When Being Positive Might Be Negative: An Analysis of Australian and New Zealand Newspaper Framing of Vaccination Post Australia's No Jab No Pay Legislation

"...implications for the media on best practice reporting of vaccination information."

Given the influence of information shared through the news media on public attitudes and behaviours toward vaccination - and considering the rise of vaccine hesitancy worldwide - scholars have examined how the media frame vaccination and how these frames impact the wider public. The present study explores the framing of news reports about vaccination and the potential effects this framing may have had on the wider public over the years 2016-2017 in both Australia and New Zealand (when changes in vaccination policy and publicity, respectively, were on the agenda). In January 2016, Australia introduced No Jab - No Pay, a policy not adopted by New Zealand. The law withholds 3 state payments for parents of children under 20 years of age who are not fully immunised or under a government recognised catch-up scheme.

Four Australian (The Australian, Sydney Morning Herald, Daily Telegraph, and The Age) and 4 New Zealand (New Zealand Herald, Dominion Post, The Press, and Otago Daily Times were selected for the study. The researchers undertook a content analysis of 197 articles, coding them for the following: newspaper; type of article; sources used; emphasis of the frame of the story - e.g., anti (negative) or pro (positive) towards vaccination; labels to describe people unwilling to vaccinate and those who do vaccinate; emotive or loaded terms appearing; and type of anti-vaccination argument.

Differences were found in the sources most prevalent in vaccination stories between the two countries. The medical/health profession dominated New Zealand stories, whereas political sources dominated the Australian media, largely due, it is suggested, to the January 2016 arrival of the No Jab - No Pay campaign. The researchers suggest that medical arguments for vaccination may have become of less import to readers than the potential financial impacts of non-vaccination choices.

In both Australia and New Zealand, the news media messages were predominately positively framed, as seen in 146 of the 197 stories (with 19 stories containing more than one pro-vaccination argument). The Australian newspapers appeared to talk of vaccination more in terms of protecting the community or society than New Zealand newspapers, which argued that vaccines prevented and protected against disease. Both Australian and New Zealand newspapers were inclined to suggest those opposed to vaccinations were putting their own and other children at risk.

It is here where emphasis framing theory comes into play, in the researchers' estimation. They cite Koch and Peter (2017), who posit that people learn socially to expect credible news from traditional mass news media and to expect this news media to be negative; when news media messages are positive, the credibility relationship is weakened. As positive news media messages about vaccination could also be viewed as advertising, a sense of coercion results from positively framed messages, suggesting that readers may find them less credible in terms of factual information.

This analysis illustrates the difficulty faced by those trying to communicate to vaccine-hesitant parents. On the one hand, negative information has been linked to negative messages being spread in social media and lowered vaccination rates. On the other hand, positive information can be seen as a form of persuasion and advertising and thus can cause those who read such information to distrust or resist the messages.

In short, this study suggests that the media emphasis on positive vaccination reporting may be having the opposite effect of engendering resistance to vaccination within those who are vaccine-hesitant. In particular, the vaccination rates of New Zealand particularly (where no policy changes mandating vaccination took place) have been decreasing.

Per the researchers: "The answer may lie in the presentation of neutral, balanced information only in media reports with the goal of informing the general news media public. However, this is easier said than done....Balance as defined by end-users in a previous study..., noted that caregivers making decisions about vaccination for pre-school children wanted clear factual information only, e.g., the number of deaths attributed to the vaccine versus the number of deaths attributed to the disease, and then be left to make their own decisions. This information also needed to come from a credible source. Sources that are obviously positive towards vaccination (e.g., government health departments) could be viewed as attempting to persuade, so...end-users [in the aforementioned previous study] were particularly convinced by health information from health professionals they trusted. Trusting relationships between health professionals and vaccination decision-makers are key but must be combined with the presentation of factual information and perhaps the viewing of that information as neutral and factual, rather than positive/persuading or negatively framed."

In conclusion, while the influence of the news media is only one of the many factors that impact a caregiver's vaccination decision, this study has shown that the positive emphasis of media stories may have an unexpected reverse effect when looked at via emphasis framing theory. The researchers indicate that more research is needed on the possibility that positive news media stories on topics such as vaccination may lead to unwanted feelings of coercion and therefore reactance/resistance. But it does seem clear that journalists and media commentators should "reflect on the impact of their positioning of health articles. Neutral, factual reporting to help construct an informed public is needed, rather than positively or negatively slanted articles."