Improving Vaccine Attitudes and Misinformation Resistance through Gamification: A Pilot Study in Kenya and Uganda

Misinformation about vaccines poses a significant challenge to vaccination efforts, including in low- and middle-income countries. Pre-emptive strategies to neutralize the influence of misinformation have gained attention, with psychological inoculation theory found to be an effective framework. Digital games have emerged as engaging, cost-efficient, and scalable tools to implement inoculation interventions and promote health-related behaviors. The Cranky Uncle Vaccine game, co-designed in Uganda, Kenya, and Rwanda, and piloted in Kenya and Uganda, aimed to establish the effectiveness of Cranky Uncle Vaccine in increasing vaccine acceptance, intent to get vaccinated, and discernment between vaccine facts and fallacies, as presented in this paper. Pre- and post-game surveys identified significant improvement in vaccine attitudes, with participants showing a more positive stance toward vaccination after playing the game. Among participants who expressed vaccine hesitancy before the game, 58% switched to being somewhat or very likely to get vaccinations after playing the game. Perceived reliability of vaccine facts increased while perceived reliability of fallacies decreased, indicating improved ability to distinguish true from false statements. Demographic factors such as education and age moderated the effectiveness of the game, with greater effects seen in lower-educated and older participants. The game's emphasis on the importance of vaccination, explanation of misleading techniques, and interactive learning contributed to positive outcomes, improving vaccine attitudes and reducing the influence of vaccine misinformation. Our findings highlight the relevance of game-based interventions in addressing misinformation and promoting vaccine acceptance.