Giving health news a shot in the arm : an audience study of journalistic techniques used in vaccination stories : a thesis presented in partial fulfilment of the requirements for the degree of Master of Business Studies in Communication at Massey University, Manawatū, New Zealand

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The risks of infant vaccination have sometimes been overstated in vaccination news stories through construction techniques that emphasise controversy and conflict, or put an undue focus on the opinions of non-experts. This “false balance” may have contributed to the growth in vaccine hesitancy or refusal around the world. Some scholars have suggested adding interpretative elements to vaccination stories, balancing quotes in line with the known evidence on an issue, or using more photographs of vaccine-preventable disease. In this qualitative research, these approaches were explored in an audience study with individuals who read three versions of a news story about vaccination risks that exhibited varying degrees of balance and evidence. The first version exposed an audience to a falsely balanced story about the risk of the MMR (measles, mumps, and rubella) vaccine, featuring prominent opinions about the risk. The second version used evidentiary balance, where a greater space was taken up by experts quoted on MMR vaccine safety, mirroring the scientific consensus. The third version featured a balanced story with the addition of photographs of children showing symptoms of vaccine-preventable diseases. The mixed-methods study primarily used individual semi-structured interviews with 17 parent/caregiver participants, with support from two questionnaires. The goal of the research was to determine the audience responses to the stories, and if the three variations affected feelings of safety about the vaccine, or the reported vaccine intentions of participants. The research found that even vaccine-confident individuals responded to a story alleging vaccine risks with a degree of anxiety or unsettled feelings about the vaccine. Future vaccination intentions were not impacted, but some participants expressed a desire to look further into vaccine safety in the future. When exposed to the story constructed with a balance of vaccine safety content that better reflected the scientific evidence, anxieties were reversed and participants expressed relief. In contrast, the vaccine-hesitant and -refusing participants responded to the first story by agreeing with the allegations, and considered the second story biased. The third version, with photographs alongside the story, drew mixed responses: some participants were interested in the images and these reinforced their vaccination intent; others disliked them or thought they were manipulative. The results of the study suggest interpretative and evidentiary balanced approaches to vaccination stories, as well as careful use of photographs, do represent useful strategies for journalists to use in more accurately conveying risk in contested science or health stories, and could play a limited role in increasing the vaccination intentions of readers. The study findings highlight the potential falsely balanced stories have for sowing doubts about vaccine safety in news consumers or reinforcing vaccine-refusing attitudes. This research has added significance in light of the global Covid-19 pandemic and vaccine rollouts, and could inform news media’s use of balance in contested health or science stories in the future.