{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T00:38:19Z","timestamp":1793147899273,"version":"4.5.0"},"reference-count":49,"publisher":"American Academy of Pediatrics (AAP)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2014,4,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVES:<\/jats:title>\n                    <jats:p>To test the effectiveness of messages designed to reduce vaccine misperceptions and increase vaccination rates for measles-mumps-rubella (MMR).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>A Web-based nationally representative 2-wave survey experiment was conducted with 1759 parents age 18 years and older residing in the United States who have children in their household age 17 years or younger (conducted June\u2013July 2011). Parents were randomly assigned to receive 1 of 4 interventions: (1) information explaining the lack of evidence that MMR causes autism from the Centers for Disease Control and Prevention; (2) textual information about the dangers of the diseases prevented by MMR from the Vaccine Information Statement; (3) images of children who have diseases prevented by the MMR vaccine; (4) a dramatic narrative about an infant who almost died of measles from a Centers for Disease Control and Prevention fact sheet; or to a control group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>None of the interventions increased parental intent to vaccinate a future child. Refuting claims of an MMR\/autism link successfully reduced misperceptions that vaccines cause autism but nonetheless decreased intent to vaccinate among parents who had the least favorable vaccine attitudes. In addition, images of sick children increased expressed belief in a vaccine\/autism link and a dramatic narrative about an infant in danger increased self-reported belief in serious vaccine side effects.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>Current public health communications about vaccines may not be effective. For some parents, they may actually increase misperceptions or reduce vaccination intention. Attempts to increase concerns about communicable diseases or correct false claims about vaccines may be especially likely to be counterproductive. More study of pro-vaccine messaging is needed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1542\/peds.2013-2365","type":"journal-article","created":{"date-parts":[[2014,3,3]],"date-time":"2014-03-03T22:37:56Z","timestamp":1393886276000},"page":"e835-e842","source":"Crossref","is-referenced-by-count":951,"title":["Effective Messages in Vaccine Promotion: A Randomized Trial"],"prefix":"10.1542","volume":"133","author":[{"given":"Brendan","family":"Nyhan","sequence":"first","affiliation":[{"name":"Department of Government, Dartmouth College, Hanover, New Hampshire;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason","family":"Reifler","sequence":"additional","affiliation":[{"name":"Department of Politics, University of Exeter, Exeter, United Kingdom;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sean","family":"Richey","sequence":"additional","affiliation":[{"name":"Department of Political Science, Georgia State University, Atlanta, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gary L.","family":"Freed","sequence":"additional","affiliation":[{"name":"The Child Health Evaluation and Research (CHEAR) Unit, Division of General Pediatrics, University of Michigan, Ann Arbor, Michigan; and"},{"name":"Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor, Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2014,4,1]]},"reference":[{"key":"2021120903183265500_B1"},{"key":"2021120903183265500_B2","volume-title":"Deadly Choices: How the Anti-Vaccine Movement Threatens Us All","author":"Offit","year":"2010"},{"issue":"12","key":"2021120903183265500_B3","doi-asserted-by":"crossref","first-page":"2361","DOI":"10.1016\/j.vaccine.2010.02.052","article-title":"Fear, misinformation, and innumerates: how the Wakefield paper, the press, and advocacy groups damaged the public health.","volume":"28","author":"Poland","year":"2010","journal-title":"Vaccine"},{"issue":"7","key":"2021120903183265500_B4","doi-asserted-by":"crossref","first-page":"1709","DOI":"10.1016\/j.vaccine.2009.12.022","article-title":"A postmodern Pandora\u2019s box: anti-vaccination misinformation on the Internet.","volume":"28","author":"Kata","year":"2010","journal-title":"Vaccine"},{"issue":"25","key":"2021120903183265500_B5","doi-asserted-by":"crossref","first-page":"3778","DOI":"10.1016\/j.vaccine.2011.11.112","article-title":"Anti-vaccine activists, Web 2.0, and the postmodern paradigm\u2014an overview of tactics and tropes used online by the anti-vaccination movement.","volume":"30","author":"Kata","year":"2012","journal-title":"Vaccine"},{"issue":"1","key":"2021120903183265500_B6","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1215\/03616878-1496020","article-title":"The legitimacy of vaccine critics: what is left after the autism hypothesis?","volume":"37","author":"Kirkland","year":"2012","journal-title":"J Health Polit Policy Law"},{"issue":"35","key":"2021120903183265500_B7","first-page":"689","article-title":"National, state, and local area vaccination coverage among children aged 19-35 months\u2014United States, 2011.","volume":"61","author":"Centers for Disease Control and Prevention (CDC)","year":"2012","journal-title":"MMWR Morb Mortal Wkly Rep"},{"issue":"4","key":"2021120903183265500_B8","doi-asserted-by":"crossref","first-page":"747","DOI":"10.1542\/peds.2009-1653","article-title":"Measles outbreak in a highly vaccinated population, San Diego, 2008: role of the intentionally undervaccinated.","volume":"125","author":"Sugerman","year":"2010","journal-title":"Pediatrics"},{"issue":"6","key":"2021120903183265500_B9","doi-asserted-by":"crossref","first-page":"1132","DOI":"10.1016\/j.vaccine.2011.12.006","article-title":"Risk factors associated with parents claiming personal-belief exemptions to school immunization requirements: community and other influences on more skeptical parents in Oregon, 2006.","volume":"30","author":"Gaudino","year":"2012","journal-title":"Vaccine"},{"issue":"4","key":"2021120903183265500_B10","doi-asserted-by":"crossref","first-page":"718","DOI":"10.1542\/peds.2007-0538","article-title":"Parents with doubts about vaccines: which vaccines and reasons why.","volume":"122","author":"Gust","year":"2008","journal-title":"Pediatrics"},{"issue":"4","key":"2021120903183265500_B11","doi-asserted-by":"crossref","first-page":"654","DOI":"10.1542\/peds.2009-1962","article-title":"Parental vaccine safety concerns in 2009.","volume":"125","author":"Freed","year":"2010","journal-title":"Pediatrics"},{"issue":"1","key":"2021120903183265500_B12","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1542\/peds.2011-3154","article-title":"Frequency of alternative immunization schedule use in a metropolitan area.","volume":"130","author":"Robison","year":"2012","journal-title":"Pediatrics"},{"issue":"5","key":"2021120903183265500_B13","doi-asserted-by":"crossref","first-page":"848","DOI":"10.1542\/peds.2011-0400","article-title":"Alternative vaccination schedule preferences among parents of young children.","volume":"128","author":"Dempsey","year":"2011","journal-title":"Pediatrics"},{"key":"2021120903183265500_B14","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1177\/00333549111260S215","article-title":"Parental delay or refusal of vaccine doses, childhood vaccination coverage at 24 months of age, and the Health Belief Model.","volume":"126","author":"Smith","year":"2011","journal-title":"Public Health Rep"},{"issue":"24","key":"2021120903183265500_B15","doi-asserted-by":"crossref","first-page":"3145","DOI":"10.1001\/jama.284.24.3145","article-title":"Individual and community risks of measles and pertussis associated with personal exemptions to immunization.","volume":"284","author":"Feikin","year":"2000","journal-title":"JAMA"},{"issue":"15","key":"2021120903183265500_B16","first-page":"253","article-title":"Measles - United States, 2011.","volume":"61","author":"Centers for Disease Control and Prevention (CDC)","year":"2012","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"2021120903183265500_B17","unstructured":"Boseley S, Meikle J. Vaccination campaign launches with hope of halting measles outbreak. The Guardian. April 25, 2013. Available at: www.theguardian.com\/society\/2013\/apr\/25\/vaccination-campaign-mmr-measles. Accessed April 25, 2013"},{"key":"2021120903183265500_B18","unstructured":"Press Association. Measles cases in south Wales outbreak climb to 942. The Guardian. April 25, 2013. Available at: www.guardian.co.uk\/society\/2013\/apr\/25\/measles-cases-south-wales-outbreak-up. Accessed April 26, 2013"},{"key":"2021120903183265500_B19","doi-asserted-by":"crossref","first-page":"S167","DOI":"10.1542\/peds.2010-2720E","article-title":"Childhood immunization: when physicians and parents disagree.","volume":"128","author":"Gilmour","year":"2011","journal-title":"Pediatrics"},{"key":"2021120903183265500_B20","doi-asserted-by":"crossref","first-page":"S127","DOI":"10.1542\/peds.2010-1722S","article-title":"How to communicate with vaccine-hesitant parents.","volume":"127","author":"Healy","year":"2011","journal-title":"Pediatrics"},{"issue":"1","key":"2021120903183265500_B21","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/S0264-410X(03)00532-2","article-title":"Communicating science to the public: MMR vaccine and autism.","volume":"22","author":"Offit","year":"2003","journal-title":"Vaccine"},{"issue":"2","key":"2021120903183265500_B22","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1007\/s11109-010-9112-2","article-title":"When corrections fail: the persistence of political misperceptions.","volume":"32","author":"Nyhan","year":"2010","journal-title":"Polit Behav"},{"key":"2021120903183265500_B23","unstructured":"Nyhan B, Reifler J. Misinformation and fact-checking: research findings from social science. New America Foundation Media Policy Initiative Research Paper; 2012. Available at: http:\/\/newamerica.net\/sites\/newamerica.net\/files\/policydocs\/Misinformation_and_Fact-checking.pdf. Accessed January 21, 2014"},{"issue":"3","key":"2021120903183265500_B24","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1177\/1529100612451018","article-title":"Misinformation and its correction: continued influence and successful debiasing.","volume":"13","author":"Lewandowsky","year":"2012","journal-title":"Psychol Sci Public Interest"},{"issue":"11","key":"2021120903183265500_B25","doi-asserted-by":"crossref","first-page":"2098","DOI":"10.1037\/0022-3514.37.11.2098","article-title":"Biased assimilation and attitude polarization: the effects of prior theories on subsequently considered evidence.","volume":"37","author":"Lord","year":"1979","journal-title":"J Pers Soc Psychol"},{"issue":"1","key":"2021120903183265500_B26","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1037\/0022-3514.71.1.5","article-title":"A disconfirmation bias in the evaluation of arguments.","volume":"71","author":"Edwards","year":"1996","journal-title":"J Pers Soc Psychol"},{"issue":"3","key":"2021120903183265500_B27","doi-asserted-by":"crossref","first-page":"755","DOI":"10.1111\/j.1540-5907.2006.00214.x","article-title":"Motivated skepticism in the evaluation of political beliefs.","volume":"50","author":"Taber","year":"2006","journal-title":"Am J Pol Sci"},{"issue":"4","key":"2021120903183265500_B28","doi-asserted-by":"crossref","first-page":"439","DOI":"10.1177\/0093650212441794","article-title":"Partisan evaluation of partisan information.","volume":"39","author":"Gunther","year":"2012","journal-title":"Communic Res"},{"issue":"3","key":"2021120903183265500_B29","doi-asserted-by":"crossref","first-page":"790","DOI":"10.1111\/0022-3816.00033","article-title":"Misinformation and the currency of democratic citizenship.","volume":"62","author":"Kuklinski","year":"2000","journal-title":"J Polit"},{"issue":"5","key":"2021120903183265500_B30","doi-asserted-by":"crossref","first-page":"899","DOI":"10.1037\/0022-3514.50.5.899","article-title":"Judging health status: effects of perceived prevalence and personal relevance.","volume":"50","author":"Jemmott","year":"1986","journal-title":"J Pers Soc Psychol"},{"issue":"2","key":"2021120903183265500_B31","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1037\/0278-6133.7.2.183","article-title":"Appraising the threat of illness: a mental representational approach.","volume":"7","author":"Ditto","year":"1988","journal-title":"Health Psychol"},{"issue":"4","key":"2021120903183265500_B32","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1111\/j.1547-5069.2005.00059.x","article-title":"Risk perception and compliance with quarantine during the SARS outbreak.","volume":"37","author":"Cava","year":"2005","journal-title":"J Nurs Scholarsh"},{"issue":"2","key":"2021120903183265500_B33","doi-asserted-by":"crossref","first-page":"263","DOI":"10.2307\/1914185","article-title":"Prospect theory: an analysis of decision under risk.","volume":"47","author":"Kahneman","year":"1979","journal-title":"Econometrica"},{"issue":"1","key":"2021120903183265500_B34","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1037\/0033-2909.121.1.3","article-title":"Shaping perceptions to motivate healthy behavior: the role of message framing.","volume":"121","author":"Rothman","year":"1997","journal-title":"Psychol Bull"},{"issue":"6","key":"2021120903183265500_B35","doi-asserted-by":"crossref","first-page":"624","DOI":"10.1037\/0278-6133.21.6.624","article-title":"The effects of framing and action instructions on whether older adults obtain flu shots.","volume":"21","author":"McCaul","year":"2002","journal-title":"Health Psychol"},{"issue":"pt 4","key":"2021120903183265500_B36","doi-asserted-by":"crossref","first-page":"667","DOI":"10.1348\/000712607X190692","article-title":"Message framing with respect to decisions about vaccination: the roles of frame valence, frame method and perceived risk.","volume":"98","author":"Ferguson","year":"2007","journal-title":"Br J Psychol"},{"issue":"6","key":"2021120903183265500_B37","doi-asserted-by":"crossref","first-page":"745","DOI":"10.1037\/0278-6133.26.6.745","article-title":"Using message framing to promote acceptance of the human papillomavirus vaccine.","volume":"26","author":"Gerend","year":"2007","journal-title":"Health Psychol"},{"issue":"7","key":"2021120903183265500_B38","doi-asserted-by":"crossref","first-page":"821","DOI":"10.1080\/08870440902893708","article-title":"Moving beyond the function of the health behaviour: the effect of message frame on behavioural decision-making.","volume":"25","author":"Bartels","year":"2010","journal-title":"Psychol Health"},{"issue":"5","key":"2021120903183265500_B39","doi-asserted-by":"crossref","first-page":"591","DOI":"10.1177\/109019810002700506","article-title":"A meta-analysis of fear appeals: implications for effective public health campaigns.","volume":"27","author":"Witte","year":"2000","journal-title":"Health Educ Behav"},{"issue":"1","key":"2021120903183265500_B40","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1111\/j.1559-1816.2010.00710.x","article-title":"Does exposure to cigarette health warnings elicit psychological reactance in smokers?","volume":"41","author":"Erceg-Hurn","year":"2011","journal-title":"J Appl Soc Psychol"},{"key":"2021120903183265500_B41","unstructured":"Knowledge Networks. KnowledgePanel Design Summary. Available at: www.knowledgenetworks.com\/knpanel\/docs\/KnowledgePanel(R)-Design-Summary-Description.pdf. Accessed April 12, 2013"},{"key":"2021120903183265500_B42","unstructured":"Centers for Disease Control and Prevention (CDC). Measles, mumps, and rubella (MMR) vaccine. Available at: www.cdc.gov\/vaccinesafety\/vaccines\/mmr\/mmr.html. Accessed April 12, 2013"},{"key":"2021120903183265500_B43","unstructured":"Centers for Disease Control and Prevention (CDC). MMR vaccine (measles, mumps, and rubella): What you need to know. Available at: www.cdc.gov\/vaccines\/hcp\/vis\/vis-statements\/mmr.pdf. Accessed January 21, 2014"},{"key":"2021120903183265500_B44","unstructured":"Centers for Disease Control and Prevention (CDC). 106 Degrees: a true story. Available at: www.cdc.gov\/vaccines\/vpd-vac\/measles\/unprotected-story.htm. Accessed April 12, 2013"},{"key":"2021120903183265500_B45","unstructured":"Illinois Department of Public Health. Vaccine preventable childhood diseases. Available at: www.idph.state.il.us\/about\/vpcd.htm. Accessed April 26, 2013"},{"key":"2021120903183265500_B46","volume-title":"Regression Models for Categorical Dependent Variables Using Stata","author":"Long","year":"2006"},{"issue":"3","key":"2021120903183265500_B47","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1007\/BF02879904","article-title":"Narrative communication in cancer prevention and control: a framework to guide research and application.","volume":"33","author":"Kreuter","year":"2007","journal-title":"Ann Behav Med"},{"key":"2021120903183265500_B48"},{"key":"2021120903183265500_B49","doi-asserted-by":"crossref","first-page":"S107","DOI":"10.1542\/peds.2010-1722P","article-title":"Sources and perceived credibility of vaccine-safety information for parents.","volume":"127","author":"Freed","year":"2011","journal-title":"Pediatrics"}],"container-title":["Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/133\/4\/e835\/1099351\/peds_2013-2365.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/133\/4\/e835\/1099351\/peds_2013-2365.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,9]],"date-time":"2021-12-09T12:44:59Z","timestamp":1639053899000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/pediatrics\/article\/133\/4\/e835\/32713\/Effective-Messages-in-Vaccine-Promotion-A"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,4,1]]},"references-count":49,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2014,4,1]]},"published-print":{"date-parts":[[2014,4,1]]}},"URL":"https:\/\/doi.org\/10.1542\/peds.2013-2365","relation":{"has-review":[{"id-type":"doi","id":"10.3410\/f.718297840.793494098","asserted-by":"object"}]},"ISSN":["0031-4005","1098-4275"],"issn-type":[{"value":"0031-4005","type":"print"},{"value":"1098-4275","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,4,1]]}}}