Investigating an Issue-Attention-Action Cycle: A Case Study on the Chronology of Media Attention, Public Attention, and Actual Vaccination Behavior during the 2019 Measles Outbreak in Austria.

The present study investigated the chronology of media attention, public attention, and actual vaccinations during a recent measles outbreak in Austria. The analysis indicated that initial news coverage about the measles outbreak (the first wave of media attention) sparked public attention and led to additional heavy news coverage about measles (the second wave of media attention). The observed patterns of public and media attention reflect typical issue-attention cycles, as revealed by previous research. As a supplement to previous studies, the present study links media and public attention with a consecutive increase in the number of vaccinations, thereby supporting the notion of an issue-attention-action cycle. Additional curve-fitting analyses showed that the day-by-day variations in media and public attention resembled sharp, short-term "spotlight effects," whereas consequences on vaccination behavior represented a broader, long-term "echo effect." Above and beyond the theoretical contributions, we discuss practical implications: Surveilling the development of media and public attention in the immediate aftermath of a measles outbreak may be a cost-effective strategy to predict future patient load, thereby helping to effectively allocate resources for vaccination programs. A thorough understanding of the issue-attention-action cycle contributes to this aim.