Omair Ali

Perspectives Editor

vax
Photo credit: Maggie Fox, NBC News

There is no doubt that the anti-vaccine movement presents a formidable danger to our nation’s safety and well-being. “Anti-vaxxers” spread poorly-cited information that influences misinformed decision-making regarding vaccine use among many individuals in our country. They are also partly to blame for the rise in vaccine-preventable disease outbreaks. The efforts of anti-vaxxers have also been acknowledged by the World Health Organization, who list vaccine hesitancy as one of the top 10 threats to global health in 2019.

 

Although the anti-vaccine movement has been around since the innovation of vaccines, but contemporary anti-vaccine beliefs was strengthened 20 years ago when an erroneous journal article was published in 1998 that linked the MMR vaccine with autism. The study was retracted for its falsified study results, poor study design, unreproducible results, and several subsequent studies that have shown. But this faulty information on vaccines was one of the key factors that spawned a global community of activists who oppose vaccines for its potential dangers on human health. Many, if not all philosophical anti-vaxxers, question the efficacy and safety of vaccines, as they are afraid of the risks associated with vaccine use. This risk of vaccine injury that is claimed is related to ingredients that are found in vaccines, and beliefs that the use of vaccines are correlated with injury. However, there are many well-documented cases worldwide that have demonstrated the safety of vaccines and campaigns have made the world more protected from the spread of deadly diseases.

 

According to the National Vaccination Information Center, vaccines are mandatory for the entire population, but certain exemptions from vaccines can be made on the grounds of medical beliefs, religious beliefs, and personal beliefs. In many instances where philosophical differences by anti-vaxxers are claimed, vaccine hesitancy can also be attributed to poor confidence in the social structures that are supposed to support us, including the institutions of medicine and government. Some in the anti-vaccine camp believe that the government and biotechnology industry have ulterior motives that explain their promotion and distribution of vaccines. However, there are other factors at play in the growth of the anti-vaccine movement. Anti-vaccine rhetoric on social media is persuasive and effective. And social media echo chambers are a force that reinforce existing belief systems within online communities. The presence of influential figures in the anti-vaccine movement, including celebrities, religious leaders, and politicians, further obscures public confidence. As such, vaccine scientists now struggle with disclosing their work publicly out of fear of reprisal by their community (i.e., anti-vaxxers with nefarious intentions) or their own colleagues.

 

With vaccinations, there is always risk involved, much like other activities, like driving a car, getting a CT scan, or drinking alcoholic beverages. But this risk of vaccine injury is exaggerated and misunderstood by anti-vaxxers, who distort the risk and make extreme claims about vaccine injury, including its claimed link to autism. Consequently, there are many studies that have disproved their claims. For instance, a  recently-published study in Pediatrics indicated no risk of infants developing Autism Spectrum Disorder associated with pre-natal use of the commonly-administered Tdap vaccine. Likewise, vaccine campaigns have made the world safer from infectious diseases, such as the global anti-polio campaign. Although there are a few risks  associated with vaccine usage (pertaining to allergic reactions and very rare injuries), vaccines are overall safe, effective, and arguably necessary for the well-being of our society.

 

The CDC recently reported data that suggests that the percentage of children under the age of 2 who have not received vaccinations has quadrupled within the last two decades. Despite the beliefs parents may have against vaccination of their children, they should be aware of the significantly-increased risk of acquiring and transmitting vaccine-preventable infections when they fail to vaccinate their children. Coinciding with this increased in vaccine refusal are vaccine-preventable outbreaks throughout the United States, indicating a link between vaccine hesitancy and vaccine-preventable disease outbreaks. So how do we convey a message of truth about vaccine safety and efficacy? To start, the efforts should exclude prejudice and demoralizing attitudes toward proponents of the anti-vaccine movement.

Stigmatizing anti-vaxxers is detrimental to the ambition of universalizing vaccine compliance. This is because a confrontational, patronizing attitude is not helpful in persuading and building trust with anti-vaxxers. At the same time, it is simply not enough to suggest to anti-vaxxers that vaccines should be supported because there is a widespread consensus of confidence across the scientific and medical communities. We must also accept the reality that some people will never change their skepticism towards vaccines. Even so, the growing refusal of vaccines and the rise of vaccine-preventable disease outbreaks raises enough concern such that the government should step forward and advance a factual understanding of vaccines—an understanding that ultimately supports the use of vaccines– that can be achieved through the implementation of a national campaign.

 

Public campaigns are known to make a significant impact longitudinally on health behaviors.  Take the Tips From Former Smokers (Tips) campaign, which was produced by the CDC. A study revealed that Tips was associated with over 1.73 million smokers attempted to quit and 104,000 successful attempts to quit, making this a successful effort. A rigorous nationwide vaccine campaign, led by the CDC, would be an effective strategy to anti-vaxxers’ attitudes towards the dangers of vaccine. A national campaign should not be focused on scaring the public about the dangers of vaccine hesitancy. Instead, they should implement a measured response that is focused on building an understanding through: empathizing with anti-vaxxers concerns about vaccine safety; a compassionate attitude across all communities; and factual, evidence-based reasoning with the aim to ensure that vaccines are safe, accessible, and effective. A campaign should not only recruit famous supporters of vaccines, but also ordinary people with diverse sociodemographic characteristics who support the use of vaccines. Further, we should include: educational animations to appeal to younger audiences; creative storytelling that makes the science behind vaccines easier to understand for the general population; and a heightened presence on social media sites to attract a broader audience into this campaign. The efforts by the government to advance vaccine understanding are very passive and there are currently no national, multimedia campaigns to promote support for vaccine. But given the success of previous public health campaigns for tobacco use, a pro-vaccine would help clear at least some skepticism about vaccines.

 

Accomplishing trust in a government-led campaign can be difficult in this era of political polarization, where trust is hard to acquire after politics in recent years have left a sour taste in the mouths of Americans. But as more individuals’ attitudes change in favor of vaccine denial, we should all make an effort to continue to trust in the public scientific institutions who are tasked with producing evidence-based facts and using this information to protect us. At the same time, our government should hasten to launch vaccine education that emphasizes factual understanding and doesn’t explicitly single out anti-vaxxers for their beliefs. In support of an improved public understanding of vaccines without incorporating stigmatizing attitudes towards vaccine skeptics, let’s all move together in a direction towards collective understanding and well-being.

 

In the next issue, I will look more closely at the science behind vaccines and analyze claims that raise concerns about vaccine injury.