DISEASE OUTBREAK & PUBLIC OPINION: HOW THE 2014-15 MEASLES OUTBREAK IMPACTED PUBLIC PERCEPTION OF CHILDHOOD VACCINES Michael A. Cacciatore Glen Nowak Nate Evans Department of Advertising & Public Relations Grady College University of Georgia International Crisis & Risk Conference Orlando, FL March, 2016

THE AMERICAN PUBLIC AND CHILDHOOD VACCINATIONS Vaccination intentions tied to confidence and concerns/hesitancy that parents have in vaccinations Growing vaccine hesitancy has been associated with an increases in parents delaying or declining vaccines for their children The result has been an noticeable increase in cases of vaccine-preventable illness in recent years

THE 2014-15 MEASLES OUTBREAK

POSSIBLE OUTBREAK IMPACTS ON PARENTAL ATTITUDES & BEHAVIORS Fear appeals: Messages used to arouse fear in the audience before providing a suggestive form of action Health Belief Model: Behaviors are determined by threat perceptions along with strategies to mitigate the threat Did the outbreak increase confidence in vaccines, concerns about under-vaccinations, and future vaccination intentions by highlighting a threat (Measles) and a coping strategy (vaccination)?

A QUASI-EXPERIMENTAL DESIGN METHODOLOGY: A QUASI-EXPERIMENTAL DESIGN Data: Pair of YouGov surveys surrounding the 2014-15 measles outbreak Response rates of 36.3% and 32.7% Parents (N = 1,000 across each survey) with at least one child age 5 or younger Analysis: Regressions predicting vaccine confidence, concerns and future intentions Interactions to examine outbreak impacts among different population groups

RESULTS: VACCINE CONFIDENCE *** *** *** **

RESULTS: CONCERN THAT A VACCINE MIGHT NOT PREVENT THE DISEASE ** ** *** *** ***

RESULTS: DIFFERENTIAL OUTBREAK EFFECTS BASED ON VACCINATION STATUS AND INTEREST

RESULTS: CONCERN THAT WERE MY CHILD NOT VACCINATED THEY WOULD BE AT RISK *** *** ** ** *

RESULTS: DIFFERENTIAL OUTBREAK EFFECTS BASED ON VACCINATION STATUS AND INTEREST

RESULTS: FUTURE VACCINATION INTENTIONS Multinomial logistic regression findings: No overall impacts of outbreak (i.e., pre- vs. post-outbreak) White respondents more likely to report positive future vaccination intentions Child’s current vaccination status positively predicts future intentions, as does interest in the issue of vaccines

Has your child received the recommended vaccines to date? Vaccine Interest? Plan on having child receive recommended vaccines? Pre-outbreak Post-outbreak None or Some Low No 35.3% 38.6% Unsure 27.2% 25.0% Yes 37.5% 36.4% None or some High No 20.0% 37.0% Unsure 32.2% 11.1% Yes 47.8% 51.9% All Low No 3.1% 10.3% Unsure 8.1% 12.3% Yes 88.8% 77.4% All High No 5.3% 5.8% Unsure 4.3% 4.8% Yes 90.3% 89.4%

THE CASE OF THE MEASLES OUTBREAK TAKE-HOME MESSAGES: THE CASE OF THE MEASLES OUTBREAK Some clear patterns in vaccine perceptions Education, interest and child’s current vaccination status were largely stable predictors of parental vaccine attitudes The outbreak itself was more complicated Vaccine confidence increased from Time 1 to Time 2, mostly among those most interested in vaccines However, concerns that vaccines might not prevent the disease increased as well

THE CASE OF THE MEASLES OUTBREAK TAKE-HOME MESSAGES: THE CASE OF THE MEASLES OUTBREAK The outbreak had differential impacts on respondents based on their current vaccination behaviors and their interest in the topic Some evidence that getting parent’s who are not up-to-date with the child vaccination schedule interested in the topic can lead to more favorable vaccine attitudes However …

THE CASE OF THE MEASLES OUTBREAK TAKE-HOME MESSAGES: THE CASE OF THE MEASLES OUTBREAK … this did NOT necessarily translate into positive future vaccination intentions Rather, it made parents more certain, with many showing a decreased intention to vaccinate their children in the future

COMMUNICATING ABOUT VACCINES TAKE-HOME MESSAGES: COMMUNICATING ABOUT VACCINES Crisis and risk communicators: Highly visible outbreaks can positively affect awareness, intentions and support for public health measures But, communicators should NOT assume that high media visibility equals universal awareness of the outbreak and recommended preventive measures Some of the people who closely followed news of the outbreak might still be opposed to accepting recommended measures

THANK YOU! Questions? Contact: mcacciat@uga.edu gnowak@uga.edu nevans4@uga.edu