Web 2.0 for Vaccination Decisions

vacindexThis post looks at a paper that was put together at a conference on risk perception and risk communication regarding vaccination decisions in the age of social media.  The paper: “Opportunities and challenges of Web 2.0 for vaccination decisions”, was published in the Journal Vaccine 30(2012)3727-3733.  Two of the authors are Cornelia Betsch and Valerie Reyna.  I think both of them are insightful.

Web 2.0 is defined basically as today’s internet that allows two-way  and multiple way communication.  It includes Facebook and Twitter et. al. where support can be easily expressed publicly and “friends” notified. Blogs can modify and reuse information and then that crowd sourced information can be commented upon.  In Web 2.0 the lines between reception and production of media content are blurred.

The paper looks at three actors in Web 2.0:

  1. The person trying to make a decision–the user–as the receiver of information on the internet.
  2. Health communicators who try to disseminate facts about vaccination as well as messages supporting recommended vaccinations.
  3. Anti-vaccination activists who disseminate messages, facts, and beliefs that oppose some or all recommended vaccinations.

The paper suggests that there are three stages in vaccination decision making:

  1. In the pre-decisional phase, people consider their options such as to vaccinate or not or to delay the recommended schedule.
  2. In the decisional phase, individuals may perceive themselves or their loved ones to have a low risk since vaccines have created low incidence rates for vaccine preventable diseases. Few individuals will have first or even second-hand experience with such diseases and thus lack vivid representations of disease risk.  Furthermore, herd immunity can make free riding attractive.  Vaccinations can have adverse outcomes and falsely attributed adverse outcomes may be just as influential on decision making. Thus, it may be easier to visualize that vaccinations are harmful.
  3. In the post-decisional phase, individuals are likely to receive imbalanced feedback regarding their decision.  Vaccination costs such as pain, time, money, and possible adverse events are immediate and quite tangible, while the benefits are preventive and thus largely invisible.

vaccimagesOn-line information is widely available on vaccination and as many as 72% of Americans trust health information on the internet. Clearly, a large amount of the information does not even try to be correct.  The power of narrative or what we might technically call anecdotal evidence is strong. Narratives of purported vaccination injuries include all the elements of memorable messages. They are easy to understand, concrete, emotional, and credible in the way a first person story of victimization is credible.  The narratives only represent the anti-vaccination side because there is no story in developed countries if you do not get the disease.  Narratives are also important because people tend to want to know what the consequences might be rather than the likelihood of the consequences.  However, once they start looking at narratives, many people tend to relate the narratives they read to the distribution in the real world.  Thus, when they see the overwhelmingly negative experience of the narratives on the internet, they are likely to perceive that the weight of experiential evidence is against vaccination.

vacccimagesPublic health officials have the goal of disseminating information that user need, connect users with that information, and create understandable information.  Health messages that have a chance to go viral must be memorable and interesting and tied to social hubs adequate to spread the message.  Probably, more likely and significant is the ability to keep inaccurate information from going viral.




1 thought on “Web 2.0 for Vaccination Decisions

  1. Pingback: Bernanke and the Gist | Judgment and Decision Making

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