NIHR Health Protection Research Unit in Vaccines and Immunisation, Department of Global Health Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, United Kingdom.
NIHR Health Protection Research Unit in Behavioural Science and Evaluation, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom.
Vaccine. 2023 Jan 27;41(5):1018-1034. doi: 10.1016/j.vaccine.2022.12.059. Epub 2023 Jan 9.
Misinformation and disinformation around vaccines has grown in recent years, exacerbated during the Covid-19 pandemic. Effective strategies for countering vaccine misinformation and disinformation are crucial for tackling vaccine hesitancy. We conducted a systematic review to identify and describe communications-based strategies used to prevent and ameliorate the effect of mis- and dis-information on people's attitudes and behaviours surrounding vaccination (objective 1) and examined their effectiveness (objective 2).
We searched CINAHL, Web of Science, Scopus, MEDLINE, Embase, PsycInfo and MedRxiv in March 2021. The search strategy was built around three themes(1) communications and media; (2) misinformation; and (3) vaccines. For trials addressing objective 2, risk of bias was assessed using the Cochrane risk of bias in randomized trials tool (RoB2).
Of 2000 identified records, 34 eligible studies addressed objective 1, 29 of which also addressed objective 2 (25 RCTs and 4 before-and-after studies). Nine 'intervention approaches' were identified; most focused on content of the intervention or message (debunking/correctional, informational, use of disease images or other 'scare tactics', use of humour, message intensity, inclusion of misinformation warnings, and communicating weight of evidence), while two focused on delivery of the intervention or message (timing and source). Some strategies, such as scare tactics, appear to be ineffective and may increase misinformation endorsement. Communicating with certainty, rather than acknowledging uncertainty around vaccine efficacy or risks, was also found to backfire. Promising approaches include communicating the weight-of-evidence and scientific consensus around vaccines and related myths, using humour and incorporating warnings about encountering misinformation. Trying to debunk misinformation, informational approaches, and communicating uncertainty had mixed results.
This review identifies some promising communication strategies for addressing vaccine misinformation. Interventions should be further evaluated by measuring effects on vaccine uptake, rather than distal outcomes such as knowledge and attitudes, in quasi-experimental and real-life contexts.
近年来，围绕疫苗的错误信息和虚假信息有所增加，在新冠疫情期间更是如此。针对疫苗错误信息和虚假信息的有效策略对于解决疫苗犹豫问题至关重要。我们进行了一项系统综述，以确定和描述用于预防和减轻错误和虚假信息对人们围绕疫苗接种的态度和行为的影响的基于沟通的策略（目标 1），并检查了它们的有效性（目标 2）。
我们于 2021 年 3 月在 CINAHL、Web of Science、Scopus、MEDLINE、Embase、PsycInfo 和 MedRxiv 上进行了搜索。该搜索策略围绕三个主题（1）沟通和媒体；（2）错误信息；和（3）疫苗构建。对于针对目标 2 的试验，使用 Cochrane 随机试验偏倚风险工具（RoB2）评估了偏倚风险。
在 2000 条确定的记录中，有 34 项符合条件的研究涉及目标 1，其中 29 项也涉及目标 2（25 项 RCT 和 4 项前后对照研究）。确定了 9 种“干预方法”；大多数方法侧重于干预或信息的内容（辟谣/纠正、信息、使用疾病图像或其他“恐吓策略”、使用幽默、信息强度、包括错误信息警告，以及传达证据权重），而有两种方法侧重于干预或信息的传递（时机和来源）。一些策略，如恐吓策略，似乎无效，并且可能会增加对错误信息的认可。还有研究发现，确定性的沟通，而不是承认疫苗功效或风险的不确定性，也会适得其反。一些有前景的方法包括传达有关疫苗和相关神话的证据权重和科学共识、使用幽默以及纳入有关遇到错误信息的警告。试图辟谣、信息方法和传达不确定性的方法效果不一。
本综述确定了一些针对疫苗错误信息的有前景的沟通策略。干预措施应在准实验和现实生活环境中，通过衡量对疫苗接种的影响，而不是通过知识和态度等间接结果，进一步进行评估。
