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Communications and Vaccines

K. Viswanath, PhDDr. K. Viswanath
Harvard School of Public Health
Dana-Farber Cancer Institute
Dana-Farber/Harvard Cancer Center

We are in exciting times for science and technology.  Developments in biological sciences and information and communication technologies (ICT) offer tremendous potential for advancing our understanding of disease causation, prevention, discovery, development and delivery of treatments.  The communications revolution has changed radically the way we learn, play, work, entertain ourselves, and relate to each other.  It is in the way we learn and relate to each other that is germane to our discussion on vaccines.  To understand the importance of the communication revolution to vaccines, we must understand its four key features as noted elsewhere in our writings.  

First, the sheer amount of information that is being generated, good and bad, accurate and inaccurate, trivial and important, is overwhelming; unlike anything we have seen in history, and that which can be accessed from a variety of platforms and devices.

Second, because of these multiple platforms virtually ANYONE with access to the Internet and few technical skills can generate information and offer opinions or critiques.  The consequence is that traditional command and control over dissemination of scientific information is increasingly contested by grassroots participation of interested stakeholders.  That is the good news.  On the other hand, it is also true that scientific facts become malleable in the hands of those who have a stake in working against them, and the platforms allow them to disseminate their opinions widely.

Third, the networked environment has brought about a marvelous ability to connect people and places.  Yet the same environment, especially in social media, where people tend not to be exposed to other view points, have become echo chambers for misrepresentation of science and repetition of canards.  

Last, the benefits of the ICT revolution are accruing unequally across socioeconomic, racial and ethnic groups, a phenomenon characterized as communication inequalities.  While informed decision-making is noble, important and necessary, not all groups benefit because of lack of access to information, the complexity of the information or the lack of capacity to act on it.

Where does this leave us?  The National Vaccine Plan boldly lays out goals for the country to address such critical topics as developing new and improved vaccines, enhancing the vaccine safety system and using communications to enhance informed decision-making among others.  The recommendations are timely if not urgent.  We can draw on the social sciences to understand the individual and social contextual determinants that influence perceptions of vaccine safety, affect confidence and acceptance and vaccination behaviors.  Based on this understanding, drawing upon health communication sciences and social marketing principles, we should be able to address misperceptions and reinforce trust in science, improve access to reliable information and facilitate action.  Specifically, we need more work in three specific areas: what are the individual, population and contextual determinants that engender, influence, reinforce and change attitudes and perceptions towards vaccines and how do they, in turn, influence actual behaviors?  Two, how do we construct messages that promote confidence in vaccines and their acceptance among different audience groups and for different types of vaccines across the lifespan—childhood, adolescence and youth and adults?  Last, what role do new ICTs (e.g. social media) play in disseminating information about vaccines?  What kind of evidence-based interventions do we need to deliver the information effectively across population groups of different socioeconomic, racial, ethnic, and geographic backgrounds and promote informed decision making?  In short, we need a solid evidence base to inform our vaccine policies and programs and there is an urgent imperative to develop one.

The ICT revolution provides an incredible opportunity to interact with people about vaccines and make them partners in advancing the benefits from one of the most powerful tools in the public health arsenal.  It is said that vaccines are one of the greatest public health success stories of the 20th century.  We should take advantage of developments of the 21st century to ensure that the story continues and thrives.