Gwenyth Mercep ’22

The role of autonomy, or self-reliance, in medical decision making is intertwined with the complex narrative surrounding vaccinations. Vaccinations are a paramount preventative tool responsible for completely eradicating certain diseases and drastically reducing the incidence of others.  Although vaccine hesitancy is often positioned in mainstream media as resulting from pseudoscience or misinformation about safety, psychological traits like reactance can also play a role in shaping an individual’s compliance with vaccine guidelines  [1].  Psychological reactance is defined as an individuals’ propensity to restore their behavioral freedoms when they perceive that others are trying to impose their will on them  [1]. This research analyzes the relationship between trait reactance and vaccine priority as measured by satisfaction with pediatrician communication about vaccinations  [1]. Finkelstein et al predict that individuals high in trait reactance will rank pediatrician communication quality less favorably, in consequence perceive vaccines as less safe, and reduce the priority placed on vaccinating their children  [1].

Participants completed the study via an online survey measuring their psychological reactance, attitudes toward vaccine safety, vaccination priority, and perceived quality of their pediatrician’s vaccine-related communication  [1].  Questions presented such as, “It is a priority for me to vaccinate my child(ren) on the schedule recommended by my pediatrician”, and “regulations trigger a sense of resistance in me” elicited responses on a scale of  1 = strongly disagree, to 7 = strongly agree  [1]. The results indicated that parents who possess stronger psychological reactance reported lower vaccination priority and poorer quality of vaccine-related physician dialogue [1]. 

Increased psychological reactance is connected to a heightened desire for freedom and rebellion against circumstantial authority figures. With this information, public health professionals and clinicians have the opportunity to curate their communication strategies to improve compliance and overall health outcomes. In the current climate of COVID-19, a vaccine would have the capability to quickly build herd immunity and save countless lives. In the future with the potential release of a vaccine and subsequent pressure to vaccinate, we need to consider the likelihood of reactance within populations to inform our health communication. 

[1]  S. Finkelstein, et al., “Psychological reactance impacts ratings of pediatrician vaccine-related communication quality, perceived vaccine safety, and vaccination priority among U.S. parents”, Human Vaccines & Immunotherapeutics, 1-7 (2019). DOI: 10.1080/21645515.2019.1694815

[2] Image retrieved from: https://www.motherjones.com/politics/2019/05/pediatrician-sean-oleary-talk-to-parents-vaccines-mutual-decision-making/