A doctor below says, "Many humans, especially those who already have concerns and distrust systems, don't like being told what to do,” Again, when you hear of thousands of people dying horribly, you are usually grateful to have a chance to get vaccinated and avoid the alternative.
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Liz Szabo, MA, CIDRAP, April 2, 2026
"Vaccine-hesitant older adults were more willing to accept hypothetical COVID shots when they were described as way to preserve their freedom and autonomy rather than as an action that complies with government recommendations, a new study finds.
"In an experiment in which 907 participants were asked to rate their willingness to get a hypothetical COVID shot, many people concerned about vaccine safety responded favorably when researchers framed COVID vaccination as a way to maintain their freedom from disease and avoid restrictions on activities caused by illness.
"Participants responded to an online survey about their concerns and beliefs about COVID shots, as well as their willingness to receive hypothetical vaccines with varying levels of effectiveness and side effects. Hypothetical vaccine choices were accompanied by additional reasons to vaccinate, including “personal freedom to do what you want to do,” “help prevent spread of disease,” and “comply with government recommendations.”
"People with vaccine concerns were 6.3 percentage points more likely to say they would accept a COVID shot if the survey listed autonomy as a benefit than if the survey mentioned government recommendations, according to the study, which was conducted in 2024 and published this week in JAMA Network Open.
"Talking about freedom also appealed to adults who believe misinformation about COVID shots, such as the false claim that vaccination will alter their DNA or implant microchips in their bodies. This group was 4.6 percentage points more likely to say they would agree to a COVID shot when hearing how vaccines could protect their liberty.
"Among people without serious concerns or misconceptions about COVID shots, so-called “freedom framing” didn’t change their willingness to be vaccinated, according to the study, led by researchers at the University of Houston’s C.T. Bauer College of Business. The average age of people in the study was 70. About 90% of participants were white. Political party affiliation was equally dived among Democrats, Republicans, and independents.
"Framing immunization as a way to protect others was associated with increased vaccine acceptance regardless of participants’ feelings about COVID shots.
“These findings suggest that non-authority-based message framing may influence stated vaccine acceptance,” the authors wrote in the study, noting that their finding has “implications for both targeted and broadly applicable communication strategies.”
Working to promote vaccination
"Although COVID shots have saved millions of lives, doctors and public health advocates have struggled to persuade people to be vaccinated. And while people age 65 or older have the highest risk of hospitalization or death from COVID-19 of any group, only 22% are up to date on COVID vaccines.
"Some public health advocates say they’re happy to have more evidence about how to talk to people with different views on vaccines.
“I'm really glad work like this is being published,” said Elisabeth Marnik, PhD, an immunologist and executive director of The Evidence Collective, a group of scientists and clinicians helping communities combat health misinformation. “Oftentimes, it feels like we are multiple steps behind in figuring out what framing actually is beneficial. This paper gives us great insights, and also highlights areas where we could benefit from additional investment.”
"Marnik said she uses freedom framing when talking to people who are hesitant about vaccination.
“Many humans, especially those who already have concerns and distrust systems, don't like being told what to do,” said Marnik, who wasn’t involved in the new research. “I have found authoritarian framing usually shuts down conversations, or results in them digging in their heels around the decision to not vaccinate.”
"Marnik said it’s important to listen to people’s concerns about vaccines.
“There is a lot of value in varying communication styles and knowing who your audience is,” Marnik said.
Language can bias how people view vaccines
"But some public health experts say freedom framing may be less influential in the real world than in the study, in which people were asked about hypothetical scenarios.
"Jess Steier, DrPH, founder and CEO of Unbiased Science, which provides evidence-based answers to pressing questions in public health, called the increases in vaccine acceptance related to freedom framing “pretty modest.”
"Steier said the language used in the study may have biased some participants’ responses.
“The ‘comply with government recommendations’ framing is so explicitly compliance-oriented that it almost primes reactance on its own, which could artificially inflate how well freedom framing performs by contrast,” said Steier, who was also not involved in the new research.
"When designing vaccination campaigns for a diverse audience, public health advocates may have the best overall success by pitching COVID shots as a way to protect others, Steier said, because that message seemed to appeal to everyone.
Trust matters when talking about vaccines
"The new study was conducted before Health and Human Services Secretary Robert F. Kennedy Jr. launched a wide-ranging assault on vaccines, and stopped recommending COVID vaccines for healthy children and pregnant women, who are at higher risk. Although a federal judge has put many of Kennedy’s policies on hold, surveys show that misinformation spread by the Trump administration is shaping public attitudes about health.
"Given the tectonic shifts in federal vaccine policy over the past year, people today may feel differently about COVID shots than they did two years ago, said David Higgins, MD, MPH, an assistant professor of pediatrics at the University of Colorado Anschutz, who was not involved in the new research.
"Trust in federal health agencies such as the Centers for Disease Control and Prevention has fallen sharply since 2024, according to a study released in March from the University of Pennsylvania’s Annenberg Public Policy Center. Americans have more confidence in career scientists at those agencies and organizations such as the American Academy of Pediatrics, than they do the federal agency chiefs.
"The new vaccine study, which included older adults, also may not help health care providers talk to younger people, including parents of small children, Higgins added.
“No single message works for all parents,” Higgins said. “Providing more information or trying to correct misconceptions alone often doesn’t change behavior and can even backfire. Trust in the messenger, relationships, and how messages are delivered are all important.”
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