Adult vaccination and the Health Belief Model: Historical lessons about vaccine controversy from polio and the 1976 National Influenza Immunization Program

Since Irwin Rosenstock's first analyses of participation factors in polio vaccination programs that resulted in the Health Belief Model, perceived seriousness and susceptibility to disease have been key components of how public health officials gauge likelihood to vaccinate. Although ACIP guidelines recommend that all individuals over six months of age be vaccinated against flu (barring contraindications), current vaccination rates continue to fall below expectations, particularly among adults. Increasing vaccination rates among adults is a long-standing challenge.

This presentation examines the role that vaccination campaign communications, and the resulting media responses, have played in two major vaccination efforts in the twentieth century--polio in the 1950s and 1960s and the National Influenza Immunization Program in 1976 and 1977. This presentation reports on a rhetorical analysis, or the study of persuasive features in language, of both government and media reporting on these two vaccines and corresponding vaccination programs. This research finds that increased public concern about the vaccination, rather than the disease it aims to prevent, shifts popular perceptions about severity and susceptibility to disease to concerns about adverse vaccine reactions. Therefore, communication received through media and from health officials is instrumental in not only informing the public about severity and susceptibility of the disease a vaccine aims to prevent but, particularly in an environment of vaccine skepticism, this communication must also instill confidence in the safety as well as immunological efficacy of the vaccination.