Yet, despite the recommendation by the Centers for Disease Control and Prevention that girls age 11 to 12 get the vaccine, few states have included HPV in the school vaccination schedule for girls, and many parents have chosen not to vaccinate their daughters. 

The answer may have something to do with culture. In a study published Wednesday, Dan Kahan of Yale Law School employs "cultural cognition theory" to examine the cultural factors in the debate over the riskiness of the HPV vaccine. His findings show that people are sometimes more influenced by cultural identity than facts when assessing risk factors -- such as those of vaccines. He also suggests ways of presenting information so that people view it with less bias.

For the study, 1,538 U.S. adults completed an online opinion analysis. Two sets of questions rated participants according to their cultural worldview: as individualist or communitarian, and as hierarchical or egalitarian. Another set of questions measured perception of vaccine risk and benefit.

The questions were completed in three conditions. In one condition, no arguments for or against vaccinations were included with the scales. In another condition, pro and con arguments were included without being attributed to specific sources. The arguments consisted of statements such as, “Girls administered the vaccine will be protected from a variety of forms of HPV, which account for 70 percent of the cancers attributed to the virus,” and “The vaccine offers no protection against types of HPV responsible for 30 percent of the cancers caused by the virus.” In the third condition, the same arguments are randomly attributed to fictional personas representing the four possible cultural worldviews: Hierarchical Individualist, Egalitarian Individualist, Hierarchical Communitarian and Egalitarian Communitarian.

Overall, the researchers found that cultural worldview coincided with vaccine risk assessment, and that people rated issues as riskier when they were a challenge to their cultural values. For example, people scoring high on the hierarchy scale are in favor of traditional social values. They judged the HPV vaccine as risky because they were concerned that young women would overrate the protection of the HPV vaccines and become more promiscuous. On the other hand, people on the egalitarian end of the scale usually highly value gender equality. Egalitarians were less likely to agree that vaccination put women at risk of becoming promiscuous.

The researchers also found that including arguments in the questionnaire could affect people's opinions. When they included unattributed arguments, participants' risk assessments were polarized by cultural worldview, consistent with previous research. Providing people with unattributed information from two viewpoints increased this polarization instead of mitigating it, probably because participants paid more attention to information that coincided with their worldview, leading them to believe the information confirmed their opinion.

When fictional advocates were aligned with the arguments, participants' risk assessment was even more polarized, as long as the advocates drew the expected conclusions and participants identified more with one advocate than the other. On the other hand, if the advocate was aligned with an unexpected argument or if the participant identified with more than one advocate, participants became less polarized by cultural worldview.

The authors emphasize that the findings do not show that one side of the debate is wrong or reasoning poorly. Both sides responded to information with bias by cultural worldview and, under most circumstances, information increased disagreement between sides. Presenting facts ended with the debate drifting further from resolution.

The researchers draw the conclusion that one way to encourage individuals to see public policy with less bias would be to present a variety of perspectives that are similar to those of the audience -- but not too similar -- so that people will pay equal attention to all of the perspectives. “Try to recruit a diverse array of communicators. It is important to have people who not only have scientific credentials but who are likely to be understood by the people with whom they’re communicating as having values like theirs,” Kahan said at a video conference (watch below) on Tuesday.

Image courtesy of James Gathany, Centers for Disease Control and Prevention.

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