When someone erroneously believes that vaccines are loaded with dangerous toxins, it's tempting to want to plop down reams of data and argue them out of that opinion. But a new review of vaccination research suggests that trying to educate people about the safety of vaccines just doesn't work.
In fact, a far more effective strategy is to try to change that person's behaviors without changing hearts and minds, said Noel Brewer, a professor of health behavior at the University of North Carolina at Chapel Hill. For example, instead of printing a pamphlet about the advantages of vaccination, public health departments could simply send out vaccination reminder cards.
"If you can't change people's opinions, you can certainly work with their good intentions," Brewer told Live Science. [6 Flu Vaccine Myths]
We don't need no education
Brewer and his colleagues reviewed the literature surrounding how to increase vaccination rates. They found that outright refusal of all vaccines is fairly rare in the United States, despite the loud voices of anti-vaccine activists, with only about 1 to 2 percent of people rejecting vaccines as a whole, Brewer said. But gaps in vaccination are more common, with about a quarter of 19- to 35-month-olds missing one or more vaccines. The problem of missing recommended vaccines becomes more common with age, Brewer said, with more parents and patients refusing adolescent vaccines and even more skipping vaccines such as the annual flu shot as adults.
In the review, the researchers looked at three types of efforts to improve vaccination rates: research on social processes, attempts to change behavior directly, and people's thoughts and feelings about vaccines. Much to the researchers' surprise, Brewer said, they found that educational initiatives aimed at changing people's thoughts or feelings simply weren't effective.
"We thought the educational interventions would work sometimes and not others and we'd have at least some really effective educational interventions," Brewer said. "We were really surprised when we reviewed the literature and couldn't find anything that was effective."
Reminders and recommendations
What did work, the research showed, were programs designed to alter behavior without any attempts at persuasion. Such programs might include a doctor starting from the assumption that his or her patients want the full suite of vaccines instead of immediately offering (and perhaps inadvertently introducing) the option to skip some shots, Brewer said. Recommendations from medical providers are the single most important intervention in increasing vaccination, he noted. [Just How Safe Are Vaccines? Here Are the Numbers]
Another behavioral intervention that works well is sending reminder cards in the mail, Brewer said, but many primary care offices don't send vaccine reminders.
"If those reminders are instead sent centrally by the state immunization branch, then most people will get those reminders, and those reminders will have a bigger impact," he said.
One major gap in the research is that it's unclear how social processes affect people's attitudes toward vaccines, Brewer said.
"The social context for vaccination is incredibly important and poorly understood," he said. Psychologists who study other behaviors have found that social networks, social norms and social contagion (when a behavior spreads through a social network) are important, but it's not clear how those phenomena work with vaccine acceptance, Brewer said.
"This is a really promising area for future research," he said.
The review was published on April 3 in the journal Psychological Science in the Public Interest.
Original article on Live Science.