It hasn’t been a particularly hot topic lately: the vaccine debate. But the issue hasn’t gone away. And it typifies a common challenge for health communicators: how to persuade effectively other than by only firing barrages of robust scientific evidence?

OK, the vaccine case currently lacks the 1990s’ edge provoked by the now-discredited claim made by Andrew Wakefield of a link between MMR vaccine and autism. But (notes The Atlantic) the battle between pro- and anti-‘vaxxers’ has raged unabated since Victorian times. Today it still justifies an online folder at The Independent.

Risk rising   

Meantime, fanned by the prevalence of ‘fake news’, the risk (to whole populations) is rising. As of 2016, for example, about 3m UK children and adolescents may have missed their MMR vaccine, according to Gillian Leng, deputy chief executive of NICE.

So, what? Well, if a sufficient proportion of a given population is vaccinated, a disease cannot spread and everyone is protected. This (explains The Conversation) is known as “herd immunity”. The World Health Organisation (WHO) considers 95% uptake necessary for protection. But it is estimated that, on average, the UK has slipped 2-3% below target. That falls much further towards 80% in areas of deprivation.

Deep belief and emotion

Campaigners against this trend confront deeply-embedded attitudes and beliefs. Online sites and other news media constantly reinforce the views of anti-vaccine, or sceptical, parents. These tend to fuse aligned, co-promoted behaviours (alternative medicine, homoeopathy) with what the scientific community regards rightly as misinformation (dangers of autism, brain injury etc).

In context, the heavy barrage of medical evidence may typically serve to create severe cognitive dissonance. Counter-intuitively, this embeds anti-beliefs even deeper.

Small consolation to win the ‘data battle’ but lose the emotional narrative and interpretation war.

Gaining trust

To win trust among target anti-groups, pro-campaigners need to offer alternative, and compelling, sources of emotional security.  As health comms scholars have identified, these will lie in organisations already trusted by the sceptical.  Moran and Lucas (2016) reported that a natural health foods store, for example, may offer a secure space for a vaccine workshop and/or the distribution of promotional leaflets. In turn, in personal engagements, campaigners will likely gain more traction via anecdote and individual testimonials than hard data alone.

On another tack, the Italian Ministry of Health’s Centre for Disease Prevention and Control gained significant success with its ESCULAPIO – the acronym is a rare boy’s name meaning ‘doctor’ – project. Its strategy utilised non-threatening tools such as an educational card game (named ‘Vaccine at the Fair’), a music video and reliable information websites to promote anti-flu vaccination. Notably, campaigners in the Veneto organised meetings in safe spaces such as birth centres and at home for sceptics (Bechini et al., 2018).

Quick read

These early successes should encourage more widespread testing and adoption, of an emotional approach.  An easy entry point is provided by David Cowan’s discussion of the Dialogue Box (*).

(*) Cowan, D. (2014), Strategic internal communications. London UK: Kogan Page.