Understanding Attitudes toward HPV Vaccination using Moral Foundations Theory

Authors: Seeley KML, Farris PE, Marriott L, Shannon J

Category: Behavioral Science & Health Communication
Conference Year: 2020

Abstract Body:
Purpose We used a qualitative research approach to explore the underlying morals associated with an intent to vaccinate and attitudes about HPV vaccination in rural and frontier regions of Oregon. By identifying individual moral foundations related to vaccination, we hope to tailor and adapt known strategies to improve vaccination rates in our state. Methods Six community-based focus groups and four individual interviews of community members in seven Oregon counties were conducted. Interviews were recorded and transcribed for analyses and transcripts were analyzed using Dedoose (8.2.14). We utilized the Moral Foundations Theory for thematic coding. This framework reflects Western or American moralities; the foundation dichotomies include: care/harm, authority/subversion, loyalty/betrayal, liberty/oppression, purity/degradation, and fairness/cheating. Results A total of 40 adults (40.9 ± 12.4 years), representing a range of education levels, participated in the groups and interviews. Based on preliminary code co-occurrence, those who made statements coded to care/harm were more likely to vaccinate, whereas those who made statements coded to purity/degradation were more likely to be against vaccination. Moral foundations varied amongst vaccine-hesitant participants. Participants who said their stance on vaccination depended on the vaccine or that the recommended vaccine schedule was difficult were more likely to make statements consistent with the care/harm dichotomy, aligning closely with the pro-vaccine participants. Concerns about vaccine additives or vaccines risks were often associated with purity/degradation, seeming to align with those who do not vaccinate. Conclusions These findings have the potential to help us tailor vaccine campaigns in a Western society to address concerns of those who do not vaccinate and those who are vaccine-hesitant. Our results suggest the reasons for vaccine-hesitancy may provide insight into the underlying moral foundations influencing vaccine decisions. Vaccine campaigns which respond to the foundations of care/harm and purity/degradation may be more effective and better received in rural or frontier Oregon.

Keywords: HPV, vaccination, communication