Strong vaccines messages backfire on reluctance – how can we do better?


With FDA approval of the Pfizer-BioNTech vaccine and the continuous thrust of the delta variant, governments around the world have renewed their efforts to increase the number of people vaccinated by persuading the recalcitrant. September 9, 2021, President Joe Biden announced large-scale immunization mandates, expressing frustration with refractory vaccines: “We have been patient, but our patience is running out. And your refusal has cost us all.

Like a communication scientist who has studied the effects of media and health campaigns over the past 30 years, I fear that feverish rhetoric in vaccine messages will make the refractory even more resilient. The straightforward, straightforward messages to get vaccinated that worked for three-quarters of Americans may not work for the remaining quarter. If anything, they might turn against them.

Research has shown that some health communication techniques work more effectively than others depending on the audience. This is a lesson that not only policy makers can apply, but also members of the media, industry and even parents and relatives.

When it comes to adopting new ideas and practices, research has identified five categories of people: innovators, early adopters, early majority, late majority and laggards. With the COVID-19 vaccination, it boils down to the last two, and they are the most resistant to change.

This group of unvaccinated people is important in number – there are almost 80 million people in the United States who are vaccine eligible but not vaccinated – and they are the ones who could help the United States achieve herd immunity. But, research suggests that they are also the ones who will take offense at strong urges to go get vaccinated.

A strong message can backfire

Public health messages can and often do influence people, but not always in the desired direction. In 1999 I testified in the US Congress on the power of anti-drug messages that can push teens to take drugs rather than shy away from them. Likewise, the strong language of current vaccine messages may evoke resistance rather than compliance.

To consider this title from a recent New York Times editorial: “Get Masked. To get vaccinated. This is the only way out. It follows 18 months of public health messages urging people to stay home, wash their hands and maintain social distancing.

They may be well-intentioned, but health communication research shows that such directive messages can be perceived as a “high threat,” meaning that they threaten the free will of the recipient of the message by dictating what they want. must do. They are likely to trigger what psychologists call “reactance”. In other words, when individuals feel their freedom of action is threatened, they become motivated to restore that freedom, often by trying to do the very thing that is prohibited or by refusing to adhere to recommended behavior.

Recent research by my colleagues in Penn State Communications shows that even ads that include directive slogans such as “No Mask, No Ride” – from Uber – and “Socialize Responsibly to Keep Bars Open” – a message from Heineken – can irritate consumers and make them less likely to adopt responsible behaviors.

Responsiveness to COVID-19 messages is evident in the form of widespread protests around the world. Many have taken to the streets and on social networks, with slogans such as “my body, my choice”, “let me make my own choices” and “coercion is not consent”.

These responses demonstrate not only reluctance to be vaccinated, but rather active resistance to vaccine messages, reflecting an effort to protect free will by asserting freedom of action.

Flip the script

Freedom is a central concept in anti-vaccination rhetoric. “Freedom, not strength” is the protesters’ battle cry. “If we lose medical freedom, we lose all freedom” reads a poster. “Choose freedom,” urged Senator Rand Paul in a recent editorial expressing its resistance to mask warrants and blockades. “We will make our own health choices. We will not show you a passport, we will not wear a mask, we will not be required to do random screening and testing. “

Freedom of choice has been a constant theme throughout the pandemic, whether it be masks, school and business closures, or immunizations.
Ringo Chiu / AFP via Getty Images

One way to counter such reactance is to change the communication strategy. Health communication researchers have found that simple changes in the wording of messages can make a big difference. In a study by my colleagues at Penn State who study health persuasion, researchers tested participants’ responses to sensitive health behaviors such as flossing: “If you already floss, don’t even stop for it.” a day. And, if you haven’t flossed, now is the time to start. … Flossing: It’s easy. Do it because you have to! Study participants responded to such messages by expressing their disagreement with anger and challenging the recommended behavior.

But then the researchers rephrased the same plea to be less threatening, for example, “If you already floss, keep up the good work.” And if you haven’t flossed, now might be a good time to start. And “Flossing: it’s easy. Why not give it a try? ”They found that participants’ reactance was significantly lower and their acceptance of the message higher.

Likewise, sweetening the message and using less dogmatic language might be the key to persuading some of the unvaccinated. This is because suggestive, rather than directive, messages allow people to exercise their agency. Health communication studies also suggest several other strategies for reducing reactance, ranging from offering choice to evoking empathy.

Training effects

Perhaps most important – given people’s reliance on smartphones and social media – is to make better use of the technological features of interactive media, which include websites, social media, mobile apps, and games. Smart use of digital media can help deliver strong health messages without triggering reactance.

Research in our laboratory shows that people’s responses to media posts can be influenced by the approval of other anonymous people on the internet, in the same way as consumers matter on the opinions and ratings of other people to make online shopping decisions. In a recent study, we found that freedom-threatening health messages can be made more acceptable if they are accompanied by a large number of likes on social media from other people. When many others were seen as supporting the advocacy message, the forceful language seemed no more threatening to their freedom than the milder version.

In other words, we have found that the number of likes has a strong “ripple effect” in reducing reactance. We have also found that providing an option to comment on the health message imbues a higher sense of personal agency and greater acceptance of the message.

In other recent experience, we have found that personalization, or the ability to tailor your phone or online site to your tastes, can also facilitate health communication. Whether it’s a phone app, dating site, or social media feed, personalizing a digital space allows people to reflect their personalities. Seeing a health promotion message in such a personalized space is not such a big threat in such places because people feel secure in their identities. We have found that personalization helps reduce negative reactions to health messages by increasing a sense of identity.

A communication strategy sensitive to psychological reactance could allow holdouts to be vaccinated voluntarily instead of reluctantly complying with a warrant.

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