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Soveri A, Karlsson LC, Mäki KO, Holford D, Fasce A, Schmid P, Antfolk J, Karlsson L, Karlsson H, Nolvi S, Karukivi M, Lindfelt M, Lewandowsky S. Trait reactance as psychological motivation to reject vaccination: Two longitudinal studies and one experimental study. Appl Psychol Health Well Being 2024; 16:597-614. [PMID: 37942873 DOI: 10.1111/aphw.12506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 10/17/2023] [Indexed: 11/10/2023]
Abstract
Anti-science attitudes can be resilient to scientific evidence if they are rooted in psychological motives. One such motive is trait reactance, which refers to the need to react with opposition when one's freedom of choice has been threatened. In three studies, we investigated trait reactance as a psychological motivation to reject vaccination. In the longitudinal studies (n = 199; 293), we examined if trait reactance measured before the COVID-19 pandemic was related to people's willingness to get vaccinated against COVID-19 up to 2 years later during the pandemic. In the experimental study (n = 398), we tested whether trait reactance makes anti-vaccination attitudes more resistant to information and whether this resistance can be mitigated by framing the information to minimize the risk of triggering state reactance. The longitudinal studies showed that higher trait reactance before the COVID-19 pandemic was related to lower willingness to get vaccinated against COVID-19. Our experimental study indicated that highly reactant individuals' willingness to vaccinate was unaffected by the amount and framing of the information provided. Trait reactance has a strong and durable impact on vaccination willingness. This highlights the importance of considering the role of trait reactance in people's vaccination-related decision-making.
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Affiliation(s)
- Anna Soveri
- FinnBrain Birth Cohort Study, Department of Clinical Medicine, University of Turku, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
| | - Linda C Karlsson
- FinnBrain Birth Cohort Study, Department of Clinical Medicine, University of Turku, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
| | - Karl O Mäki
- Department of Psychology and Speech-Language Pathology, University of Turku, Turku, Finland
| | - Dawn Holford
- School of Psychological Science, University of Bristol, Bristol, UK
| | - Angelo Fasce
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Philipp Schmid
- Centre for Language Studies, Radboud University Nijmegen, Nijmegen, The Netherlands
- Institute for Planetary Health Behavior, Erfurt, Germany
- Health Communication Working Group, Implementation Research, Bernhard Nocht Institute for Tropical Medicine, University of Hamburg, Hamburg, Germany
| | - Jan Antfolk
- Department of Psychology, Åbo Akademi University, Turku, Finland
| | - Linnea Karlsson
- FinnBrain Birth Cohort Study, Department of Clinical Medicine, University of Turku, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
| | - Hasse Karlsson
- FinnBrain Birth Cohort Study, Department of Clinical Medicine, University of Turku, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
- Department of Psychiatry, Turku University Hospital and University of Turku, Turku, Finland
| | - Saara Nolvi
- FinnBrain Birth Cohort Study, Department of Clinical Medicine, University of Turku, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
- Department of Psychology and Speech-Language Pathology, University of Turku, Turku, Finland
| | - Max Karukivi
- Department of Adolescent Psychiatry, University of Turku and Turku University Hospital, Turku, Finland
| | - Mikael Lindfelt
- Department of Theology, Åbo Akademi University, Turku, Finland
| | - Stephan Lewandowsky
- School of Psychological Science, University of Bristol, Bristol, UK
- Department of Psychology, University of Potsdam, Potsdam, Germany
- School of Psychological Science, University of Western Australia, Perth, Western Australia, Australia
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Soveri A, Karlsson LC, Antfolk J, Mäki O, Karlsson L, Karlsson H, Nolvi S, Karukivi M, Lindfelt M, Lewandowsky S. Spillover effects of the COVID-19 pandemic on attitudes to influenza and childhood vaccines. BMC Public Health 2023; 23:764. [PMID: 37098527 PMCID: PMC10126550 DOI: 10.1186/s12889-023-15653-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 04/11/2023] [Indexed: 04/27/2023] Open
Abstract
The current study sought to determine whether public perceptions of other vaccines and diseases than COVID-19 have been impacted by the COVID-19 pandemic. We longitudinally examined whether there had been a change from before the COVID-19 pandemic to during the pandemic in: (a) influenza vaccination behaviour and intentions; (b) the perceived benefit of childhood vaccines and influenza vaccines; (c) the perceived safety of childhood vaccines and influenza vaccines; (d) the perceived severity of measles and influenza; and (e) trust in healthcare professionals in two samples of Finnish adults (N = 205 in Study 1 and N = 197 in Study 2). The findings showed that during the pandemic, more people than before had received or wanted to receive the influenza vaccine. The respondents also believed that influenza was more dangerous during the pandemic and that vaccinations were safer and more beneficial. On the other hand, for childhood vaccines only perceived safety increased. Finally, in one of the studies, people had more confidence in medical professionals during the pandemic than they had before. Together, these findings imply a spillover of the COVID-19 pandemic on how people view other vaccines and illnesses.
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Affiliation(s)
- Anna Soveri
- FinnBrain Birth Cohort Study, Institute of Clinical Medicine, University of Turku, Turun Yliopisto, 20014, Finland.
| | - Linda C Karlsson
- FinnBrain Birth Cohort Study, Institute of Clinical Medicine, University of Turku, Turun Yliopisto, 20014, Finland
| | - Jan Antfolk
- Department of Psychology, Åbo Akademi University, Turku, Finland
| | - Otto Mäki
- Department of Psychology and Speech-Language Pathology, University of Turku, Turku, Finland
| | - Linnea Karlsson
- FinnBrain Birth Cohort Study, Institute of Clinical Medicine, University of Turku, Turun Yliopisto, 20014, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
- Department of Child Psychiatry, Turku University Hospital and University of Turku, Turku, Finland
| | - Hasse Karlsson
- FinnBrain Birth Cohort Study, Institute of Clinical Medicine, University of Turku, Turun Yliopisto, 20014, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
- Department of Psychiatry, Turku University Hospital and University of Turku, Turku, Finland
| | - Saara Nolvi
- FinnBrain Birth Cohort Study, Institute of Clinical Medicine, University of Turku, Turun Yliopisto, 20014, Finland
- Department of Psychology and Speech-Language Pathology, Turku Institute for Advanced Studies, University of Turku, Turku, Finland
| | - Max Karukivi
- FinnBrain Birth Cohort Study, Institute of Clinical Medicine, University of Turku, Turun Yliopisto, 20014, Finland
- Department of Adolescent Psychiatry, Turku University Hospital and University of Turku, Turku, Finland
| | - Mikael Lindfelt
- Department of Theological Ethics, Åbo Akademi University, Turku, Finland
| | - Stephan Lewandowsky
- School of Psychological Science, University of Bristol, Bristol, UK
- School of Psychological Science, University of Western Australia, Perth, Australia
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Karlsson LC, Soveri A, Lewandowsky S, Karlsson L, Karlsson H, Nolvi S, Karukivi M, Lindfelt M, Antfolk J. The behavioral immune system and vaccination intentions during the coronavirus pandemic. Pers Individ Dif 2021; 185:111295. [PMID: 34629582 PMCID: PMC8486622 DOI: 10.1016/j.paid.2021.111295] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 09/10/2021] [Accepted: 09/25/2021] [Indexed: 12/30/2022]
Abstract
The behavioral immune system is considered to be a psychological adaptation that decreases the risk of infection. Research suggests that, in the current environment, this system can produce attitudes with negative health consequences, such as increased vaccine hesitancy. In three studies, we investigated whether two facets of the behavioral immune system-germ aversion (i.e., aversion to potential pathogen transmission) and perceived infectability (i.e., perceived susceptibility to disease)-predicted intentions to accept COVID-19 and influenza vaccination during the pandemic. The behavioral immune system mechanisms were measured before the COVID-19 pandemic in one study, and during the pandemic in two. In contrast to previous research, those with higher germ aversion during the pandemic perceived vaccines to be safer and had higher intentions to accept vaccination. Germ aversion before the pandemic was not associated with vaccination intentions. Individuals who perceived themselves as more susceptible to disease were slightly more willing to accept vaccination. We conjecture that high disease threat reverses the relationship between the behavioral immune system response and vaccination. As the associations were weak, individual differences in germ aversion and perceived infectability are of little practical relevance for vaccine uptake.
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Affiliation(s)
- Linda C Karlsson
- Department of Psychology, Åbo Akademi University, Finland.,FinnBrain Birth Cohort Study, Department of Clinical Medicine, University of Turku, Finland
| | - Anna Soveri
- FinnBrain Birth Cohort Study, Department of Clinical Medicine, University of Turku, Finland
| | - Stephan Lewandowsky
- School of Psychological Science, University of Bristol, United Kingdom.,School of Psychological Science, University of Western Australia, Australia
| | - Linnea Karlsson
- FinnBrain Birth Cohort Study, Department of Clinical Medicine, University of Turku, Finland.,Department of Pediatrics, Turku University Hospital and University of Turku, Finland.,Centre for Population Health Research, University of Turku and Turku University Hospital, Finland
| | - Hasse Karlsson
- FinnBrain Birth Cohort Study, Department of Clinical Medicine, University of Turku, Finland.,Department of Psychiatry, Turku University Hospital and University of Turku, Finland.,Centre for Population Health Research, University of Turku and Turku University Hospital, Finland
| | - Saara Nolvi
- FinnBrain Birth Cohort Study, Department of Clinical Medicine, University of Turku, Finland.,Turku Institute for Advanced Studies, Department of Psychology and Speech-Language Pathology, University of Turku, Finland
| | - Max Karukivi
- FinnBrain Birth Cohort Study, Department of Clinical Medicine, University of Turku, Finland.,Department of Psychiatry, Turku University Hospital and University of Turku, Finland
| | - Mikael Lindfelt
- Department of Theological Ethics, Åbo Akademi University, Finland
| | - Jan Antfolk
- Department of Psychology, Åbo Akademi University, Finland
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Soveri A, Karlsson LC, Antfolk J, Lindfelt M, Lewandowsky S. Unwillingness to engage in behaviors that protect against COVID-19: the role of conspiracy beliefs, trust, and endorsement of complementary and alternative medicine. BMC Public Health 2021; 21:684. [PMID: 33832446 PMCID: PMC8027965 DOI: 10.1186/s12889-021-10643-w] [Citation(s) in RCA: 89] [Impact Index Per Article: 29.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 03/17/2021] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND We investigated if people's response to the official recommendations during the COVID-19 pandemic is associated with conspiracy beliefs related to COVID-19, a distrust in the sources providing information on COVID-19, and an endorsement of complementary and alternative medicine (CAM). METHODS The sample consisted of 1325 Finnish adults who filled out an online survey marketed on Facebook. Structural regression analysis was used to investigate whether: 1) conspiracy beliefs, a distrust in information sources, and endorsement of CAM predict people's response to the non-pharmaceutical interventions (NPIs) implemented by the government during the COVID-19 pandemic, and 2) conspiracy beliefs, a distrust in information sources, and endorsement of CAM are related to people's willingness to take a COVID-19 vaccine. RESULTS Individuals with more conspiracy beliefs and a lower trust in information sources were less likely to have a positive response to the NPIs. Individuals with less trust in information sources and more endorsement of CAM were more unwilling to take a COVID-19 vaccine. Distrust in information sources was the strongest and most consistent predictor in all models. Our analyses also revealed that some of the people who respond negatively to the NPIs also have a lower likelihood to take the vaccine. This association was partly related to a lower trust in information sources. CONCLUSIONS Distrusting the establishment to provide accurate information, believing in conspiracy theories, and endorsing treatments and substances that are not part of conventional medicine, are all associated with a more negative response to the official guidelines during COVID-19. How people respond to the guidelines, however, is more strongly and consistently related to the degree of trust they feel in the information sources, than to their tendency to hold conspiracy beliefs or endorse CAM. These findings highlight the need for governments and health authorities to create communication strategies that build public trust.
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Affiliation(s)
- Anna Soveri
- Institute of Clinical Medicine, University of Turku, Turku, Finland.
| | - Linda C Karlsson
- Department of Psychology, Åbo Akademi University, Turku, Finland
| | - Jan Antfolk
- Department of Psychology, Åbo Akademi University, Turku, Finland
| | - Mikael Lindfelt
- Department of Theological Ethics, Åbo Akademi University, Turku, Finland
| | - Stephan Lewandowsky
- School of Psychological Science, University of Bristol, Bristol, UK
- School of Psychological Science, University of Western Australia, Perth, Australia
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Karlsson LC, Soveri A, Lewandowsky S, Karlsson L, Karlsson H, Nolvi S, Karukivi M, Lindfelt M, Antfolk J. Fearing the disease or the vaccine: The case of COVID-19. Pers Individ Dif 2020; 172:110590. [PMID: 33518869 PMCID: PMC7832025 DOI: 10.1016/j.paid.2020.110590] [Citation(s) in RCA: 255] [Impact Index Per Article: 63.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 12/03/2020] [Accepted: 12/06/2020] [Indexed: 01/01/2023]
Abstract
As studies indicate that people perceive COVID-19 as a threatening disease, the demand for a vaccine against the disease could be expected to be high. Vaccine safety concerns might nevertheless outweigh the perceived disease risks when an individual decides whether or not to accept the vaccine. We investigated the role of perceived risk of COVID-19 (i.e., perceived likelihood of infection, perceived disease severity, and disease-related worry) and perceived safety of a prospective vaccine against COVID-19 in predicting intentions to accept a COVID-19 vaccine. Three Finnish samples were surveyed: 825 parents of small children, 205 individuals living in an area with suboptimal vaccination coverage, and 1325 Facebook users nationwide. As points of reference, we compared the perceptions of COVID-19 to those of influenza and measles. COVID-19 was perceived as a threatening disease—more so than influenza and measles. The strongest predictor of COVID-19 vaccination intentions was trusting the safety of the potential vaccine. Those perceiving COVID-19 as a severe disease were also slightly more intent on taking a COVID-19 vaccine. Informing the public about the safety of a forthcoming COVID-19 vaccine should be the focus for health authorities aiming to achieve a high vaccine uptake.
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Affiliation(s)
| | - Anna Soveri
- FinnBrain Birth Cohort Study, Institute of Clinical Medicine, University of Turku, Finland
| | - Stephan Lewandowsky
- School of Psychological Science, University of Bristol, United Kingdom.,School of Psychological Science, University of Western Australia, Australia
| | - Linnea Karlsson
- FinnBrain Birth Cohort Study, Institute of Clinical Medicine, University of Turku, Finland.,Centre for Population Health Research, University of Turku and Turku University Hospital, Finland.,Department of Child Psychiatry, Turku University Hospital and University of Turku, Finland
| | - Hasse Karlsson
- FinnBrain Birth Cohort Study, Institute of Clinical Medicine, University of Turku, Finland.,Centre for Population Health Research, University of Turku and Turku University Hospital, Finland.,Department of Psychiatry, Turku University Hospital and University of Turku, Finland
| | - Saara Nolvi
- FinnBrain Birth Cohort Study, Institute of Clinical Medicine, University of Turku, Finland.,Turku Institute for Advanced Studies, Department of Psychology and Speech-Language Pathology, University of Turku, Finland.,Department of Medical Psychology, Charité Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Germany
| | - Max Karukivi
- FinnBrain Birth Cohort Study, Institute of Clinical Medicine, University of Turku, Finland.,Department of Psychiatry, Turku University Hospital and University of Turku, Finland
| | - Mikael Lindfelt
- Department of Theological Ethics, Åbo Akademi University, Finland
| | - Jan Antfolk
- Department of Psychology, Åbo Akademi University, Finland
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Karlsson LC, Lewandowsky S, Antfolk J, Salo P, Lindfelt M, Oksanen T, Kivimäki M, Soveri A. The association between vaccination confidence, vaccination behavior, and willingness to recommend vaccines among Finnish healthcare workers. PLoS One 2019; 14:e0224330. [PMID: 31671115 PMCID: PMC6822763 DOI: 10.1371/journal.pone.0224330] [Citation(s) in RCA: 102] [Impact Index Per Article: 20.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Accepted: 10/11/2019] [Indexed: 12/11/2022] Open
Abstract
Information and assurance from healthcare workers (HCWs) is reported by laypeople as a key factor in their decision to get vaccinated. However, previous research has shown that, as in the general population, hesitancy towards vaccines exists among HCWs as well. Previous studies further suggest that HCWs with a higher confidence in vaccinations and vaccine providers are more willing to take the vaccines themselves and to recommend vaccines to patients. In the present study with 2962 Finnish HCWs (doctors, head nurses, nurses, and practical nurses), we explored the associations between HCWs' vaccination confidence (perceived benefit and safety of vaccines and trust in health professionals), their decisions to accept vaccines for themselves and their children, and their willingness to recommend vaccines to patients. The results showed that although the majority of HCWs had high confidence in vaccinations, a notable share reported low vaccination confidence. Moreover, in line with previous research, HCWs with higher confidence in the benefits and safety of vaccines were more likely to accept vaccines for their children and themselves, and to recommend vaccines to their patients. Trust in other health professionals was not directly related to vaccination or recommendation behavior. Confidence in the benefits and safety of vaccines was highest among doctors, and increased along with the educational level of the HCWs, suggesting a link between confidence and the degree of medical training. Ensuring high confidence in vaccines among HCWs may be important in maintaining high vaccine uptake in the general population.
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Affiliation(s)
| | - Stephan Lewandowsky
- School of Psychological Science, University of Bristol, Bristol, United Kingdom
- School of Psychological Science, University of Western Australia, Perth, Australia
| | - Jan Antfolk
- Department of Psychology, Åbo Akademi University, Turku, Finland
| | - Paula Salo
- Department of Psychology, University of Turku, Turku, Finland
- Finnish Institute of Occupational Health, Turku, Finland
| | - Mikael Lindfelt
- Department of Theological Ethics, Åbo Akademi University, Turku, Finland
| | - Tuula Oksanen
- Finnish Institute of Occupational Health, Turku, Finland
| | - Mika Kivimäki
- Finnish Institute of Occupational Health, Turku, Finland
- Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Anna Soveri
- Department of Psychology, Åbo Akademi University, Turku, Finland
- Institute of Clinical Medicine, University of Turku, Turku, Finland
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Abstract
Background: Education can be taken as a key factor in transmission of a value tradition in healthcare. In professional and educational contexts, transmission of values appears to be a kind of guarantee for an occupational group’s professional identity, awareness and ethical integrity. Given the positives of such transmission of value traditions, one can also pay attention to conflicts between the professional tradition and individuals who are brought into that tradition. Objectives: How does mediation of value tradition in healthcare education appear out of the students’ perspective based on their own narratives? Research design and participants: Students’ texts were analysed through a combination of contrastive discourse analysis and sociohistorical description and then evaluated from an ethical perspective. Data were collected from the annual electronic feedback given by students after their clinical practice at a University Hospital. Ethical considerations: Organizational approval was received. Information about the voluntary nature of participation was a part of the feedback tool. Findings: The analysis points to the fact that there is a definite theme in the students’ experiences that both the previous research has neglected and that stands in conflict with the current tradition of healthcare education in Finland. That theme can be summarized in the experience of ‘losing one’s identity’, and it is expressed in a request to experience of ‘losing one’s identity’ and it is expressed in a request to have a right to ‘use one’s own name’ also as a healthcare professional. Discussion and conclusion: Being addressed by one’s name is to make the person directly involved and responsible, realizing that that person’s perspective is of importance to the way the world is. We argue that this theme (my name) is of ethical importance and could have empowering potentiality when used in an ethically sound way.
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Abstract
Synthetic biology will probably have a high impact on a variety of fields, such as healthcare, environment, biofuels, agriculture, and so on. A driving theme in European research policy is the importance of maintaining public legitimacy and support. Media can influence public attitudes and are therefore an important object of study. Through qualitative content analysis, this study investigates the press coverage of synthetic biology in the major Nordic countries between 2009 and 2014. The press coverage was found to be event-driven and there were striking similarities between countries when it comes to framing, language use, and treated themes. Reporters showed a marked dependence on their sources, mainly scientists and stakeholders, who thus drives the media agenda. The media portrayal was very positive, with an optimistic look at future benefits and very little discussion of possible risks.
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