Enhancing Vaccine Communication to Address Intelligent Disobedience
a Written Argument by Ryan Mullin
Word Count: 2200
Introduction
According to Matthew J. Hornsey, a professor of Business at the University of Queensland Australia, “For the first time in a century, incidences of some communicable diseases—such as measles, mumps, and pertussis—are on the increase in the United States” (Hornsey et al. 1). These diseases can easily be prevented through vaccination. Yet, in recent years, people’s refusal to be vaccinated has become a complex and multifaceted problem with severe consequences if left unaddressed. Among the stimulus, a theme that emerged between FDR’s “Inaugural Address” and “Moral Courage and Intelligent Disobedience” was having the courage to act upon your beliefs (Roosevelt) (Thomas and Chaleff ). There is an urgent need to challenge the anti-vaccination movement instead of leaving it to pure discourse. One reason to do so is the “intelligent disobedience” within the anti-vaccination group. These people, based on a lack of information, believe that vaccines will cause harm, subsequently leading them to “disobey intelligently.” Naturally, this raises the question– To what extent should pharmaceutical companies dissuade intelligent disobedience of their vaccines by improving the information surrounding them? Simply put, pharmaceutical companies should convince anti-vaccination groups to accept and adopt immunization practices by refining their dissemination of vaccine information and employing clear and concise communication methods to promote informed decision-making and mitigate public health risks.
Roots of Vaccine Hesitancy in Intelligent Disobedience
To understand the need for such improvement, one must first understand why people are against such immunization practices. A primary impetus of this movement is the phenomenon of people intelligently rejecting the recommendations of physicians and pharmaceutical companies because they believe that their information will protect them more. According to Ted Thomas and Ira Chaleff in the stimulus material Moral Courage and Intelligent Disobedience, “Intelligent Disobedience requires refusing to follow orders that are either unlawful or will produce harm” (Thomas and Chaleff 59). While Thomas and Chaleff’s idea of moral courage is valid, this definition has limitations. A flaw of intelligent disobedience is that people will do what they believe to be right. However, that belief is subjective based on the information given to them; it is not always the truth. Regardless of how it is defined, intelligent disobedience requires much of what Thomas and Chaleff call “moral courage.” It requires going against the grain of society, its standards, and what it thinks is right. This behavior is exhibited when Thomas and Chaleff state, “Intelligent disobedience can simply involve the professionalism to not execute an order that would clearly have negative operational consequences. It often also involves moral courage” (Thomas and Chaleff 62). This idea is demonstrated in real life through the motivations of the anti-vaccination movement. There are several reasons why these people will intelligently disobey, most of which trace back to their knowledge surrounding vaccines, which is often based on inaccurate information, leading them to believe that it will cause them harm. The first of these reasons are personal beliefs. According to Azhar Hussain, a Professor of Pharmaceutical and Biomedical Sciences at Touro University College of Pharmacy in New York, in his peer-reviewed academic article on the anti-vaccination movement, personal beliefs, such as historical misconceptions and scientific skepticism, are common reasons why people refuse immunization practices (Hussain et al. 1-4). These beliefs skew people’s perceptions of vaccines negatively and cause people to believe that vaccines may cause harm to themselves or their children. This belief of harm stemming from vaccines is one of the reasons why people intelligently disobey trusted authorities when it comes to vaccinations, as they believe that their personal opinions should take precedence over that of authority. The next reason people intelligently disobey is that they often believe alternative therapies work better. According to Ève Dubé, a researcher at Université Laval, in her peer-reviewed academic journal article, “these alternative medical philosophies include but are not limited to, homeopathy, Christian Science, chiropractic hydrotherapy, and crystal healing, among others” (Dubé et al. 178). These alternative therapies give people the impression that they are receiving better protection from diseases than a vaccine would give, and thus, based on this impression, leads them to disobey the science surrounding vaccines. This information demonstrates that these groups are choosing not to vaccinate because they believe that the information available to them is better than what the pharmaceutical companies provide, which ultimately leads them into intelligent disobedience based on these misconceptions. Finally, psychological factors may also contribute to a person’s intelligent disobedience against vaccines. According to Piero Bocchiaro and Adriano Zamperini, researchers at Università degli Studi di Palermo and the University of Padova, respectively, in their academic study on conformity, obedience, and disobedience, “In certain contexts…simple situational factors are more powerful than personality traits in shaping human behavior” (Bocchiaro and Zamperini 290). A result of this can directly be seen in Thomas and Chaleff’s writings, as they explain the two controversies between Wells Fargo and Volkswagen, both of which were driven by greed and pressure from people’s superiors, and could have been prevented if the lower-level employees exhibited intelligent disobedience (Thomas and Chaleff 63). In the context of the anti-vaccination movement, a common motive is a belief that they are trying to prevent what they perceive as greed and pressure from pharmaceutical companies and the government from affecting themselves and their loved ones by intelligently disobeying their recommendations to vaccinate. Stepping back, one common theme that unites these reasons is the lack of quality information surrounding these vaccines. To fix this, pharmaceutical companies must refine their information distribution practices to deter people from choosing not to vaccinate based on faulty information.
Improving Vaccine Information for Informed Decisions
Pharmaceutical companies should refine the dissemination of information to effectively convey the risks and benefits associated with vaccines during the immunization process. As previously alluded to, where information comes from regarding vaccines, and the safety and efficacy of which, plays a significant role in a person’s decision whether or not to get vaccinated. According to Abbey M. Jones, a doctoral student at New York University, in her report on parents’ source of information about vaccines, “parents who did not view their child’s healthcare provider as a reliable vaccine information source were more likely to obtain vaccine information using the Internet. Parents who were younger, more highly educated, and opposed to school immunization requirements were more likely than their counterparts to use the Internet for vaccine information” (Jones et al. 1). Jones furthers this point by stating, “parents who reported using the Internet to obtain information about vaccines were less likely to agree with accepted tenets of vaccine science, [and] less likely to agree that children need or benefit from vaccines” (Jones et al. 5). This research shows a clear correlation between people who are intelligently disobeying vaccines and those who source their information from frequently unreliable sources, such as the internet. However, this does not mean that vaccine information is not readily available. Regulatory bodies, such as the United States Food & Drug Administration (FDA), mandate that information about the safety and efficacy of vaccines are released alongside them. According to the FDA, the requirements for these vaccines require information such as drug name(s), dosage form, route of administration, controlled substance symbol(s), recent major changes, warnings and precautions, adverse reactions, and drug interactions, among many other points of important information (U.S. Food and Drug Administration 7-17). The FDA makes sure that there is always enough accurate information about vaccines for them to be approved in the United States; however, implementation of these requirements often falls short of what the public needs to understand these medications fully. For instance, when examining the labeling details of the latest Pfizer/BioNTech COVID-19 vaccine, individuals are provided with a lengthy 9-page document before receiving the vaccine. This document consists of extensive paragraphs containing numerous medical terms, presented in relatively small font sizes, potentially making comprehension difficult (BioNTech et al.). Most people will neglect to read these as well, lowering their effectiveness. In fact, according to a study conducted by Ellen W. Clayton et al., when parents were presented with pamphlets with information regarding the vaccine a child would be receiving, “fewer than half (38%) read them thoroughly, and most (63%) said that they should be distributed only on the first visit for vaccinations.” (Clayton et al. 371). To address these shortcomings, pharmaceutical companies should take proactive steps to ensure that information regarding vaccines, including their safety and effectiveness, is readily available and understandable to everyone. This information should be exceptionally clear and provided to patients during vaccination. It is also crucial that the language used is accessible and easily comprehensible for recipients, with visuals aiding clarity. Moreover, integrating this information into the immunization process itself, such as through informative sessions with healthcare providers or user-friendly pamphlets, can significantly enhance understanding and decision-making. Research has also argued for this solution. According to Jane Root and Sue Stableford, in their peer-reviewed article on the need for easy-to-read consumer communication, improving the readability and clarity of medical information is greatly needed because “we all suffer from information overload. and we like necessary reading to be as quick and easy as possible” (Root and Stableford 16). By prioritizing transparent and accessible communication, pharmaceutical companies can empower individuals to make informed choices about vaccination, ultimately contributing to public health efforts. Nevertheless, it is important to acknowledge that there are limitations associated with this suggested solution. The first problem arises when dealing with the implementation of this solution. It is unclear whether the enforcement of this system should fall upon the physicians administering the vaccination, or the pharmaceutical companies who produce and manufacture the vaccine. If the responsibility fell upon the physicians, it would be unclear to the pharmaceutical companies if the patient was fully aware of the information regarding the vaccine. If it fell upon the corporations, the physicians could just as easily skip over informing the patient of the risks and benefits surrounding their immunization. In addition, this proposed solution only applies in the United States, where the scope of the research was limited. This solution has some limitations, but if implemented correctly, it can lead to a healthier, more informed public. By prioritizing transparent and accessible communication, pharmaceutical companies can empower individuals to make informed choices about vaccination. When people have access to comprehensive information about the risks and benefits of vaccines, they are better equipped to weigh their options and make decisions aligned with their personal health goals and values. This all demonstrates how improving information surrounding vaccines can directly improve the situation surrounding the anti-vaccination movement.
Counterarguments
Even if these measures were correctly implemented, counterarguments would still arise. Most of the counterarguments surrounding improving the information surrounding vaccines revolve around neglecting to accept information from pharmaceutical companies and obscuring important information by abstracting it away. Often, people have already made up their minds when deciding whether to receive a vaccine or not, and no amount of information can change their minds. This sentiment can be seen in Ève Dubé’s article, as she states, “Simply communicating information about vaccine safety and efficacy to those who are vaccine-hesitant is insufficient to stem the growth of hesitancy. More information on vaccines does not automatically result in more trust in vaccines. Worse yet, pro-vaccine messages can have unintended and undesirable consequences such as increasing resistance to vaccination” (Dubé et al. 184). Nevertheless, it is essential to realize that even if these holdout groups resist, more people will be getting vaccinated, and this will always have a positive effect, as each person protected against a disease moves the population as a whole towards less risk, as a high vaccination rate within a population provides indirect protection to those who cannot be vaccinated or are at higher risk of complications. In addition to the lack of receptiveness towards vaccine information, some may believe that improving the readability of this information may make the problem worse by inadvertently hiding critical information via abstraction. According to Jane Root and Sue Stableford, Medicaid customers had information about their plans delivered to their doorstep as a cartoon, with important information buried in the middle, which was often overlooked or misconstrued (Root and Stableford 16). This does not directly apply to vaccine information, but it shows how making the information “easier” to understand may obscure some of the more critical details. Situations like these, however, may be averted by striking a balance between comprehensibility and the importance of the information when planning these new systems. Although some counterarguments may arise, improving the dissemination of information surrounding vaccines will have a net positive impact on the public health of the United States. Conclusion In conclusion, combating anti-vaccination sentiment requires an approach that addresses the various factors contributing to this phenomenon and any counterarguments that may arise. While pharmaceutical companies must refine their communication strategies to effectively convey the importance of vaccination, it is essential to acknowledge the challenges and limitations inherent in this endeavor. Nevertheless, by prioritizing public health and promoting informed decision-making, we can strive towards a future where vaccination is embraced as a vital tool in safeguarding global health.
Works Cited
- BioNTech Manufacturing GmbH, and Pfizer, Inc. “Vaccine Information Fact Sheet for Recipients and Caregivers about COMIRNATY (COVID-19 VACCINE, mRNA).” 8 December 2022, https://labeling.pfizer.com/ShowLabeling.aspx?id=14472. Accessed 8 March 2024.
- Bocchiaro, Piero, and Adriano Zamperini. “Conformity, obedience, disobedience: The power of the situation.” Psychology–Selected papers, 2012, pp. 275-294. InTech, : http://www.intechopen.com/books/psychology-selected-papers/conformity-obedience-dis obedience-the-power-of-the-situation. Accessed 3 March 2024.
- Clayton, Ellen W., et al. “Parents’ responses to vaccine information pamphlets.” Pediatrics, vol. 93, no. 3, 1994, pp. 369-372. Health Source - Consumer Edition, https://doi.org/10.1542/peds.93.3.369. Accessed 8 March 2024.
- Dubé, Ève, et al. “Vaccine Hesitancy, Acceptance, and Anti-Vaccination: Trends and Future Prospects for Public Health.” Annual Review of Public Health, vol. 41, no. 1, 2021, pp. 175-191, https://doi.org/10.1146/annurev-publhealth-090419-102240. Accessed 1 March
- Hornsey, Matthew J., et al. “The psychological roots of anti-vaccination attitudes: A 24-nation investigation.” Health psychology, vol. 37, no. 4, 2018, [DOI](https://www.healthyliving.gr/wp-content/uploads/2018/02/The-Psychological-Roots-of- Anti-Vaccination-Attitudes-A-24-Nation-Investigation.pdf). Accessed 7 March 2024.
- Hussain, Azhar, et al. “The Anti-vaccination Movement: A Regression in Modern Medicine.” Cureus, vol. 10, no. 7, 2018, https://assets.cureus.com/uploads/review_article/pdf/13250/1612427982-1612427978-20 210204-18204-1h246tl.pdf. Accessed 29 February 2024.
- Jones, Abbey M., et al. “Parents’ Source of Vaccine Information and Impact on Vaccine Attitudes, Beliefs, and Nonmedical Exemptions.” Advances in preventive medicine, vol. 2012, 2012, https://doi.org/10.1155/2012/932741. Accessed 4 March 2024.
- Roosevelt, Franklin D. Inaugural Address. 1933.
- Root, Jane, and Sue Stableford. “Easy-to-Read Consumer Communications: A Missing Link in Medicaid Managed Care.” Journal of Health Politics, Policy & Law, vol. 24, no. 1, 1999, pp. 1-26. EBSCOhost, https://doi.org/10.1215/03616878-24-1-1. Accessed 18 March 2024.
- Thomas, Ted, and Ira Chaleff. “Moral Courage and Intelligent Disobedience in the Military.” Interagency Journal, vol. 8, no. 1, 2017.
- U.S. Food and Drug Administration. “Labeling for Human Prescription Drug and Biological Products – Implementing the PLR Content and Format Requirements.” FDA, February 2013, https://www.fda.gov/media/71836/download. Accessed 7 March 2024.
