Identifying beliefs driving COVID-19 vaccination: Lessons for effective messaging.

Increasing vaccination acceptance has been essential during the COVID-19 pandemic and in preparation for future public health emergencies. This study aimed to identify messaging strategies to encourage vaccine uptake by measuring the drivers of COVID-19 vaccination among the general public. A survey to assess COVID-19 vaccination acceptance and hesitancy was advertised on Facebook in February-April 2022. The survey included items asking about COVID-19 vaccination status and participant demographics, and three scales assessing medical mistrust, perceived COVID-19 risk, and COVID-19 vaccine confidence (adapted from the Oxford COVID-19 vaccine confidence and complacency scale). The main outcome was vaccination, predicted by patient demographics and survey scale scores. Of 1,915 survey responses, 1,450 (75.7%) were included, with 1,048 (72.3%) respondents reporting they had been vaccinated. In a multivariable regression model, the COVID-19 vaccine confidence scale was the strongest predictor of vaccination, along with education level and perceived COVID-19 risk. Among the items on this scale, not all were equally important in predicting COVID-19 vaccination. The items that best predicted vaccination, at a given score on the COVID-19 vaccine confidence scale, included confidence that vaccine side effects are minimal, that the vaccine will work, that the vaccine will help the community, and that the vaccine provides freedom to move on with life. This study improved our understanding of perceptions most strongly associated with vaccine acceptance, allowing us to consider how to develop messages that may be particularly effective in encouraging vaccination among the general public for both the COVID-19 pandemic and future public health emergencies.

Understanding Concerns about COVID-19 and Vaccination: Perspectives from Kidney Transplant Recipients.

The COVID-19 pandemic poses a significant risk for immunosuppressed groups such as transplant patients. The purpose of this study was to improve our understanding of the impact of the COVID-19 pandemic on kidney transplant recipients, including their views on COVID-19 vaccination. Semi-structured interviews were conducted from December 2021 to August 2022 with 38 kidney transplant recipients who had an appointment with their transplant care team within the previous 6 months. We used qualitative thematic analysis to characterize the perspectives of interviewees. Regardless of COVID-19 vaccination status, most interviewees reported utilizing public health measures such as masking, hand washing, and avoiding crowds to protect themselves against COVID-19. Vaccinated interviewees (n = 31) noted that they chose to receive a COVID-19 vaccine because of their increased risk due to their immunocompromised state. For unvaccinated interviewees (n = 7), reasons for not receiving a COVID-19 vaccine included concerns about the safety and efficacy of the vaccine. Both vaccinated and unvaccinated interviewees expressed concerns about the lack of adequate testing of the vaccine in transplant patients and questioned if the vaccine might have unknown side effects for transplant recipients. Regardless of the vaccination status, most interviewees noted having trust in their healthcare team. Interviewees also described interpersonal tensions that arose during the pandemic, many of which surrounded vaccination and other preventive measures that were important to participants to protect their health. Together, these data demonstrate differing concerns and experiences related to the COVID-19 pandemic for vaccinated and unvaccinated transplant recipients. These findings highlight the unique needs of transplant recipients and reveal opportunities to support this vulnerable patient population in efforts to protect their health as the COVID-19 pandemic evolves.

Correcting misperceptions of gun policy support can foster intergroup cooperation between gun owners and non-gun owners.

Past research finds that a majority of gun and non-gun owners support key gun safety policies, yet gun owners tend to underestimate other gun owners' support for these policies. We predicted that these misperceptions of support might lead gun owners to view non-gun owners as being less similar to themselves, which might undermine intergroup cooperation to promote gun safety policies and fuel intergroup animosity. Importantly, we also predicted that correcting these misperceptions would be an effective way to reduce intergroup division and enhance intergroup cooperation. We tested these predictions across two studies in which participants were randomly assigned to read information designed to correct misperceptions of gun owner support or to read other, control information. Across both studies, we find that correcting gun owners' misperceptions of gun owner support for gun safety policies leads to greater perceptions of identity overlap between gun and non-gun owners, greater willingness to work with each other to promote gun safety policies, and less negative affect towards each other. This suggests that correcting gun owner misperceptions of gun owners' support for gun safety policies might be an effective intervention to facilitate intergroup cooperation to promote these policies. Therefore, efforts to promote gun safety policies might benefit from educating gun owners about the degree of support for these policies that already exists among gun owners. Doing so might present a simple and cost-effective way to mobilize gun owners in support of these policies.

Changes in COVID-19 Vaccine Hesitancy Among Black and White Individuals in the US.

Importance: COVID-19 has disproportionately affected Black individuals in the US; however, vaccination rates among Black individuals trail those among other racial groups. This disparity is often attributed to a high level of vaccine hesitancy among Black individuals, but few studies have examined changes in vaccine hesitancy over time. Objectives: To compare changes in vaccine hesitancy between Black and White individuals in the US and to examine mechanisms that might help explain the observed differences. Design, Setting, and Participants: This survey study used 7 waves of data collected using a panel design. A total of 1200 English-speaking adults in the US were recruited from a nonprobability online panel to construct a census-matched sample. Participants were contacted monthly between December 9, 2020, and June 16, 2021. Main Outcomes and Measures: The main outcome of interest was self-reported vaccination intention, measured on a 6-point scale (where 1 indicates extremely unlikely and 6 indicates extremely likely). Beliefs about the safety, effectiveness, and necessity of COVID-19 vaccines were measured on a 5-point Likert scale, with higher scores denoting greater agreement. Results: The baseline data included 1200 participants (693 women [52.0%; weighted]; 921 White individuals [64.0%; weighted], 107 Black individuals [12.2%; weighted]; weighted mean [SD] age, 49.5 [17.6] years). The survey participation rate was 57.0% (1264 of 2218). Black and White individuals had comparable vaccination intentions in December 2020, but Black individuals experienced larger increases in vaccination intention than White individuals relative to baseline in March 2021 (b = 0.666; P < .001), April 2021 (b = 0.890; P < .001), May 2021 (b = 0.695; P < .001), and June 2021 (b = 0.709; P < .001). The belief that the vaccines are necessary for protection also increased more among Black than White individuals in March 2021 (b = 0.221; P = .01) and April 2021 (b = 0.187; P = .04). Beliefs that the vaccines are safe and effective (b = 0.125; P < .001) and necessary (b = 0.405; P < .001) were positively associated with vaccination intention. There was no evidence that these associations varied by race. Conclusions and Relevance: This survey study suggests that the intention of Black individuals to be vaccinated was initially comparable to that of White individuals but increased more rapidly. There is some evidence that this increase is associated with changes in beliefs about the vaccine. Vaccination rates continue to be lower among Black individuals than White individuals, but these results suggest that this might be less likely the result of vaccine hesitancy than other factors.

Jargon as a barrier to effective science communication: Evidence from metacognition.

In this experiment (N = 650), we examine the negative consequences of jargon on individuals' perceptions of emerging scientific technology and aim to explain these effects. We find that the presence of jargon impairs people's ability to process scientific information, and that this impairment leads to greater motivated resistance to persuasion, increased risk perceptions, and lower support for technology adoption. These findings suggest that the use of jargon undermines efforts to inform and persuade the public through the cognitive mechanism of metacognition.

Making Vaccine Messaging Stick: Perceived Causal Instability as a Barrier to Effective Vaccine Messaging.

Health officials often face challenges in communicating the risks associated with not vaccinating, where persuasive messages can fail to elicit desired responses. However, the mechanisms behind these failures have not been fully ascertained. To address this gap, an experiment (N = 163) tested the differences between loss-framed messages-one emphasizing the consequence of not receiving a flu vaccine; the other emphasizing the consequence of receiving the flu vaccine. Despite an identical consequence (i.e., Guillain-Barre syndrome), the message highlighting the consequence of not receiving the flu vaccine produced lower negative affect scores as compared to the message highlighting the consequence of receiving the flu vaccine. Mediation analyses suggest that one reason for this difference is due to non-vaccination being perceived as temporary and reversible, whereas vaccination is perceived as being permanent. Implications on health communication and future research are discussed.

The Influence of Weight-of-Evidence Messages on (Vaccine) Attitudes: A Sequential Mediation Model.

Media coverage of contentious risk issues often features competing claims about whether a risk exists and what scientific evidence shows, and journalists often cover these issues by presenting both sides. However, for topics defined by scientific agreement, balanced coverage erroneously heightens uncertainty about scientific information and the issue itself. In this article, we extend research on combating so-called information and issue uncertainty using weight of evidence, drawing on the discredited autism-vaccine link as a case study. We examine whether people's perceptions of issue uncertainty (about whether a link exists) change before and after they encounter a news message with weight-of-evidence information. We also explore whether message exposure is associated with broader issue judgments, specifically vaccine attitudes. Participants (n = 181) read news articles that included or omitted weight-of-evidence content stating that scientific studies have found no link and that scientists agree that none exists. Postexposure issue uncertainty decreased-in other words, issue certainty increased-from preexposure levels across all conditions. Moreover, weight-of-evidence messages were associated with positive vaccine attitudes indirectly via reduced information uncertainty (i.e., one's belief that scientific opinion and evidence concerning a potential link is unclear) as well as issue uncertainty. We discuss implications for risk communication.

Including "evidentiary balance" in news media coverage of vaccine risk.

Journalists communicating risk-related uncertainty must accurately convey scientific evidence supporting particular conclusions. Scholars have explored how "balanced" coverage of opposing risk claims shapes uncertainty judgments. In situations where a preponderance of evidence points to a particular conclusion, balanced coverage reduces confidence in such a consensus and heightens uncertainty about whether a risk exists. Using the autism-vaccine controversy as a case study, we describe how journalists can cover multiple sides of an issue and provide insight into where the strength of evidence lies by focusing on "evidentiary balance." Our results suggest that evidentiary balance shapes perceived certainty that vaccines are safe, effective, and not linked to autism through the mediating role of a perception that scientists are divided about whether a link exists. Deference toward science, moreover, moderates these relationships under certain conditions. We discuss implications for journalism practice and risk communication.