Public credibility drives vaccination decisions.

Abstract

In their Editorial “Addressing vaccine hesitancy” (25 April, p. [339][1]), B. R. Bloom, E. Marcuse, and S. Mnookin identify a need to combat antivaccination messages with evidence-based strategies to best communicate the importance of vaccination. “The crux of the problem,” they write, “is our inability to demonstrate to skeptical parents that vaccinations save lives.” This inability is not due to a lack of evidence. Rather, it is a struggle between public health officials and vaccination skeptics for public credibility. Public debate is frequently guided by particulars: singular cases and narratives of inexplicable deaths or illness following vaccination. These particulars are delivered by voices that skeptical parents trust. A well-calibrated display of particulars allows many people to relate to such stories ([ 1 ][2]). ![Figure][3] CREDIT: DMITRY NAUMOV/WIKIMEDIA COMMONS This suggests that public credibility is not the result of experts telling the truth as they see it. It is the result of a demonstrated ability to solve problems ([ 2 ][4]), to build trust amongst one's audience ([ 3 ][5]), and to take doubts seriously rather than rejecting them as ignorant ([ 4 ][6]). After all, beyond the boundaries of the lab, trust and narratives contribute as much as truth and data to public credibility. 1. [↵][7] 1. P. W. B. Phillips 1. S. Shapin , in Public Science in Liberal Democracy, P. W. B. Phillips, Ed. (Univ. of Toronto Press, Toronto, 2007), pp. 33–39. 2. [↵][8] 1. E. Freidson , Profession of Medicine: A Study of the Sociology of Applied Knowledge (Univ. of Chicago Press, Chicago, 1988). 3. [↵][9] 1. E. v. Rijswoud , Nature 460, 571 (2009). [OpenUrl][10][PubMed][11] 4. [↵][12] 1. G. A. Poland, 2. R. M. Jacobsen , N. Engl. J. Med. 364, 97 (2011). [OpenUrl][13][CrossRef][14][PubMed][15][Web of Science][16] [1]: /lookup/doi/10.1126/science.1254834 [2]: #ref-1 [3]: pending:yes [4]: #ref-2 [5]: #ref-3 [6]: #ref-4 [7]: #xref-ref-1-1 View reference 1 in text [8]: #xref-ref-2-1 View reference 2 in text [9]: #xref-ref-3-1 View reference 3 in text [10]: {openurl}?query=rft.jtitle%253DNature%253B%2BPhysical%2BScience%2B%2528London%2529%26rft.stitle%253DNature%253B%2BPhysical%2BScience%2B%2528London%2529%26rft.aulast%253Dvan%2BRijswoud%26rft.auinit1%253DE.%26rft.volume%253D460%26rft.issue%253D7255%26rft.spage%253D571%26rft.epage%253D571%26rft.atitle%253DFlu%253A%2Bweighing%2Bup%2Bconflicting%2Bexpert%2Binformation.%26rft_id%253Dinfo%253Apmid%252F19641575%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [11]: /lookup/external-ref?access_num=19641575&link_type=MED&atom=%2Fsci%2F344%2F6185%2F693.atom [12]: #xref-ref-4-1 View reference 4 in text [13]: {openurl}?query=rft.jtitle%253DNew%2BEngland%2BJournal%2Bof%2BMedicine%26rft.stitle%253DNEJM%26rft.issn%253D0028-4793%26rft.aulast%253DPoland%26rft.auinit1%253DG.%2BA.%26rft.volume%253D364%26rft.issue%253D2%26rft.spage%253D97%26rft.epage%253D99%26rft.atitle%253DThe%2Bage-old%2Bstruggle%2Bagainst%2Bthe%2Bantivaccinationists.%26rft_id%253Dinfo%253Adoi%252F10.1056%252FNEJMp1010594%26rft_id%253Dinfo%253Apmid%252F21226573%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [14]: /lookup/external-ref?access_num=10.1056/NEJMp1010594&link_type=DOI [15]: /lookup/external-ref?access_num=21226573&link_type=MED&atom=%2Fsci%2F344%2F6185%2F693.atom [16]: /lookup/external-ref?access_num=000286142900001&link_type=ISI