Preventable Disease Survivor Interviews Combat Vaccine Hesistancy

Brian D. Poole, PhD

A new study determined that connecting vaccine-hesitant (VH) college students with survivors of vaccine-preventable diseases (VPD) swayed their opinions towards vaccination.

The Brigham Young University (BYU) investigators—led by Brian D. Poole, PhD, from BYU’s Department of Microbiology and Molecular Biology—chose students at the university for the study in to assess whether future parents could be influenced to vaccinate their children. In return for their participation, students received extra credit in relevant classes.

Students were divided into 2 groups after taking the survey. They interviewed either a VPD survivor (intervention group) or a patient with an autoimmune disease (control group.) Both groups took a second survey at the course’s conclusion to assess whether their views on vaccines had changed and, if so, which aspects of the study had encouraged such a change.

The pre-interview survey contained 13 statements, asking subjects to rate each from 1-5, in which 1 represented “strongly disagree” and 5 represented “strongly agree.” Statements included “Vaccines are more helpful than harmful,” “Vaccines often have severe side effects,” and “Vaccines cause autism.”

The survey also included questions about autoimmune diseases and depression as a control, since students were not informed that the survey was about vaccine attitudes. Total vaccine attitude scores (VAS) between 20-25 points categorized students as pro-vaccine (PV), while >20 points categorized students as at least vaccine-hesitant (VH), if not outright anti-vaccine.

According to the World Health Organization (WHO), vaccine hesitancy is one of 2019’s top 10 threats to global health. They note that VH “threatens to reverse progress made in tackling vaccine-preventable diseases.”

“Vaccination is one of the most cost-effective ways of avoiding diseases—it currently prevents 2-3 million deaths a year, and a further 1.5 million could be avoided if global coverage of vaccinations improved,” their site read.

Initially, of the 574 students who participated, 491 were pro-vaccine and 83 were vaccine-hesitant. Of the 574 students, 149 never completed the assigned interview; 268 interviewed patients with an autoimmune disease (control group,) and 288 interviewed a survivor of a VPD (intervention group).

Approved VPDs for interviews included meningitis, measles, mumps, rubella, pertussis, shingles, tetanus, diphtheria, polio, tuberculosis, or another disease approved by Poole. A total of 214 control group members took the post-intervention analysis survey, as well as 211 members of the intervention group.

VH students in the intervention group (n= 19) experienced an average VAS shift from 17.58±0.84 to 20.53±.94 (paired t-test 95% CI difference: 4.077 - 0.817; P< .001)—an average increase of 2.95±2.34 points. Of these, 13 (68%) qualified as pro-vaccine after the intervention.

On the other hand, VH students in the control group hardly showed any increase in PV attitudes, with only 6 students (27%) becoming pro-vaccine.

In addition to the interview interventions, students enrolled in classes which provided vaccine education showed a broad, significant increase in all VH students’ (n= 5) PV attitudes, the average VAS increasing by 7.00±1.41 points even outside of the intervention group.

Overall, the intervention group caused the greatest VAS increase regardless of vaccine education curriculum, but both in tandem were the most effective. Poole told MD Magazine® investigators were surprised by the dramatic attitude changes.

“Seeing that 75% of the students who had 1 of our interventions changed their attitudes, and that these changes were enough to shift so many into the pro-vaccine group, was a much more profound result than we expected,” he said.

Most VH students (62%) said that hearing about VPD survivors’ physical pain was the strongest influence towards becoming pro-vaccination. On the other hand, 54% of students ranked financial costs as the least impactful on their attitudes towards vaccines.

“I dislike the idea of physical suffering,” said a VH student who interviewed their grandmother about tuberculosis. “Hearing about someone getting a disease made the idea of getting a disease if I don’t get vaccinated seem more real.”

In the future, Poole hopes this study will influence curriculum in college-level health courses and beyond. The addition of personal stories could complement education.

“We scientists have tended to avoid stories, because we have the truth on our side and using anecdotal stories almost seems unethical,” he told MD Mag. “However, if we are using stories to promote and motivate towards the truth, they can be a powerful tool.”

The study, “Combating Vaccine Hesitancy with Vaccine-Preventable Disease Familiarization: An Interview and Curriculum Intervention for College Students,” was published online in Vaccines.