Vaccine confidence is formed as much in cultural spaces as in clinical ones

Vaccine confidence is not built in a single interaction, but over time and across both the cultural environments families inhabit and the clinical relationships they rely on. Parents arrive at the pediatrician’s office carrying years of experience and stories that shape how they understand risk, care, and responsibility.

That is the premise driving new research that Harmony Labs developed in partnership with the FrameWorks Institute. We set out to understand how culture, media, and values shape confidence in childhood vaccines.

Our work spans a narrative landscape analysis of how vaccines and physical health are portrayed in news articles, 1,600 pieces of scripted streaming fiction, and 2,000 YouTube videos; audience segmentation of 2,000 U.S. adults by demographics, values, media habits, and narrative beliefs; and content testing of story-based interventions among 5,800 online respondents.

The result is empirically validated, audience-first research, designed to equip cultural strategists and communicators with a clear understanding of how audiences think, the media environments they inhabit, and how to reach them through the existing narratives they’re engaging with.

A confidence bubble is shaping vaccine communication

Most Americans believe vaccines work. Among the ~6,000 Americans we surveyed, a majority agree, across values, that vaccines have protected them personally. This creates a powerful foundation for vaccine communications. The challenge is that most existing vaccine communication appeals to an audience that is already aligned with public health guidance, and experiences vaccination as simple, straightforward, and socially agreed upon.

This particular audience’s confidence is reinforced by high institutional trust and by media environments that normalize vaccination as routine care. From inside this bubble, it can be difficult to see why other parents struggle, hesitate, or ask questions. Over time, this blind spot has shaped many vaccine communication strategies, anchoring them in assumptions that do not hold for other audiences.

This means that the current argument centered around vaccine safety and efficacy has gotten the support of those who already have vaccine confidence. To reach a broader audience, a new approach is needed.

That approach begins with understanding that confidence clusters around values—and that those values organize into five distinct audiences, each with its own motivations, hesitations, and pathways to confidence. These audiences—Trusting the Process, Caring for My People, Protecting My Family, Checking the Details, and Calling My Own Shots—map directly onto the values-based segmentation framework used by Harmony Labs’ Narrative Observatory, rooted in Shalom Schwartz’s Theory of Basic Human Values.

Trusting the Process

“Show it’s working, and I’m with you.”

This is the most vaccine-confident group. They present a natural trust in collective effort and in institutions, and they are champions of herd immunity. Middle-aged, more educated than all other audiences, 77% White, and strongly progressive, they overwhelmingly support vaccination for everyone’s children, not just their own.

They trust clinicians, expect clear explanations rather than emotional appeals, and encounter vaccines primarily within narratives of routine care, public health guidance, and collective response. Their only meaningful hesitation is the belief that the healthcare system can be distorted by profit motives. Transparency from institutions matters to them.

Caring for My People

“Care for my inner circle, and I might trust you.”

Relationship-oriented and attuned to what “people like me do to protect people like us,” this audience is broadly pro-vaccine. Aged 18–44, gender-balanced, the most racially diverse of the five groups, educated, center-left, and roughly 60% parents, they see vaccination as part of being responsible to their community. They have mild ingredient concerns, but their bigger hesitation is whether institutions truly operate in the public interest.

They engage with creator-driven, personality-led media, which includes lifestyle programming, family-centered stories, and relatable reality formats where health topics surface within everyday conversations rather than as standalone policy issues. They respond especially well to explanations framed in terms of care, responsibility, and protecting others.

Checking the Details

“Help me understand the details, and I can get on board.”

Skeptical by default, but not oppositional, this audience is looking for evidence of coherence, not authority. Middle-aged, majority male, largely White, and politically moderate, they are generally positive about vaccines but highly reassurance-seeking. Two-thirds worry about vaccine ingredients, and almost half believe clinicians may hold back information.

They seek out formats that prioritize transparency and evidence, and engage with creators who don’t shy away from analyzing complex topics. Clear, direct explanations from clinicians perceived as transparent could be useful. Vague reassurance, or anything that feels like it’s papering over complexity, tends to backfire.

Protecting My Family

“Guide me with respect, and I’ll protect my kids with you.”

The oldest of the five audiences, majority female, center to right-leaning, with a larger Black population than most other segments, this group is broadly supportive of vaccination, but sensitive to credibility and tone. They want guidance that signals care and respect. They harbor some institutional distrust and ingredient concerns, and they want information delivered without dismissing faith or bodily autonomy.

Their media world emphasizes family, moral clarity, and themes of safety and protection. They trust and feel heard by their doctors, but about one-third still wonder if their doctors are sharing all the information.

Calling My Own Shots

“Respect my judgment, and I’ll consider what you say.”

This audience is attuned to threats to their autonomy, and sensitive to anything that might be perceived as undermining their independence of thought and action. Older, predominantly male, right-leaning, and with higher rates of institutional skepticism, they are cautiously positive. Many believe vaccines help and support childhood vaccination, but they express significant ingredient concerns and distrust of the system.

Their media environment includes autonomy-oriented commentary, institutional critique, and individual-centered narratives. Framing that feels directive tends to reduce openness rather than build it. Feeling respected, and not overridden, is essential.

The same message can land differently with different groups

Understanding audiences is only half the equation. The other half is understanding the stories they’re already swimming in. In our narrative landscape analysis, we found that health-related stories—including those touching on vaccines—appear across audiences, but not in the same way for everyone.

Different audiences inhabit different media ecosystems, and those ecosystems carry distinct narratives about health that shape attitudes on routine care, prevention, controversy, skepticism, or crisis. These narratives differ not just in tone, but in what they imply about who is responsible, what is at stake, and whom to trust.

When messaging doesn’t align with the cultural context families are immersed in, even accurate information can miss the mark. The same vaccine message can feel calming and supportive to one audience, while feeling dismissive or threatening to another.

From media research to cultural strategy

In a cultural strategy, the goal is not simply to push out information; it is to place vaccination inside the stories, settings, and character arcs people already trust. If the goal is engaging people outside the confidence bubble, it requires understanding how parents and caregivers think, what they value, and the media ecosystems that shape their understanding of health and vaccines.

This research enables the broad public health communication field to design a cultural strategy that meets people where they already are—within the stories they watch, the creators they follow, and the norms they share—and creates a foundation for scalable narrative interventions.

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