Promoting RSV vaccine confidence through reversal narrative (RN) messaging

Infection with Respiratory Syncytial Virus (RSV) is associated with tens of thousands of hospitalizations in the United States (US) each year. Most US adults are not likely to experience severe cases of RSV, but adults aged 60 or older are at elevated risk of experiencing hospitalization or death. While RSV vaccines have recently been introduced for adults aged 60 or older and have been shown to significantly reduce severe cases of RSV, less than one quarter of those eligible have opted to receive the vaccine. The purpose of this study is to examine the impact of Reversal Narrative (RN) messages on RSV vaccine uptake. RN messages share stories about individuals who previously refused to receive the RSV vaccine, but - in response to personal negative health outcomes ("regret" RN messaging) and/or new scientific information ("rationalizing" RN messaging) ultimately changed their mind. In a large and nationally representative survey (N = 1300) of US adults, as well as a state-representative survey (N = 850) of a highly vaccinated US state, we demonstrate that unvaccinated adults over the age of 60 are significantly more likely to intend to receive an RSV vaccine when exposed to regret-focused RN messaging. We conclude by discussing the viability of RN messaging as a vaccine promotion tactic and consider how researchers might partner with health communicators to explore their viability in a wide range of health contexts.