2Zhang eJ, et al. BMJ Open 2019;9:e025866. doi:10.1136/bmjopen-2018-025866
Open access
actively condemn childhood vaccination, such as former
model Jenny McCarthy. 2 3 Television host Katie Couric,
an established bowel cancer screening spokesperson,11
portrayed doubts 14 about the safety of Human Papilloma-
virus Vaccine on her talk show.
As politicians both occupy media attention and have
the authority to direct public health policy on the
issue, their influence is potentially greater than that of
entertainment and sports celebrities. For example, the
mealses, mumps and rubella vaccine-autism controversy
sparked by the discredited Wakefield study 15 in 2001 was
influenced when the UK prime minister at the time Tony
Blair refused to disclose the vaccination status of his own
child,16 contributing to parental anxiety and fear, and
impeding the efforts of public health officials.17
US President Trump’s call for a commission into
vaccine safety in early 2017 led by vaccine sceptics Robert
Kennedy Jr and Robert De Niro has concerned health
professionals around the world.18 In Australia, Senator
Pauline Hanson created controversy in March 2017
when she advised parents to disregard the advice of their
doctors and ‘do their own research’ into vaccine safety and
promoted a non-existent ‘vaccination reaction test’ which
she subsequently retracted.5 When such views are made
public, they are often countered by medical experts, yet
there is little research on the impact of political messages
and how best to ensure optimal public health messaging.
Parental vaccine hesitancy is well studied, and gener-
ally defined as a delay in acceptance or refusal of vacci-
nation despite availability of vaccination services. 19
This definition encompasses parents with a spectrum
of vaccine-hesitant opinions, including those with fixed
antivaccination views, who generally do not change
their opinions, and uncertain parents that are not
fully compliant with vaccine schedules but could be
persuaded to change. 20 While WHO SAGE definition 21
refers to parents who are fully or mostly compliant with
vaccine schedules but experience caution or uncertainty
in doing so, the emphasis of research and health inter-
vention is rather focused on those who refuse some or
all vaccines. These vaccinating parents nevertheless may
be influenced to doubt childhood vaccination and delay
or refuse vaccinations in the future and may still be
susceptible to negative vaccine messages. 22 While health
promotion and intervention tend to focus on parents at
the hesitant end of the spectrum, it is currently unknown
how easily influenced the silent majority of vaccinating
parents are, whose continued compliance is necessary
for upholding effective vaccination coverage rates. Hesi-
tant but compliant parents in Australia are influenced by
vaccine-related events and news coverage, contributing
to complex unresolved concerns regarding the safety
of vaccines, and could potentially reduce their future
compliance accordingly. 23 The aim of this survey was to
investigate parental vaccination attitudes and responses
to vaccine-related media messages from political and
medical leaders of all types of parents through an alter-
nate model of classifying parental vaccine opinions by
susceptibility to change rather than their behaviour of
vaccine refusal.
MethODs
This study was designed to measure parental attitudes at
baseline and following viewing of vaccine messaging from
public figures through a 15–20 min online questionnaire
of parents of children aged 0–5 years in Australia. The
questions used in the online survey were formulated by the
authors of this paper to answer the research questions of
this paper and to obtain a range of qualitative and quanti-
tative data on parental attitudes towards childhood vacci-
nations and sociodemographic information. Short video
clips and corresponding transcripts of vaccine messages
from US President Donald Trump, Australian Senator
Pauline Hanson and head of the Australian Medical
Association Michael Gannon were then shown to partic-
ipants and responses collected. The first two messages
(Trump, Hanson) questioned vaccine safety, whereas
the last message (Gannon) affirmed vaccine safety (for
transcripts, see online supplementary appendix 1). The
impact of these messages on parental willingness to vacci-
nate and perception of vaccine safety was compared
against baseline views.
recruitment
A market research company Survey Sampling Interna-
tional was employed to randomly distribute the survey link
to representative sample (see table 1) aged 18–60 years
stratified by gender and state/territory of residence from
a database of registered panel members (n=400 000).
Distribution of points redeemable for gift cards, cash out
or charity donation provided incentive.
A total of 1727 potential participants clicked on the
survey link. A total of 1316 of these participants had no
children or only had children over 5 years of age and
were ineligible; 411 parents comprised the final eligible
sample.
sample size calculation
The study was powered for a separate study, assessing
acceptance of a new vaccine policy. Assuming 50%
support for vaccination, 385 participants were required,
with alpha=0.05 and power of 80%. The study aimed to
recruit 400 participants, with sampling designed to be
proportionate to the population of states and territories
in Australia.
Analysis
Descriptive analysis was conducted on the responses from
the population survey. Influences on parental vaccina-
tion attitudes (eg, doctors, health professionals, personal
experiences, familial/friend advice, media/internet)
were determined prior to exposure to political media
messages (see online supplementary appendix 2). X2
test and OR were used to evaluate the change in parental
views following exposure to vaccine messages from the
copyright. on September 5, 2019 at India:BMJ-PG Sponsored. Protected byhttp://bmjopen.bmj.com/BMJ Open: first published as 10.1136/bmjopen-2018-025866 on 26 March 2019. Downloaded from

Influence of Political And Medical Leaders

Contribute Materials

Related Documents

+13062052269

info@desklib.com