Reexamining the Response to the Anti-vaccination Movement
Traditional explanations of how the anti-vaccination movement came into popularity focus on the misunderstanding of the science behind vaccines by the public, with ignorance and fear leading to susceptibility to anti-vaccine arguments. The battle between science and ignorance creates the framework for these narratives.
Most responses to the anti-vaccine argument by the medical and scientific community followed the approach of both illuminating the untrustworthiness of its proponents and scientifically debunking their claims and theories, thus combatting the public’s ignorance, the theoretical source of the problem.
And yet, fears and misgivings about vaccine safety and necessity persist in the public. Some evidence shows that perhaps the pro-vaccine messaging missed the mark. Parents had the capacity to understand that vaccines were probably good for the public at large. What they were concerned with, however, was the risk to their individual child.
Decisions not to vaccinate were often based on individual assessments of their children with the knowledge that vaccine reaction can vary. For example, “My first daughter had milk intolerance and was very ill for the first two years of her life. We didn’t vaccinate her with MMR because she was quite weak,” or “I was more frightened of the potential side effects of measles should I decide not to get Luke vaccinated. Had he been a poorly sickly baby with allergies I might have considered single jabs” (referring to separating out vaccines due to MMR being potentially harder on child).
Rather than approaching the problem from a pure anti-science view, complete fear or ignorance, or with a total disregard for public health, decisions were calculated based on protecting their individual children. As parents have been trained to take an active role in the healthcare of their children, the decision on whether to vaccinate just became one of the decisions they had to weigh.
Agencies such as Health Canada have put out releases such as:
“Misconception: Vaccines are not safe.
The Facts: Vaccines are among the safest medical products available. Prior to approval they are extensively tested and they continue to undergo rigorous ongoing evaluations of their safety when on the market. Serious side effects such as severe allergic reactions are very rare. On the other hand, the diseases that vaccines fight present serious threats. Diseases like polio, diphtheria, measles, and pertussis (whooping cough) can lead to paralysis, pneumonia, choking, brain damage, heart problems, and even death. The dangers of vaccine preventable diseases are many times greater than the risk of a serious adverse reaction to the vaccine.”
Extolling the scientific soundness and population level safety of vaccines, which the statement does quite well, misses the point though. If parents are primarily concerned about the rare “serious side effects” that could happen to their individual child, then rather than this statement being reassuring it is actually alarming in confirming that concern.
Dearth of Engagement with the Public in Disasters
After hurricanes Harvey and Irma, the National Science Foundation funded multiple studies on the impacts and responses to the disasters, including a study at the University of Arkansas investigating the role of social networks and communities in disaster recovery.
Initial findings of the study have not reflected kindly on government disaster preparedness communications. Though two-thirds of residents reported being connected to their local community, they did not report using these communities to help prepare for disaster. Disaster preparedness efforts were not effectively channeled through these communities, marking a huge missed opportunity and support for the view that individuals are generally not prepared for disasters even in disaster prone areas.
In terms of perception of government response, nearly half of the respondents did not think their communities prepared for disasters, despite many townships having disaster preparedness plans in place. Even worse, the respondents thought that these same deficient local responses were significantly better than federal responses, again despite a very active federal disaster response to the disaster.
The researchers are rightly concluding that government agencies and relief organizations need to do more to communicate with the public before, during, and after disasters.
Public health should engage with the public about programs and elicit feedback on the drivers of public perception. Vaccination policy and hurricane response are only two of many areas where programs were constructed based on effective population level responses only to have serious flaws revealed due to poor communication with and understanding of the public.
The anti-vaccination movement could have potentially been thwarted by having a better understanding of the emotional and protective responses of parents and connecting with them on that level rather than a pure scientific education campaign.
And obviously, there was a lack of communication with the public about the disaster programs in place to assist them both before and after the hurricanes, which both decreased the efficacy of these programs and potentially decreased public enthusiasm for supporting said programs which were perceived to have not worked.
Properly identifying public motivations and continually communicating with the public while playing to these motivations throughout all stages of a program, including after the conclusion of a program’s main effort (such as after a vaccine decreases disease prevalence), is crucial to long term success. We need to be better.
Questions, comments, feedback about today's Weekly Update? Please email Dr. James Kincheloe
Receive the Weekly Update right in your inbox on Tuesdays and Thursdays. Subscribe now at z.umn.edu/WeeklyUpdateSubscribe