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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.
Nyhan B et al. Effective messages in vaccine promotion: A randomized trial. Pediatrics 2014 Mar 3; [e-pub ahead of print]. (http://dx.doi.org/10.1542/peds.2013-2365)
Comment
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.