Trial reportHuman vaccines & immunotherapeutics2021
Backfire effect of salient information on vaccine take-up experimental evidence from scared-straight intervention in rural northern Nigeria.
Trial report in Human vaccines & immunotherapeutics, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
5 citing papers in PubMed.
- Childhood immunization barriers and interventions in low- and middle-income countries: A scoping review of access, delivery systems, and health literacy.Human vaccines & immunotherapeutics · 2026Article
- Effectiveness of "naturalness" value-based narrative intervention on vaccination acceptance in two randomized controlled trials.NPJ vaccines · 2026Article
- Review
- Message Effectiveness of Fear Appeals in Vaccination Communication Campaigns: A Systematic Review.Vaccines · 2024Review
- Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Vaccination is the most cost-effective way to prevent mothers and infants from contracting tetanus. However, developing countries struggle with the persistent low take-up of vaccination. The low risk perceptions of disease can be one of the barriers to vaccination. One way to increase the risk perceptions of disease is to use salient loss-framed messages to highlight negative consequences of not getting vaccinated. We conducted a randomized controlled trial among 1,660 women in 80 villages in northeastern Nigeria. Respondents were randomly assigned to view one of two flipcharts: (1) control flipcharts, which contained written explanation about the severity of the disease, or (2) `scared-straight' flipcharts that contain the salient information about the disease severity in addition to the written explanation about the severity of the disease. Additionally, respondents were provided randomly assigned amounts of cash incentives. The scared-straight intervention backfired among women with no previous experience of tetanus vaccination: it decreased their vaccine take-up by 3.7-6.1 percentage points, even though it increased their perceived risk of disease and their fear level. The negative effect of the scared-straight intervention is the most prevalent among women who received the lowest amount of cash incentive. Women without experience of tetanus vaccination might have responded to the scared-straight flipcharts by denying the information provided because the flipcharts were too frightening. The use of the scared-straight tactic is not recommended to aim for the improved take-up of vaccination in developing countries where people might face budget constraints for achieving desirable behaviors.Trial Registration: The trial was registered at ISRCTN registry (ID: ISRCTN95083356).
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