Pro-Vaccine Messages: Do They Work? Are They Harmful?

Summary and Comment |
March 24, 2014

Pro-Vaccine Messages: Do They Work? Are They Harmful?

  1. Deborah Lehman, MD

Some messages can be counterproductive and increase distrust in vaccines.

  1. Deborah Lehman, MD

Despite the availability of an effective vaccine to protect against three serious childhood diseases — measles, mumps, and rubella (MMR) — increasing numbers of parents have concerns about the safety and side effects of the vaccine. As a result, recent outbreaks have occurred in the U.S. (NEJM JW Pediatr Adolesc Med Jan 13 2014). Physicians are encouraged to have frank discussions with families about the seriousness of vaccine-preventable diseases and to dispel misinformation about the false link between MMR and autism.

Researchers examined the effectiveness of vaccine-promotion messaging among1759 parents who participated in a nationally representative survey in 2011 regarding attitudes about vaccines and immunization practices. Parents were surveyed before and after they were randomized to receive one of four informational interventions to encourage MMR vaccination using CDC materials: (1) correction of misinformation, (2) education about disease risks, (3) a dramatic narrative about a 10-month-old with measles, and (4) visuals of the diseases. A control group received written information about bird feeding.

Although the pro-vaccine messages reduced misperceptions about a link between MMR and autism, the messaging resulted in a decrease in intent to vaccinate, especially among parents with the least favorable initial attitudes toward vaccinations. The narrative about a child with measles increased concern for serious vaccine side effects, and the disease images increased belief in a link between MMR and autism.


This study goes against the common belief that correcting misinformation about vaccines leads to an increase in vaccine acceptance. Lest we be too discouraged by these counterintuitive results, this study did not employ healthcare providers in their messaging interventions, and previous studies have demonstrated the effect of direct communication on parental trust and decisions to vaccinate. The results do, however, challenge us to find new approaches toward reluctant parents to ensure the health of all children.

Editor Disclosures at Time of Publication

  • Disclosures for Deborah Lehman, MD at time of publication Nothing to disclose


Reader Comments (1)

Janice Kregor, M.D. Physician, Pediatrics/Adolescent Medicine, University of Kentucky

I practiced General Peds for 26 years. I now teach med students. When talking with a parent who was reluctant to vaccinate, I REALLY had to dial back my passion. This worked best. I would start with a disease that I was familiar with, (and one that was still prevalent)----usually H.flu Type B. I would give the parents reading material (usually from the AAP and CDC) or direct them to websites. I would finish the well baby checkup, and ask the parents to read the materials, and come back another day to talk more---and (hopefully!) vaccinate their child. I think the parents HAVE to feel that it is their decision, and they can't be rushed, or coerced. I would chat about how I knew they wanted what was best for their child. Sometimes, I would agree to spread out the different vaccines (even though I knew it was OK to give them all in the same visit). Containing the speeding train and "she-bear" within me with regards to vaccines was key. I certainly wasn't 100% successful, but I did manage to "convert" quite a few families---and get the kids fully vaccinated!

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