ArticleMedical decision making : an international journal of the Society for Medical Decision Making2026
From Stories to Action: How Framing, Perspective, and Identifiability in Personal Narratives Influence Vaccination Decisions.
Article in Medical decision making : an international journal of the Society for Medical Decision Making, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
PurposeWe examined how different narrative aspects related to the COVID-19 pandemic influenced unvaccinated individuals' willingness to vaccinate (WTV) against a future virus. We tested whether the stories focused on the perspective of the actor (who chose to vaccinate or not) versus the affected (affected by that decision), framing the outcome as death versus survival, and presenting an identified individual versus an unidentified group.MethodsA total of 1,545 respondents read scenarios depicting individuals' (actors') decisions to either vaccinate against COVID-19 or refuse vaccination, alongside the framing of the consequences for the affected individuals: death versus survival. The protagonists were either identified by name and photo or described as a group of unidentified people. Participants reported their emotions, perceived risk from the virus and the vaccine, and their future WTV against a new virus. They also reported their past vaccination decisions.ResultsWhen the narrative focused on affected individuals, framing outcomes in terms of death increased WTV by heightening the perceived threat of the virus. Conversely, when the focus was on the actor, the lifesaving frame was more effective, especially when the actor was identified. A concrete case of someone vaccinated who saved others evoked positive emotions, boosting WTV.LimitationsOur hypothetical scenarios and the cross-sectional methodology might limit understanding of the long-term effects.ConclusionsScenarios highlighting a person who died increase the perceived threat of the virus and enhance WTV. Conversely, information about a person who was vaccinated and saved others boosts positive emotions and increases WTV.ImplicationsPublic health campaigns can boost vaccination by sharing stories of vaccinated individuals who saved lives, evoking positive emotions. Highlighting the virus's dangers can also raise the perceived threat and motivate uptake.HighlightsVariations in narratives influence unvaccinated individuals' willingness to vaccinate.Emphasizing the death of those affected evokes greater threat perception of the virus, enhancing vaccine intent.Personal stories of vaccinated individuals saving others can boost positive emotions and vaccination willingness.
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