Vaccine Hesitancy and COVID-19 Misinformation

Huang Fellow Alex LaTrenta Reflects on the 2021 Huang Fellows Symposium

Saving lives during the COVID-19 pandemic depends on effective dissemination of scientific information which recognizes the diverse perspectives of its audience and the pervasive influence of misinformation. The disciplines of Decision Science, Communication, and Public Policy can provide insights that shape policy and help the government and scientific community inform the public. Despite the need to achieve herd immunity and the life-saving benefits of vaccination, a Center for Disease Control survey still indicates that one in five Americans plan to decline the COVID-19 vaccine.

On April 16th, 2021, undergraduates, graduates, and faculty gathered over Zoom to address vaccine hesitancy and misinformation for the annual Huang Fellows
symposium, The Struggle Between Fact & Fiction: Multidisciplinary Perspectives on COVID Vaccine Misinformation.

The first section of this student-led event featured Dr. Dietram Scheufele — the Taylor-Bascom Chair in Science Communication and a Vilas Distinguished Achievement Professor at the University of Wisconsin-Madison — as the keynote speaker to provide a comprehensive discussion of the COVID-19 “infodemic.”

The panel following his talk utilized various disciplines to probe the issue of medical misinformation and included the following Duke faculty: the James R. Shepley Distinguished Professor of Public Policy Dr. Phil Napoli, the Chair of Department of Psychology and Neuroscience Dr. Scott Huettel, Associate Professor of Medicine Dr. Poonam Sharma, and Assistant Professor of the Practice of Medical Education and the Co-Director of the Duke Program on Medical Misinformation Dr. Jamie Wood. This multidisciplinary panel addressed several complex issues in the effort to combat COVID-19 misinformation and promote vaccine acceptance.

While medical misinformation is not a new phenomenon, the uncertainty of the COVID-19 pandemic has exacerbated the issue while revealing low scientific literacy in the American public. Dr. Sharma observed that advances in scientific knowledge are usually discussed in a peer review setting before being released to the public. The urgent need to develop a COVID-19 vaccine and to understand this novel virus result in the science of the pandemic playing out in the public sphere. However, Dr. Wood discussed how scientists often struggle to communicate with the general public who may not comprehend scientific principles leading to misunderstanding and hence misinformation.

“While medical misinformation is not a new phenomenon, the uncertainty of the COVID-19 pandemic has exacerbated the issue while revealing low scientific literacy in the American public.”

Furthermore, Dr. Napoli addressed social media’s “democratized and inverted model of gatekeeping” which contributes to the spread of COVID-19 misinformation. He described how social media disseminates news before fact-checking and how the subsequent popularity of the post determines its perceived accuracy. Dr. Napoli also asserted that people on social media including myself often use these applications to affirm their identity rather than consume reliable news. Furthermore, he explained how the First Amendment in the Bill of Rights protects false statements on social media which prompts a fascinating ethical debate on media regulation. This discussion of balancing free speech with the need for accurate public information reminds me of a common theme throughout this pandemic and American History: the battle between individual freedoms and the safety/security of Americans.

Multiple speakers also attributed the dilemma of misinformation to pitfalls in how we interpret facts and perceive risk. Dr. Scheufele addressed the concept of “motivated reasoning”—the observation that even when individuals agree on the accuracy of a set of facts, they more readily accept those facts which reinforce their personal biases and identity. This concept resonated with me because I realized how emotionally biased reasoning leads me to integrate facts into my existing belief system rather than allowing new information to adjust my mindset.

Dr. Scheufele revealed that even a credible spokesperson may not help to overcome this deep-seated bias. In a fascinating study, even when the Pope served as a conservative spokesperson to assert the reality and immediacy of climate change, his speech only induced greater political polarization. Rather than motivating conservatives to acknowledge the existence of climate change, the study participants instead discounted the messenger and their views became more extreme. I realize now that rather than demanding that conservative leaders speak out in favor of COVID-19 vaccination, policymakers need to research alternative communication strategies to overcome motivated reasoning.

“This discussion of balancing free speech with the need for accurate public information reminds me of a common theme throughout this pandemic and American History: the battle between individual freedoms and the safety/security of Americans.”

In order to achieve herd immunity for COVID-19, various speakers explored how we could “reframe” the act of receiving the vaccine. Dr. Scheufele proposed that promoting COVID-19 vaccination may achieve greater success by appealing to potential economic, political, or nationalistic gains. One could alternatively frame vaccination as an altruistic act that saves lives, a moment of catharsis from protecting oneself and one’s inner circle, or an economic benefit that allows businesses to reopen and the economy to rebound. Multiple messaging may encourage individuals who do not perceive COVID-19 as a personal threat to receive a vaccine. Just as schools teach with an awareness of different learning styles, I understand now that we could frame this decision by providing multiple incentives.

As we discuss vaccination, we must also carefully select language and avoid words that may provoke negative emotional responses as exemplified by the
conservative outcry against vaccine “passports.” Words clearly matter. For conversations with friends and family, Dr. Wood and Dr. Sharma advised that
one should build a stronger relationship with any individual by listening to their opinions before discussing the benefits of vaccination rather than commanding them to get vaccinated.

By discussing the consequences of “tribalism,” the speakers provided a better understanding of why people may denounce the vaccine before engaging in
conversation and how to remedy this relatable issue. Dr. Huettel explained that some individuals may view the decision to refuse masks as immediately advantageous because it enhances their “social status” by remaining loyal to their tribe in contrast to the more probabilistic harm of getting COVID-19 in the future. In the commission-omission principle, people may view themselves as responsible for any negative consequences if they elect to receive the vaccine whereas COVID-19 infection is not their doing. These two decision science principles help to explain the politicization of masks and vaccines as loss aversion.

CDC Vaccine Card


Within the keynote, panel, and Q/A, the symposium also explored the fascinating ethical dilemma of how and why we must combat misinformation with
scientific principles that may eventually be discredited by further research. The speakers addressed the core principle of biomedical discovery: scientific knowledge is constantly invented, disproved, and modified particularly with emerging diseases like COVID-19. I view the skepticism which drives research as healthy and reassuring because science questions itself and acknowledges its mistakes through a “self-correcting” process as described by Dr. Wood.

Dr. Scheufele revealed that public trust in science has actually grown during the COVID-19 pandemic; many Americans appear to have realized that although science is not static and constantly evolves, this does not mean that it discredits itself. However, I believe that because some Americans perceive science as dogma, flawed or retracted COVID-19 studies may cause them to renounce science altogether and embrace misinformation.

Dr. Scheufele’s assertion that science should inform policy but not solely determine it harkens back to the Huang Fellows’ mission and Professor Hank Greely’s discussion at this year’s orientation event. Inspired by a question, Dr. Scheufele described how vaccine hesitancy in the African American community due to structural racism in the public health sector demonstrates the integration of medicine, policy, and social justice. Science should integrate with political, economic, and personal factors to adjust policy, and this symposium provided yet another example of this need while exploring a multidisciplinary framework for combating COVID-19 vaccine misinformation.

As the science of COVID-19 remains in flux, how can we encourage responsible behavior through public education without alienating people? The panelists and Dr. Scheufele cited reframing COVID-19 research as a potential solution; we must assert that our current scientific knowledge remains the best option. While emotionally provocative misinformation and wild accusations may appear alluring, trust and patience in science and its self-correcting nature have the greatest chance of keeping us safe from this deadly disease.

Alex LaTrenta ’24

LaTrenta_AlexAlex is a first-year Trinity student from Connecticut planning to double major in Biology and History while exploring Decision Science on the pre-health track.