With the continuous surge in FDA approval of the Pfizer-BioNTech vaccine and delta variants, governments around the world have renewed their push to persuade adherents to increase the number of vaccinations. On September 9, 2021, President Joe Biden announced a comprehensive vaccine authorization, expressing disappointment at the resistance of the vaccine: “We have always been patient, but our patience is fading. Your refusal cost us all .”
As a communications scientist who has been studying the impact of media and health campaigns for the past 30 years, I am worried that the fanatical propaganda in vaccine information may make resisters even more resistant. Direct, straightforward information about vaccinations that are effective for three-quarters of Americans may not apply to the remaining quarter. If anything, they may backfire.
Research shows that, depending on the audience, certain health communication technologies are more effective than others. This is a lesson that can be applied not only by policymakers, but also by the media, industry and even parents and relatives.
In terms of accepting new ideas and practices, the study identified five categories of people: innovators, early adopters, early public, late public, and laggards. For COVID-19 vaccination, it comes down to the last two, they are the most resistant to change.
This group of unvaccinated people is huge—nearly 80 million people in the United States qualify for vaccination but have not yet been vaccinated—they are people who can help the United States achieve herd immunity. However, studies have shown that they can also be angry because of the strong demand for vaccinations.
Strong messaging can be counterproductive
Public health information can and does often affect people—but not always in the expected direction. As early as 1999, I testified before the U.S. Congress that anti-drug messages might enable young people to take drugs instead of quitting drugs. Likewise, the strong language of current vaccine information may induce resistance rather than compliance.
Consider the headline of a recent editorial in The New York Times: “Put on a mask. Get vaccinated. This is the only way out.” This is after 18 months of public health information, urging people to stay at home, wash their hands, and maintain Social distancing.
They may be well-intentioned, but health communication studies have shown that such instructional messages may be regarded as “high threats,” meaning that they threaten the free will of the information recipients by instructing them what they should do. They are likely to trigger what psychologists call “reactions.” In other words, when individuals feel that their freedom of movement is threatened, they will have the motivation to regain their freedom, usually by trying to do prohibited things or refusing to comply with recommendations.
Recent research by my correspondent colleague at Penn State University shows that even if the ad contains such things as “don’t wear a mask, don’t ride” (from Uber) and “socialize responsibly to keep the bar open” (a message from Heineken) ) And other indicative slogans can also anger consumers and make them less likely to act responsibly.
The response to the COVID-19 message was evident in widespread protests around the world. Many people took to the streets and social media, chanting slogans such as “My body, my choice”, “Let me call the shots” and “Forced not to agree.”
These responses not only show hesitation to vaccination, but also show active resistance to vaccine information, reflecting efforts to protect individual initiative by maintaining individual freedom of movement.
Freedom is a key concept in anti-vaccine rhetoric. “Freedom, not force” is the rallying cry of the protesters. “If we lose medical freedom, we will lose all freedom,” a poster read. “Freedom of choice,” Senator Rand Paul urged in a recent column that he opposed wearing masks and blockades. “We will make our own health choices. We will not show you a passport, we will not wear masks, and we will not be forced to conduct random screening and testing.”
One way to deal with this response is to change the communication strategy. Health communication researchers have found that simple changes to the wording of information can make a big difference. In a study conducted by colleagues who study health persuasion at Pennsylvania State University, researchers tested participants’ responses to reasonable health behaviors such as dental flossing: “If you’re already using dental floss, don’t stop it for a day. And, if you I haven’t used dental floss yet, now is the time to start…. Dental floss: It’s easy. Do it because you have to do it!” The study participants responded to this information by expressing their disagreements and Contempt for the promoted behavior.
But then the researchers rephrased the same advocacy to be less threatening, for example: “If you already use dental floss, please continue to do a good job. If you haven’t used dental floss, now may be a good time to start.” and “Use dental floss: it’s easy. Why not try it?” They found that participants’ reactions were significantly lower and their message acceptance was higher.
Similarly, softening information and using less dogmatic language may be the key to persuading some unvaccinated people. This is because suggestive rather than prescriptive information provides people with space to exercise their free will. Health communication research also suggests several other strategies to reduce response, from offering options to evoke empathy.
Given people’s reliance on smartphones and social networks, it may be more important to make better use of the technical features of interactive media, including websites, social media, mobile applications, and games. The clever use of digital media can help convey strong health messages without triggering a reaction.
Research in our laboratory shows that people’s reactions to media messages are affected by the approval of anonymous others on the Internet, just as consumers rely on the opinions and star ratings of other people to make online purchase decisions. In a recent study, we found that health information threatening freedom becomes more palatable if it is accompanied by a lot of likes from other people on social media. While many others are seen as supporting the advocacy message, hard language does not seem to threaten their freedom more than the mild version.
In other words, we found that the number of likes has a strong “following effect” in reducing reactance. We have also found that providing the option of commenting on health information can increase personal motivation and better accept information.
In another recent experiment, we found that customization, or the ability to customize a mobile phone or online website to your liking, can also help healthy communication. Whether it’s a mobile app, a dating site or a social media feed, a customized digital space allows people to reflect their personalities. Seeing health promotion information in such a personalized space does not pose too much threat in such a place, because people feel safe about their identities. We have found that customization can help reduce negative reactions to health information by increasing a person’s sense of identity.
A communication strategy that is sensitive to psychological reactions can enable adherents to vaccinate voluntarily instead of just following instructions.
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