The Empathetic Refutational Interview to tackle vaccine misconceptions: Four randomized experiments

Objective:
We introduce and report early-stage testing of a novel, multi-component intervention that can be used by health care professionals (HCPs) to address false or misleading anti-vaccination arguments while maintaining empathy for and understanding of people’s motivations to believe misinformation: the “Empathetic Refutational Interview” (ERI).

Methods:
We conducted four experiments in 2022 with participants who were predominantly negative or on the fence about vaccination (total n = 2,545) to test four steps for tailoring an HCP’s response to a vaccine-hesitant individual: (1) elicit their concerns, (2) affirm their values and beliefs to the extent possible, (3) refute the misinformed beliefs in their reasoning in a way that is tailored to their psychological motivations, and (4) provide factual information about vaccines. Each of the steps was tested against active control conditions, with participants randomised to conditions.

Results:
Overall, compared to controls, we found that observing steps of the ERI produced small effects on increasing vaccine acceptance and lowering support for anti-vaccination arguments. Critically, a HCP who affirmed participants’ concerns generated significantly more support for their refutations and subsequent information, with large effects compared to controls. In addition, participants found tailored refutations (compared to control responses) more compelling, and displayed more trust and openness towards the HCP giving them.

Conclusions:
The ERI can potentially be leveraged and tested further as a tailored communication tool for HCPs to refute anti-vaccination misconceptions while maintaining trust and rapport with patients.