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Why Some Parents Can't Be Convinced to Vaccinate

A new study shows what separates vaccine-hesitant parents from those whose kids get the shots.

Doctor Wearing Gloves Gives Child Flu Vaccine In Arm Dmitry Naumov/Shutterstock

Want a sure-fire way to get into arguments with other moms? Start talking about vaccines. This hot-button issue may have fierce supporters on both sides of the fence, but the medical community is firmly pro-vaccination. So what makes some parents so hesitant about giving vaccines to their children even when their doctors tell them they should? A new study by public health researchers at Emory University published in the journal Nature Human Behavior discovered that the reason depends on the values these parents hold most dear.

Values hold the key

The study was based on the already established "moral foundations theory," which explains differences in how we make decisions based on five values: care/harm, fairness, loyalty, authority and purity. "Just like our taste buds are triggered by different stimuli and people have underlying sensitivity to different tastes, some have more emphasis on one type of value versus another," study author Saad B. Omer, MBBS, MPH, PhD, a professor of global health, epidemiology and pediatrics at Emory, tells Parents.com. Using standard tests for both moral foundations and vaccine attitudes, the researchers questioned study participants. "What we found was that in those who were highly hesitant there was an association with purity and liberty, and there was a negative association with authority," he says.

Traditional messages doctors (and angry moms on the internet) use to try to convince parents to vaccinate are usually based on the values of care and fairness: Vaccines protect your baby from harm, and everyone is protected if more people are vaccinated. But these messages might be not be reaching those who hold other values highly. "We're not necessarily saying that you stop talking about harm associated with diseases or protection with vaccines," says. "But you may also want to focus on things like purity and liberty."

These two values—purity and liberty—are what anti-vaccine messages tap into. Saying that vaccines contain toxins or that they are not "natural" appeals to those who value purity. Not wanting doctors, schools or any other authority to tell them what to do with their children is another message that resonates strongly with parents who value liberty.

This doesn't mean that vaccine-hesitant parents don't care about protecting their kids from harm—just that "care/harm" is not a value that separates them from the parents who do vaccinate. "The care/harm value may still be relevant, it's just not a differentiating aspect [among parents who do or don't vaccinate]," Dr. Omer says.

New messages to target vaccine hesitancy

So what public health advocates should also be focusing on is how vaccination actually fits into the values of vaccine-hesitant parents. "It's a little bit of framing—for example, saying vaccinating your baby is indeed a decision that is in line with your rights to protect your baby," Dr. Omer says. "Similarly, emphasizing things like vaccines are based on a natural physiological phenomenon, that they are a natural product in the sense that they leverage your own immune system." Along those same lines could be how diseases attack the body's purity, he says.

It sounds a bit like marketing, but these efforts could have far-reaching consequences for how many kids get sick and even die from diseases that could be eradicated by vaccination. "It's a lost opportunity to ensure the health of a population if we do not vaccinate," Dr. Omer says. "Vaccines are one of the most effective sources to protect against diseases—this is a consensus among public health and biomedical experts that they work incredibly well."

But, Dr. Omer cautions that this study was only the first step in exploring the phenomenon of how values relate to vaccination, and new ways to appeal to vaccine-hesitant parents have not yet been tested. "What we and others will be doing is to develop messages in line with these values, and then test this messaging," he says. For now, just keep it in mind the next time you get into an online vaccine "discussion" with other parents.