Governments failing to use evidence-based strategies for vaccine acceptance

The greatest threat to the acceptance of childhood vaccines may be the failure of governments to use evidence-based strategies to avoid threats to the science communication environment, according to a recent article in Science.

In the article, Dan Kahan, a professor of law and psychology at Yale Law School, uses the controversy over the introduction of the human papillomavirus vaccine to show how inattention to the insights from the empirical study of science communication puts decision-relevant science at risk. Kahan said that by using the findings of experimental studies that link controversy to cultural cognition, scientists could have avoided the conditions that triggered political opposition to proposed legislation of the HPV vaccine.

"It was likely inevitable that people of opposing cultural orientations would react divergently to a high-profile campaign to enact legislation mandating vaccination of 11- to 12- year-old girls for a sexually transmitted disease," Kahan said. "Yet there was nothing inevitable about the HPV vaccine being publicly introduced in a manner so likely to generate cultural conflict."

Kahan noted the absence of public controversy over the vaccination for hepatitis B virus, which is also a sexually transmitted disease that causes cancer. HPV immunization stands at just 33 percent for adolescent girls and seven percent for boys. By comparison, childhood vaccination coverage for the HBV vaccine stands at 90 percent.

When introducing the HPV vaccine, the U.S. Food and Drug Administration permitted Merck, the vaccine's manufacturer, to seek fast-track approval of a girls only version of the vaccine. As a result, most parents first learned about the HPV vaccine from news coverage of a mandatory, girls only, sexually transmitted disease shot.

"Many public health experts warned that the HPV vaccine was being introduced in a manner that risked provoking needless and disorienting controversy," Kahan said. "The problem was that there's no mechanism in the FDA or in the federal government generally for focusing attention on and collecting evidence on how the circumstances in which a medicine or other new technology will affect how citizens learn and evaluate information about it."

Kahan said that uninformed and counterproductive risk communication is the byproduct of a lack of a systemic, evidence-based alternative.