Pilot Testing a French and Kinyarwandan Game to Improve Vaccine Attitudes and Misinformation Resilience in Rwanda

Vaccine misinformation causes negative impacts such as decreased vaccine acceptance and reduced intent to get vaccinated. The association between susceptibility to vaccine misinformation and vaccine hesitancy underscores the need for interventions that increase public resilience against misinformation. One promising intervention is psychological inoculation, where recipients receive a “weakened form” of misinformation to build immunity to real-world misinformation. Misinformation is delivered in weakened form by exposing its misleading techniques. Cranky Uncle Vaccine is an interactive, digital game that applies inoculation theory, explaining facts about vaccines as well as the misleading techniques used to cast doubt on the facts. We document a pilot study testing the effectiveness of an East African version of Cranky Uncle Vaccine conducted in Rwanda. Two translations of the game were made available with participants choosing either a Kinyarwandan-speaking (n = 535) or French-speaking (n = 499) version. Among Kinyarwandan-speaking players, the average age was 27.8 years with more males (52.7%) than females (46.9%). Among French-speaking players, the average age was 29.9 years with more males (55.3%) than females (44.7%). Among both languages, participants were highly educated (median education level “Some/all university”). Before and after playing the game, participants filled out surveys measuring vaccine attitudes and discernment between facts and fallacies. French-speaking participants showed significant improvement in general vaccine attitude and vaccine importance but while the change in intent to get vaccinated was positive, it was not statistically significant. Kinyarwandan-speaking players showed significant improvement in general vaccine attitude, vaccine importance, and intent to get vaccinated. The game was most effective among players who expressed vaccine hesitancy in the pre-game survey with 55% of hesitant French-speaking participants and 71% of Kinyarwandan-speaking participants switching to being likely to get vaccinated. These results show that a digital game employing an inoculation approach is effective in building public resilience against vaccine misinformation and boosting vaccine acceptance, particularly among those expressing vaccine hesitancy.