Amanda Bradshaw: Addressing Vaccination Hesitancy and Misinformation
CJC doctoral candidate Amanda Bradshaw was interviewed on Oct. 20, 2020 about her research on vaccination hesitancy and misinformation.
Below the video is an edited transcript of that interview.
What sparked your interest in pursuing research on health and science communication and advertising?
Bradshaw: Before pursuing my PhD here at UF, I worked for a multidisciplinary, multi-location medical group and I handled all of their strategic communication efforts. The group included pediatrics, family medicine, child psychology. What I did was manage all of their public relations, social media, rebranded the company, and helped the doctors maintain a positive image with their patients. I also managed patient recruitment and retention and physician recruitment, trying to get providers to come to rural Alabama to work.
Through all of that, I realized that I wanted to connect not only the professional hands-on side, but also learn more of the theoretical background and all of those concepts that advertising and public relations practitioners rely on every day in the real world, specifically in the context of health communication.
You’ve done a lot of research on anti-vaccination communications. Why did you decide to pursue that line of research?
Bradshaw: Part of my job working with the medical group was to help with the expectant parent tours and help expectant parents start to acclimate their children into the practice. Vaccinations occur within 24 hours of birth, so there’s actually a pretty quick decision to be made. We would actually speak with parents during expectant parent tours and try and prepare them for that possibility. But sometimes, people would come to the practice and not be aware, or they would have older children who were not vaccinated, and they would push back and they wouldn’t want to vaccinate their children. In our case, the doctor had a policy that if you didn’t vaccinate, she would actually dismiss patients from the practice.
It made me realize during my time at the medical group that more and more people were declining vaccines. Just in my own experience, I was having more of these conversations where mothers just weren’t sure about vaccinating their children against one or more diseases that vaccines were available for. That really sparked my interest in learning a little bit more about the communication process behind this and trying to figure out ways to help mothers and fathers make informed decisions about vaccines for their children.
What are some of the key findings you’ve discovered through the course of your research?
Bradshaw: One of the first research studies I actually did here at the University of Florida was published in Health Communication journal, and it was featured by the Centers for Disease Control Health Science Digest back in January as one of the key papers to look at focusing on social media and health topics at this time.
Basically, that study involved joining the largest anti-vaccine closed Facebook group to understand the dialogue and how that dialogue might persuade new mothers, mothers who might be on the fence. I keep saying mothers because the research just constantly shows they are the primary decisionmakers for vaccination, but it could be any caregiver. Even in the course of comment threads in this group, people would come in on the fence or wanting to learn more of the pros and cons. And in some cases, within the course of just a few hours or days, they actually decided, at least according to the comments, to not vaccinate their children based on this Facebook information, based on resources they were given, such as documentary links, links to other social media pages.
I have learned that this is a multifaceted process. You really have to target your campaigns to very different audiences because vaccine decision making is ongoing, and it’s on a spectrum. Some people come to the doctor ready to vaccinate their children and may need one message of reassurance or letting them know from doctors that they are following the scientific consensus with the safety and efficacy of vaccines. Versus a brand new mother who’s questioning, never made that decision before, not sure what to do. Or someone who’s inclined against vaccination based on their personal beliefs or research they’ve done on their own. So you really have these different groups. The communication strategies that you might use with those groups definitely differs.
Does your research point to any particular kinds of messaging, particularly for people who are anti-vaccination, that might be more effective?
Bradshaw: The crux of the matter is that people who oppose vaccination definitely dislike messages that are presented as black and white. Any medical intervention in the world has risks involved. Messages that dismiss those or messages that are dismissive of internet research or things they might have seen on Facebook, those don’t tend to work as well. In fact, there’s a backfire effect that sometimes can antagonize people that are opposed to vaccines.
I think they’re looking for the research supports, messages that are more two-sided, that do acknowledge that risks do exist, putting that into a form that’s understandable. So it may be a statistical form, like this percentage of people will have this side effect. For some people, that may resonate. For others, it could be more of a visual form. Maybe showing a Gator stadium full of people and showing the number sitting down that might’ve had a reaction. Some sort of visual often works. There are decision aids out there that pediatricians can use and doctors can use in that process. A lot of my research focuses on trying to develop messages that public health experts can use in their conversations with parents to aid shared decision-making.
Now with COVID-19, we have a whole other realm of vaccine hesitancy. So even “pro-vaccine” parents may be disinclined to accept the COVID-19 vaccine based on the speed in which it’s been developed and the politicization of the whole process. That’s a whole other layer, which I am starting to look at a little bit in a survey that I conducted this spring. But I’m still interpreting those findings and writing that up at this time.
What research are you now exploring?
Bradshaw: I’m doing a framing analysis of all the vaccine ads on Facebook in the last couple of months, really since January. Looking at the framing of those ads, some of these social network platforms, such as Facebook and Twitter, have cracked down on misinformation, particularly in paid advertising. So new regulations exist trying to eliminate misinformation. My study is actually building on some baseline findings. Some authors did a similar study a few years ago before the misinformation guidelines were implemented, so I’m trying to compare and contrast and see what the advertisements look like using that key word vaccine or vaccination, immunization and how they’re framing vaccination.
Similarly on Twitter, I am looking at the hashtag hijacking of #DoctorsSpeakUp, which was a campaign that some physicians invented to have their voices be heard. The idea behind the hashtag was that physicians would come together on March 5, 2020 and explain the importance of vaccines. However, some individuals who oppose vaccination got word of the hashtag and actually decided to come together and post counter-messages using the same hashtag. So another part of my dissertation actually looks at that and seeing how #DoctorsSpeakUp was leveraged actually for the opposing purpose that it was developed.
I’m continuing to interview providers and expectant parents about this whole vaccine decision-making process, what advertisements or public service campaigns resonate versus which ones might be misguided. That’s really my focus at this point, but I’m sure that it will continue. I’m hoping to actually develop a prenatal education program about vaccines. Right now in the United States, that does not exist. And there is a big need because vaccine decision making does happen during pregnancy. Helping to develop something like that and secure funding for that would be my next step.