Childhood vaccine hesitancy: The power of metaphors

Health communication is an issue that deserves attention since there is evidence that the words used to describe a health condition can influence vaccine acceptance. This study aims to carry out a qualitative analysis of the metaphors used by Brazilian parents to describe how vaccines work.

Data were obtained from a cross-sectional study performed through an online survey from November 17 to December 14, 2021 in Brazil to assess the willingness of adult parents of children and adolescents residing in Brazil during the survey to prevent COVID-19 A set of 4 metaphors of how vaccines work was presented for the participant to choose which one best summarized how vaccines worked ("Vaccines are teachers that teach the body's defense system to fight infections", "Vaccines are weapons in the war against viruses", "Vaccines are medicines capable of fighting the virus", "Vaccines work like vitamins making the defense system stronger". A qualitative analysis was also performed using the Iramuteq software for the open-ended question that investigated whether there was any phrase that best described how vaccines work. The interpretation and analysis were based on conceptual metaphor theory.

The survey included answers from 15,297 caregivers. Of these, 93.9 % (14,364) chose previously prepared phrases. Around 64,7 % (9902) chose metaphors linked to the instruction scenario, 19.2 % (2941) to the war scenario, 5.2 % (789) to the medication scenario and 4.8 % (732) associated with vitamins. Around 687 respondents wrote options on the form that were analyzed qualitatively with the help of Iramuteq software.

This study highlights that metaphors are a powerful instrument for vaccine adherence, but they should be used based on studies that demonstrate those with positive and negative impacts that may vary from one region to another depending on the sociocultural context.