Acknowledging Distrust and Liberty Made Vaccine Messages Land, Study Shows

Public health communication has long operated on a simple assumption: give people the facts, and the facts will do the work. A new study from researchers at Oregon State University-Cascades, published in PLOS One, suggests that assumption breaks down precisely where it matters most, among adults who are hesitant about vaccination. When messages acknowledged distrust of government or affirmed values such as personal liberty, vaccine-hesitant adults became measurably more willing to consider getting a COVID-19 vaccine. The findings, drawn from two online surveys involving 1,170 unvaccinated U.S. adults in spring 2021, offer a technically grounded account of how value alignment, rather than factual volume alone, shapes health behavior intentions during a public health crisis.

The research team, led by Christopher Wolsko, an associate professor of psychology, and Elizabeth Marino, an associate professor of anthropology, set out to test whether vaccination messages tailored to values commonly held by vaccine-hesitant individuals could shift intentions to vaccinate. Vaccine-hesitant individuals, defined in the study as those who delay accepting or refuse vaccinations despite their availability, represent a population that standard informational campaigns have repeatedly failed to reach. Rather than treating hesitancy as a knowledge deficit, the researchers approached it as a matter of values and lived experience, a framing that informed every stage of their experimental design.

The study began with qualitative groundwork. In early 2021, the researchers conducted focus groups with vaccine-hesitant adults and identified three recurring concerns underlying their hesitancy: distrust of institutions, concerns about personal liberty and freedom of choice, and a desire to protect and reconnect with family. These were not abstract attitudes but coherent value frameworks, and the team translated each into a concise messaging slogan. For institutional distrust, the message read, “You don’t have to trust the government, here are the facts.” For family concerns, it read, “Everybody wants to get back to their families,” affirming participants’ concerns about maintaining normal family life. For choice, it read, “It’s your life, it’s your choice.” And for liberty, it read, “COVID and politicians: Don’t tread on me.”

A control message was also developed, directing participants to “consider the following information about the COVID-19 vaccines from physicians at the Mayo Clinic and the Centers for Disease Control and Prevention (CDC).” Participants were then randomly assigned to view one of the value-based slogans in large, bold font, or the control message, before receiving one page of vaccine information drawn from the Mayo Clinic and the CDC. This design isolated the effect of the value framing itself: every participant saw identical health information, and the only experimental variable was the sentence that preceded it. Attitudes were measured in several ways, including a six-point intention scale ranging from “I will definitely NOT get the vaccine” to “I am certain that I’ll get the vaccine.”

The results were striking in their magnitude. In the first survey, 49.5 percent of participants in the control group said they would get the vaccine as soon as possible. Among participants who received the government slogan, that figure rose to 65.6 percent, an increase of 16 percentage points. Rates also climbed for the families slogan, at 58.1 percent, and the choice slogan, at 55.1 percent. The first survey did not include the liberty slogan. In the second survey, 40.7 percent of control participants indicated they would get vaccinated as soon as possible, compared with 48.5 percent in the liberty slogan group, an increase of nearly 8 percentage points, and 45.2 percent in the government slogan group. In the second survey, the families slogan, at 39.4 percent, and the choice slogan, at 39 percent, did not outperform the control.

From a methodological standpoint, the pattern across the two surveys is instructive. The government-distrust message produced the largest and most consistent effect, appearing effective in both surveys, while the liberty message showed a meaningful effect in the survey where it was tested. The family and choice messages, by contrast, showed gains only in the first survey and fell to or below control levels in the second. This variability suggests that value alignment is not a uniform lever; different framings resonate differently across populations and time points, and communicators cannot assume that any affirmation of values will automatically translate into behavioral change. The timing of the surveys, conducted as vaccines became widely available in spring 2021, also situates the findings in a specific and shifting information environment.

Importantly, the authors caution against reading the approach as a tool of persuasion or manipulation. “We’re not saying this is a way to get people to take the vaccine, but it is a way to create the conditions for information to be heard and considered,” Wolsko said. He noted that the background research underpinning the article indicates that the experience of distrust is often rooted in personal experiences, such as feeling dismissed or discriminated against in a health care setting, rather than exposure to misinformation or disinformation. That distinction matters for how the findings are interpreted: hesitancy, in this account, is less a failure of information and more a rational response to accumulated experiences of not being heard.

Marino emphasized how small the effective intervention can be. Even a brief acknowledgement that people’s fears and feelings of distrust are valid, she said, can completely change the likelihood that the next part of a conversation will go well. “Especially in today’s highly polarized social environment, we think people are constantly trying to determine whether someone poses a threat,” she said. “When you authentically reduce that threat, they become more open to considering new information.” In psychological terms, the value-affirming slogans appear to function as threat-reduction signals, lowering defensive responses before any factual content is encountered, thereby allowing the same CDC and Mayo Clinic information to be processed rather than rejected.

The study, titled “Incorporating public values into public health communications: Effects of value affirmations on intentions to vaccinate and trust in the U.S.,” supports a broader communication strategy that aligns messages with audience values, and Marino and Wolsko argue that the approach extends well beyond vaccination. They have applied the same framework to encouraging safe firearm storage as a suicide prevention measure, promoting conservation behaviors among climate change skeptics, and fostering more inclusive attitudes toward rural individuals among urban centers of higher education, all areas they have studied as co-directors of the Laboratory for the American Conversation at OSU-Cascades. “Our findings suggest that understanding and empathizing with the authentic experiences of vaccine-hesitant individuals can make communication around health policy less defensive, less volatile and more open to new information, for both sides of the issue,” Wolsko said. In an era when public health guidance routinely collides with political identity, the study offers a concrete, evidence-based alternative to campaigns that simply repeat the facts louder: meet people’s values first, and the facts may finally get a hearing.

Subject of Research: Value-aligned public health messaging and COVID-19 vaccination intentions among vaccine-hesitant adults

Article Title: Value-aligned messages increased COVID-19 vaccination intentions, study finds

Article References: Value-aligned messages increased COVID-19 vaccination intentions, study finds. (n.d.). Original publication

Image Credits: AI Generated

DOI: Not provided

Keywords: COVID-19 vaccines, vaccine hesitancy, health communication, value affirmation, public health, personal liberty, institutional distrust, PLOS One, Oregon State University, behavioral science, risk perception, survey research