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« Dear Seth Mnookin & other great science journalists | Main | What is the evidence that an "anti-vaccination movement" is "causing" epidemics of childhood diseases in US? ("HFC! CYPHIMU?" Episode No. 2) »
Tuesday
Feb262013

Six modest points about vaccine-risk communication

1. Public fears of vaccines are vulnerable to exaggeration as a result of various influences, emotional, psychological, social, and political.

2. Fears of public fear of vaccines are vulnerable to exaggeration, too, as a result of comparable influences.

3. High-profile information campaigns aimed at combating public fear of vaccines are likely to arouse some level of that very type of fear. As Cass Sunstein has observed in summarizing the empirical literature on this effect, “discussions of low-probability risks tend to heighten public concern, even if those discussions consist largely of reassurance.

4.  Accordingly, an informed and properly motivated risk communicator would proceed deliberately and cautiously.  In particular, because efforts to quiet public fears about vaccines will predictably create some level of exactly that fear, such a communicator will not engage in a high-profile, sustained campaign to “reassure” the general public that vaccines are safe without reason to believe that there is a meaningful level of concern about vaccine risks in the public generally. 

5.  Not all risk communicators will be informed and properly motivated. Some communicators are likely to be uninformed, either of the facts about the level of public fear or of the general dynamics of public risk perception, including the potentially perverse effects of trying to “reassure” the public.  Others will not be properly motivated: they will respond to incentives (e.g., to gain attention and approval; to profit from fears of people who understandably fear there will be a decline in public vaccination rates) to exaggerate the level of public fear of vaccines.

6.  Accordingly, it makes sense to be alert both to potential sources of misinformation about vaccine risk and to potential sources of misinformation about the level of public perceptions of the risk of vaccines.  Being alert, at a minimum, consists in insisting that those who are making significant contributions to public discussion are being strictly factual about both sorts of risks.

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Reader Comments (4)

Dan --

You said this earlier.

If there isn’t evidence for the sorts of reports I’m describing, is it constructive to make people believe that nonvaccination is playing a bigger role than it actually is in any outbreaks of childhood diseases? Might doing so actually reduce proper attention to the actual causes of such outbreaks, including ineffective vaccines? Might they stir up anxiety by actually inducing people to believe that more people are worried about the vaccines than really are?

Not as a defense for fear-mongering about fear-mongering (stoking fears about those who stoke fears about vaccines), but this looks to me like it might be fear-mongering about fear-mongering about fear-mongering (stoking fears about those who stoke fears about those who stoke fears about vaccines).

Assuming that you are right, and the links between the "anti-vaccine movement" and "epidemics" are overstated (an important question to resolve) - where is your evidence that making those links has the potential for your hypothetical results?

This reminds me of the confident statement from "skeptics" that over-statements from climate scientists will undermine trust in scientists. Logical reasoning as a hypothetical - but where's the evidence?

Although I'm not 100% on board with the thesis of this post, I think it makes an important related point:

http://grist.org/climate-energy/the-virtues-of-being-unreasonable-on-keystone/

If you are going to hypothesize about something being counterproductive (as opposed to unproductive), it seems to me that it is important to bring something evidence to the table showing causality. There are many things that we could hypothesize about.

February 26, 2013 | Unregistered CommenterJoshua

@Joshua: I'm asking & framing questions. I don't know the answers. But if those who are engaged in communication with the public are making claims, *they* should have answers to questions like these. The worst way to proceed is without reflection.
It does comfort me to know, too, that my blog is not a meaningful source of information for the public at large as opposed to some select group of people interested in science communication. If I were, say, publishing op eds or news stories in major papers, I would feel a great sense of responsibility to be sure that I didn't misrepresent facts or communicate information in a way that might have an adverse effect on public health. If those engaged in this activity are not worried enough to figure out the answers to these questions, then I would not feel bad to think my reflections will "scare" them into being more considered!

February 26, 2013 | Registered CommenterDan Kahan

I think this is all really interesting. Thanks for promoting this topic!

The "group" seeming to get the most attention are parents seeking non-medical, non-religious exemptions to vaccinations (http://www.nejm.org/doi/full/10.1056/NEJMc1209037#t=article). The scientists/doctors/experts in the Pediatric Infectious Diseases Society has published a very strong statement about these sorts of exemptions: http://www.pids.org/images/stories/pdf/pids-pbe-statement.pdf.

I can't help wondering where these non-religious vaccine refusers would fit on the cult. cog. group-grid scale, assuming they would.

It might paint an interesting picture of the Risk assessment differences observed. Some people see it as terribly Risky to vaccinate. Some people see it as terribly Risky for others to refuse vaccines (for their children, mostly). So each experiences particularly motivated cognitions in this area, and the potential for hyperbole in news reports becomes amplified by this emotional-cognition engagement.

These news reports of the threat of vaccine refusers strike me as very moralistic: bad things happen to people who don't vaccine *and* they cause bad things to happen to innocent people who did the right thing and were vaccinated but whose vaccination protection has declined or never took properly or who were never able to get a vaccination (infants, people who can't get vaccinated for medical reasons).

It could be an across-grid/group conflict, like climate change, but I also don't see why it couldn't be an intra-grid/group conflict. What is normative within a grid/group culture can shift, and some may not want it to shift and so are concerned to prevent that.

I've said it before, but I think vaccinations are a particularly interesting source of public policy conflict along group-grid lines because, as far as I can see, there are good reasons for each segment of the group/grid scale to dislike them.

February 26, 2013 | Unregistered CommenterIsabel Penraeth

Dan -

Points well-taken, that said (and please don't assume that any of the following is necessarily directed towards you):

A pet peeve of mine is when people point to sensationalism in the media with some operating but unproven assumption about the (pet peeves are a red flag for motivated reasoning, are then not?) resultant harms. If the harms can be proven in some validated way, I'm all ears. You talk of potential for counterproducivity, but I need to read that fleshed out more to understand if it would really be a concern.

In the meantime, I consider a couple of related aspects.

1. People on all sides of these debates point to harm (or potential harm) from "the media." I find it fascinating that people are absolutely convinced of harm in exactly opposite ways. "Skeptics" claim that sensationalist media over-hype the dangers of climate change. "Realists" claim that a motivated media under-report the dangers of climate change. I have not doubt that people on both sides of the vaccination issue claim that the media harms the public in exactly opposite ways. Blaming the media for harm is an integral part of the victimization mentality that goes hand-in-hand with motivated reasoning as it plays out in these political debates.

2. Even if harm from sensationalism in the media, junk science reporting, bias to under-report dangers, etc., can be proven, basically I say, "Well, ok, so what?" No one every promised us a rose garden. Bad things happen. This isn't a perfect world.

That isn't to excuse bad reporting - questioning the veracity of reporting that links anti-vaxers to increased disease prevalence is absolutely a valid concern. But overhype in the media is an inevitability - and as such, it is far, far preferable to the only real alternative which is less media being made available. As much as people say that sensationalistic media is a problem in our society - in point of fact we have more easy access to more information reflecting differing views on more topics than we have ever had before. That is not an unmitigated good - as it means that we have more access to crap as well. But I'll take our current access to media, warts and all, over what we had even a decade ago.

So I say limit the focus to the specific issue at hand, rather than focusing on some larger phenomenon related to the problems of media over-hyping in a more general sense. Like I said, If there are concrete ways to identify counterproductivity from linking anti-vaxers to disease prevalence, I'm all ears.

February 26, 2013 | Unregistered CommenterJoshua

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