Who's Afraid of the HPV Vaccine?

http://www.sciencedaily.com/releases/2010/01/100113172401.htmp

ScienceDaily (Jan. 14, 2010) - A new study concludes
that people tend to match their risk perceptions about
policy issues with their cultural values, which may
explain the intense disagreement about proposals to
vaccinate elementary-school girls against human-
papillomavirus (HPV). The study also says people's
values shape their perceptions of expert opinion on the
vaccine.

HPV is a widespread disease that, when sexually
transmitted, can cause cervical cancer. In October of
2009, the Center for Disease Control and Prevention
(CDC) recommended that the vaccine be given to all girls
ages 11 or 12. However, the recommendation has been
mired in controversy, and so far adopted in only one
state and the District of Columbia.

An online experiment involving more than 1,500 U.S.
adults reveals that individuals who have cultural values
that favor authority and individualism perceive the
vaccine as risky, in part because they believe it will
lead girls to engage in unsafe sex. But individuals with
cultural values that favor gender equality and pro-
community/government involvement in basic health care
are more likely to see the vaccine as low risk and high
benefit.

The study was funded by the National Science Foundation
(NSF) and is being published online this week in the
journal Law and Human Behavior. It found that people
exposed to unattributed, balanced information about HPV
vaccines tended to produce something called "biased
assimilation," a phenomenon in which culturally-
identifiable groups draw opposing conclusions and become
more divided rather than less divided as they consider
evidence.

But when biased assimilation was compared to another
survey result, researchers were surprised. "An even
bigger effect for all subjects was the perceived values
of experts," said Yale University law professor Dan
Kahan referring to another part of the experiment in
which arguments about the vaccine were matched with
fictional experts.

Researchers designed fictional, but culturally
identifiable advocates to be seen by respondents as
holding opposing and culturally distinct values. The
researchers devised the "advocates" to be seen as
holding pro-authority and individualistic, or pro-
community and pro-equality worldviews.

When views about HPV vaccines came from sources
respondents believed shared their values, individuals
tended to be more willing to accept the information. But
when it came from an expert whom they perceived held
values different from theirs, the information was not
accepted. In the first instance, respondents perceived
the experts to have cultural credibility and
trustworthiness, but when respondent values differed
from the experts, the experts were perceived to lack
cultural credibility.

As a result, when experts thought to hold pro-authority
and individualistic values asserted the vaccine was
risky, respondents who held the same values agreed with
them. When other experts who were thought to hold
egalitarian and pro-community values argued that it was
safe, respondents who held the same values agreed with
them, intensifying overall disagreement about use of the
vaccine.

"This is what the debate in public looks like," said
Kahan, who led the study. "Basically, people who hold
one set of values see experts with whom they identify as
reinforcing their views."

Nevertheless, when experts who held pro-authority and
individualistic values asserted that the vaccine was
safe, and experts perceived as holding egalitarian and
pro-community values argued it was risky, subjects with
those values tended to moderate their original
viewpoints and give consideration to an opposing
viewpoint, because the information came from someone
they perceived shared their values.

The study is the most recent in a series researchers
have conducted with NSF support to test the "cultural
cognition thesis:" the idea that because individuals
can't easily judge risks when it comes to evaluating
complicated or disputed policy issues, they rely on
beliefs grounded in cultural ideology to help them.
Previous findings have shown cultural cognition thesis
explains disagreements over the risks of private gun
ownership, conflict over the risks of novel sciences
like nanotechnology, and the relatively low perception
of various risks displayed by white males relative to
other groups.

The Food and Drug Administration used "fast track"
procedures to approve the HPV vaccine in 2006, and a CDC
committee recommended universal vaccination of school
girls shortly thereafter. In September 2009, the CDC
approved an HPV vaccine for males ages 9 to 26 for
prevention of genital warts, but stopped short of
recommending mandatory vaccinations. The CDC's Advisory
Committee on Immunization Practices plans to look at the
vaccine's effectiveness in preventing HPV-related
cancers in males at its next session this February.

"We hypothesized that 'cultural credibility' would have
an effect," said Kahan. "But we didn't expect it to be
as large as it turned out to be."

>From previous studies, the researchers knew that "biased
assimilation" would have an effect, perhaps even a
larger effect than "cultural credibility." But, that was
not the case. "Biased assimilation" divided subjects,
but "cultural credibility" had the biggest impact.

"The result suggests that the identity of the source is
a more important cognitive cue than how people feel
about the information alone," said Kahan.

The researchers suggest that anyone who has a stake in
promoting informed public debate make an effort to
recruit information providers that have diverse cultural
outlooks and styles. The key, they say, is to avoid
creating or reinforcing any impression--even a tacit
one--that a scientific debate over policy is an "us
versus them" dispute.

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