participants to provide feedback on the animation as it developed, ensuring that it aligned with their vision. When it came to creating the audio, the team first thought about hiring professional voice actors, but then realised that their main character needed a teenage voice to bring them to life. After a successful audition, one young participant worked with the animators to supply the voice of Kori, the animation’s protagonist.
The story of Kori
The animation focuses on a budding social influencer, Kori, and their family. We step through the worries, thought processes and decisions surrounding vaccinations of Kori and their family. They grapple with tackling misinformation, overcoming bias and following the best available science. Kori goes on to communicate what they learn with their followers. In an original style inspired by graphic novels, the animation brings the collective work of twenty people to life.
Through Kori’s experiences, the animation provides teenagers with an accessible introduction to the importance of science literacy and how to critically examine information sources and potential biases. Alongside the animation, the team created resources for teachers and non-profit organisations to amplify these messages. The animation can be found on YouTube in English or French.
Lessons from the animation
The ‘Vaccine Confidence’ animation highlights four ways that you can help the people around you build vaccine confidence.
1. Become a vaccine champion: share why you get vaccinated and encourage others to do the same.
2. Talk to friends and family: listen to concerns they might have about vaccines with empathy, and answer any questions they might have.
3. Address vaccine misinformation: analyse how misinformation spreads, engage with your community, share accurate and accessible information, and use trusted messengers to get the point across.
4. Celebrate and share your vaccination decisions: use tools such as social media to share your vaccination story.
Do you have a question for Connie, Karen or Stella?
Write it in the comments box below and Connie, Karen or Stella will get back to you. (Remember, researchers are very busy people, so you may have to wait a few days.)
Discover more about how vaccines work:
www.futurumcareers.com/how-can-we-develop-more-effective-vaccines
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