PONE-D-21-02562

Active pro-vaccine and anti-vaccine groups: their group identities and attitudes toward science.

PLOS ONE

Dear Dr. Polak

Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process.

I have read the ms and the feedback provided by three expert reviewers. All Rs found merit in this research but they also raise important issues that prevent me from accepting the ms in its present state. A particular opportunity here is that R2 is a qualitative researcher and this is an opportunity for you to make sure that the concepts and language is accessible even to those who are not well versed in some aspects of your study. R1 and R2 are concerned that the rationale is under-developed and does nor motivate the hypotheses. R2 also points out that the abstract needs to better represent the study. R3 on the other hand invites you to consider the role of group membership and the role it plays more prominently. 

In addition to these I would like you to consider:

1. Language and style needs some work

2. Please elaborate on Ariadna Nationwide Research Panel, e.g. where, which country, public daya or not?

3. Provide full list of items as supplement if you have not done so already.

4. Detail the software you used

5. Figures appeared to be directly copied and pasted from SPSS output? While this is not a major issue it gives the manuscript a rahter naive (for lack of a better description). Consider editing the format. You may find other prreviosuly published papers useful for ideas.

6. More importantly, consider running additional analyses to determine which aspect of group membership is more influential on attittudues toward science and vaccination. I would even consider a more complex model where dimensions of identity predict attitudues toward vaccination via attitudues toward vaccination. 

7. Please elaborate on the limitations of your research. This is important.

I would like to reiterate that my decision on the revised version of the ms will depend on how well you would be able to adress issues raised by the Reviewers and my own observations I detail above.

Please submit your revised manuscript by May 23 2021 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file.

Please include the following items when submitting your revised manuscript:

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• A marked-up copy of your manuscript that highlights changes made to the original version. You should upload this as a separate file labeled 'Revised Manuscript with Track Changes'.
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If you would like to make changes to your financial disclosure, please include your updated statement in your cover letter. Guidelines for resubmitting your figure files are available below the reviewer comments at the end of this letter.

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We look forward to receiving your revised manuscript.

Kind regards,

Huseyin Cakal

Academic Editor

PLOS ONE

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Partly

Reviewer #2: Yes

Reviewer #3: Yes

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2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: I Don't Know

Reviewer #2: I Don't Know

Reviewer #3: Yes

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3. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #2: Yes

Reviewer #3: Yes

**********

4. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #2: Yes

Reviewer #3: Yes

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5. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: In the manuscript entitled “Active pro-vaccine and anti-vaccine groups: their group identities and attitudes toward science”, the authors make use of a sub-sample of 350 participants to examine attitudes towards science, social identification, and outgroup attitudes among people active in discussions pro- or against vaccines. It provides several interesting correlations between these variables, shedding light on the similarities and differences between vocal supporters and opponents of vaccines.

I found the overall argumentation and structure of the article rather difficult to follow. Although several aims and hypotheses were described, I did not find a clear research question in the manuscript. Additionally, there were some inconsistencies between hypotheses, measures, and the reported findings; most notably around the concept of social identity. I will elaborate on these concerns below.

Regarding the use of social identity in the current manuscript, some things did not become clear to me. My main concern is that the manuscript does not provide a clear reason why and how group identity/social identity should play a role among vaccine supporters and opponents. I am sure there are plenty of good reasons to study group processes here, but without a clear reason how it needs to be studied, I found it difficult to assess whether the methods were appropriate to do so. Could, for example, being personally pro- or anti vaccines not explain the same patterns in support for science?

The methods to assess social identification match the useful distinction between the four aspects of group identity (p.4). However, two things are unclear or inconsistent here. First, the hypotheses mention “level of group identity” as a singular measure, whereas the correlations are presented for each of the four aspects of group identity. Moreover, the single reliability coefficient in the measures section suggests that indeed all 16 items are considered as a single group identity scale. When considered separately, I think a factor analysis would add to the understanding of these four sub-scales. Second, the methods section lacks sample items for the identity scale. Based on the data set, I could not fully assess what the group identity exactly pertains clearly to in the items. I think this is especially important given my earlier point that it is unclear what the group identity adds in explanatory power over and above personally being pro- or anti vaccines. In the theory, I also would have liked to a see a specific discussion on this: what does a pro- or anti vaccine identity look like exactly?

I think the sub-sample drawn from the larger representative sample is fitting to test the hypotheses. The selection criteria are well-argued in the methods section. Perhaps the introduction could have been clearer that the current study concerns active/involved opponents and supporters of vaccines. Based on vaccination rates, vaccine supporters can either be an overwhelming majority group or form a minority and this can influence identification processes. Some more background information on this would help argue for the current hypotheses: how do the opponents and supporters compare to the general representative sample that they were drawn from? And what can be said beforehand about pro- and anti-vaccine groups in the current context, both practically and theoretically?

The methods and results sections contained some other puzzling information. I found the types of involvement very useful in order to get a better understanding of who the participants in the study were. However, the type of involvement was not mentioned in the introduction, hypotheses, nor methods and therefore came as a surprise to me. In the results and discussion, involvement seems to be discussed as a predictor. Additionally, the “outgroup identity” in Table 2 was not clear to me. I did not find this measure in the methods section.

For the general methodological approach of the manuscript, I think the language in the abstract, introduction, and hypotheses is not always consistent. For example, the abstract mentions “mechanisms”, suggesting group identity to potentially play a mediating role that is not test. On page 2, “understanding the predictors of […] attitudes towards vaccination” is mentioned, suggesting at least some kind of inference about predictors rather than correlations. The correlational analyses are correct as far as I can tell, but I think in some cases a regression analysis would be helpful to examine the unique contribution of, for example, the different aspects of identity in certain relations.

Finally, I would suggest to consider addressing some conceptual and theoretical concerns in the introduction and discussion. In the introduction, I would suggest to address in more depth what the expectations are for the identification processes of opponents of vaccines. Based on the current overview of the literature, it seems that it is already clear that anti-science is not central to their ingroup or beliefs. This would make answering the question, like it is done in the current study, superfluous. Another thing I think would be important for the discussion, in what “belief in science” or “trust in science” would mean for either group. This might be hard to answer based on the measures in the study, but I could imagine that each group has “their own science” to trust, meaning that the absolute level of trust in science is less relevant than which scientific findings are believed by either group.

Minor points

The methods section mentions that the questionnaire consists of three parts, but only two are explained

I think there is a slight mismatch in the number of participants between abstract and methods section.

The second hypothesis is not formally tested: it states that the correlation between level of identity and acceptance of science is stronger in the pro-vaccine group. The findings are presented in Table 4, but no conclusion is drawn about the difference between the pro- and anti-vaccine groups.

The writing is generally clear. Some expressions or phrases need to be made more consistent or clear, such as the “predictors”, “mechanisms” that I mentioned before, but also a phrase like “another question that arises” (p.5) needs some substantiation: where does this arise from exactly? Other than that, I thought that the language and writing was clear.

Reviewer #2: This well-written article explores group identity in pro- and anti- vaccination individuals who self-identify as being active in conversations about this issue. It finds that pro-vaccination participants have stronger group identity, both groups identify as pro-science more than not, and both take a dim view of the other’s scientific basis. With some adjustments, I think this article would be a good addition to the literature.

I note that the abstract does not really pull out the most interesting findings and urge the authors to edit it to play to the article’s strengths.

The authors build from a basis of thinking about vaccinators and non-vaccinators as people who engage in (non)scientific thinking, but at line 97-99 this appears somewhat jarring as a basis for the study, even though the authors have offered some basis for why we might think this. I think the reason it doesn’t feel right here is that pro-vax supporters are assumed to be pro-science and that this is a causal factor for their support for vaccination. I will return to this topic later. For now, I think these lines can be improved by offering evidence as to why we might believe that pro-vaxxers are also passionately pro-science. There may be academic articles that cover this point, and the authors should look for some. Failing that, they could rest on the evidence that many skeptic organisations (who are first and foremost science lovers!) engage quite heavily with the vaccination issue, including through podcasts, articles etc, and cite some examples. I feel that this evidence would make the authors’ assertion that science views matter to pro-vax views more convincing, and hence make the study’s premise more convincing.

I note that I’m a qualitative researcher so I cannot comment on the article’s quant methods. It did strike me that the N is small, and I’d like the authors to defend in the article whether the study is sufficiently powered.

Because I’m not a psychologist, I prefer explanations of results that non-quant people can understand. So, for example, at lines 212, I’d like the sentence about significant differences to actually explain who thought what. Likewise at line 221, please explain what this means in concrete language about the people in your study. At line 260, please add something that demonstrates what it means (you talk about attitudes toward science but not in which direction) Eg “meaning that pro-science people had stronger group identities, whether they were pro or anti vaccine.” This is the kind of concrete language I’m asking for throughout. At line 262, again please explain in concrete terms what the first half of this sentence is saying about your population. Including a basic explanation of what your findings actually mean in concrete terms will make your article more readable and probably more likely to be cited by others outside your discipline.

At line 290 , once again we revisit the idea that pro science motivates pro- vax behaviour / attitude / action. I’d like the authors to consider, and include in their limitations, the idea that it might swing the other way. It could also be that pro-vax people get socialised into being strong supporters of science! I raise this point because this was my journey; it might well be that of other people. Consider that causation runs the other way.

Line 313, you find that there was not a factor that clearly unites vaccine rejecters. This has been discussed in other literature – see

Kahan, D. M. 2014. Vaccine Risk Perceptions and Ad Hoc Risk Communication: An Empirical Assessment. In CCP Risk Perception Studies: Yale Law School; Harvard University - Edmond J. Safra Center for Ethics.

And then see critiques that he, too, might not have looked for the right thing:

Attwell, K., and Smith, D. T. 2017. Parenting as Politics: Social Identity Theory and Vaccine Hesitant Communities. International Journal of Health Governance 22 (3):183-198.

For your reflections on how the groups view each other’s scientific knowledge at lines 326-332, some other studies may be useful:

Attwell, K., Smith, D. T., and Ward, P. R. 2018. ‘The Unhealthy Other’: How vaccine rejecting parents construct the vaccinating mainstream. Vaccine 36 (12):1621-1626. doi: https://doi.org/10.1016/j.vaccine.2018.01.076.

Rozbroj, T., Lyons, A., and Lucke, J. 2019. The mad leading the blind: Perceptions of the vaccine-refusal movement among Australians who support vaccination. Vaccine 37 (40):5986-5993. doi: https://doi.org/10.1016/j.vaccine.2019.08.023.

And for your discussion of the motivations of anti-vaccinators lines 338-340, these may be useful:

Ward, P. R., Attwell, K., Meyer, S. B., Rokkas, P. R., and Leask, J. 2017. Understanding the perceived logic of care by vaccine-hesitant and vaccine-refusing parents: A qualitative study in Australia. PLoS One 12 (10).

Reich, J. 2014. Neoliberal Mothering and Vaccine Refusal: Imagined Gated Communities and the Privilege of Choice. Gender & Society 28 (5):679-704. doi: 10.1177/0891243214532711.

All suggestions are made for the authors’ benefits with no expectations that they cite any of them unless they consider them useful for their framing and wider analysis.

Reviewer #3: The paper provides a helpful insights to an important topic, which hopefully will have a positive impact in both practical and theoretical aspects. I was thrilled by the decision of the researcher to adopt a group dynamic approach to the topic, which does provide more depth of understanding. I have no major comments on the manuscript, except one concern in regard how the researchers talk about group identity, as following:

The researchers seem to base their approach on assumption that science is “the” fundamental force behind the position toward vaccines and activism around it. Thus, they measured attitude towards science and science-based social identity, and used them in their analysis. Although the authors believe that “any domain (value, symbol, attitude) can become the basis for group identity, provided that it is accepted and considered valid by the members of the group” (P.4, Line 91) they seemed to be over focused on science alone as base for group membership, and ignoring other possible sources, which might explain some possible flaws in the analysis and conclusions. Other possible sources for group identity can be the individual liberal rights (resisting the tyranny of state), which is known to be a common part of anti-vaccine debates. It is true that the paper makes an excellent argument that anti-vaccine groups are not necessarily have a common negative attitude toward science , and show in the result that such attitude seems not to be the base for their group identity; However, I’m concerned about framing such results as denying the role of social identity, in general. So, if the authors aims to explore specifically the role of science-based social identity, then I would suggest making that clear, wherever needed, to avoid misleading conclusions such as “social identity of vaccination rejecters is weaker than that of vaccination supporters”.

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6. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files.

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Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy.

Reviewer #1: No

Reviewer #2: No

Reviewer #3: No

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Attachments

Attachment

Submitted filename: Review.docx

PONE-D-21-02562R1

Active pro-vaccine and anti-vaccine groups: their group identities and attitudes toward science.

PLOS ONE

Dear Dr. Polak,

Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process. While one reviewer recommend accept, the other recommended substantial changes to nearly all aspects of the paper from tiny details to big picture issues.

Please submit your revised manuscript by Nov 20 2021 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file.

Please include the following items when submitting your revised manuscript:

• A rebuttal letter that responds to each point raised by the academic editor and reviewer(s). You should upload this letter as a separate file labeled 'Response to Reviewers'.
• A marked-up copy of your manuscript that highlights changes made to the original version. You should upload this as a separate file labeled 'Revised Manuscript with Track Changes'.
• An unmarked version of your revised paper without tracked changes. You should upload this as a separate file labeled 'Manuscript'.

If you would like to make changes to your financial disclosure, please include your updated statement in your cover letter. Guidelines for resubmitting your figure files are available below the reviewer comments at the end of this letter.

If applicable, we recommend that you deposit your laboratory protocols in protocols.io to enhance the reproducibility of your results. Protocols.io assigns your protocol its own identifier (DOI) so that it can be cited independently in the future. For instructions see: https://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols. Additionally, PLOS ONE offers an option for publishing peer-reviewed Lab Protocol articles, which describe protocols hosted on protocols.io. Read more information on sharing protocols at https://plos.org/protocols?utm_medium=editorial-email&utm_source=authorletters&utm_campaign=protocols.

We look forward to receiving your revised manuscript.

Kind regards,

Peter Karl Jonason

Academic Editor

PLOS ONE

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation.

Reviewer #1: (No Response)

Reviewer #2: All comments have been addressed

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2. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Partly

Reviewer #2: (No Response)

**********

3. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: I Don't Know

Reviewer #2: (No Response)

**********

4. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #2: (No Response)

**********

5. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #2: (No Response)

**********

6. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: In the revised manuscript “Active pro-vaccine and anti-vaccine groups: their group identities and attitudes toward science”, most of the suggestions made by reviewers seem to be addressed in one way of another. Additionally, the relevance of the topic of attitudes towards vaccination remains an important one. Nonetheless, I do think that the structure of the manuscript still contains omissions between the theoretical rationale, hypotheses, and reported findings.

One of the problems that is still in the manuscript, is how “level of involvement” is treated. First, the findings on level of involvement are reported quite extensively in section 3.2 of the results. Also, on line 198, it says that there is an aim of investigating this variable in relation to group identity. However, there is no specific theory, hypothesis, nor a clear measure for it. Moreover, because the participants are selected on this variable, I think section 3.2 can logically only be used as some kind of description of either group. The conclusion on page 19 (in the discussion) seems to indicate that this was the intended way of using level involvement as well.

Another problematic part of the manuscript remains the role of social identity and how it is operationalized. The reasons why social identity is used is not entirely clear even in the revised manuscript, especially when it comes to the four dimensions of social identity. In the expectations in the theoretical framework, but also in the hypothesis itself, there is no mention of difference between any of the four types of identification. Yet, these are measured and reported separately in the methods and results section. I find the regression analysis of the various social identity measures interesting but also would like to know how strongly they are related. Additionally, ideally there would be some kind of control variable for religiosity in these analyses in order to rule out alternative explanations for attitudes towards science. I do not know whether such additional measures are available.

Additionally, I think there is still work to be done in order to completely make the case for what the identities are that are measured; what their content could be. For example, some of the individual differences that are mentioned on page 3 include orthodox religiousness and moral purity concerns, both of which could easily be part of shared ingroup norms and not individual differences. The authors do not make clear how, then, the intergroup relations perspective adds to this line of research. One solution for this, I suggest, would be to provide context as to who individuals in either group could be, given the current sociopolitical situation in Poland. On page 6, there is some information on why the anti-vaccine group might have more diverse motivations and therefore identify less as anti-vaccine supporters. In many contexts, this might seem counter-intuitive because the majority group in most situations would identify less strongly. I urge the authors to expand on this point of view by using the national context and existing literature. The Rutjens et al article on line 168 might be useful here, but then some reflection on how the current study adds to these findings is important.

I would recommend changing the structure of the theoretical framework to some extent, in order to be able to see the main hypotheses and their argumentation sooner. For example, I find the hypothesis about perception of anti-science attitudes of the other group interesting, but there is barely any theorizing on it. The few lines around line 212 mention “basic rules of social cognition” while only when discussing the hypotheses, the theoretical foundations of outgroup bias are mentioned (line 231) but not discussed in depth.

All in all, quite a few confusing aspects of the initial manuscript are resolved in this revision and the correlates of pro- and anti-vaccine individuals are reported clearer now. Nonetheless, my points above still make it difficult sometimes to assess the necessity and purpose of some of the measures.

Minor issues

Space missing on line 69 and line 128

The reference on opinion-based groups should maybe already been mentioned on line 136.

The discussion paragraph starting at line 459 invokes all kinds of motivations for group membership, but I suggest making clearer what is known from previous literature versus what the findings of the current research are.

The discussion does not engage much with the theory: the findings are explained well, but it is not clear what it means for existing theory.

Reviewer #2: xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx

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7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files.

If you choose “no”, your identity will remain anonymous but your review may still be made public.

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Reviewer #1: No

Reviewer #2: No

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Active pro-vaccine and anti-vaccine groups: their group identities and attitudes toward science.

PONE-D-21-02562R2

Dear Dr. Polak,

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication.

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Peter Karl Jonason

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Reviewers' comments: