Over the past two decades, anti-vaccine activism in the US has evolved from a fringe subculture to an increasingly well-organized networked movement with significant public health implications. The COVID-19 pandemic has exacerbated this evolution and magnified the scope of vaccine misinformation. Anti-vaccine activists, who for many years primarily targeted niche communities hesitant about childhood vaccines, have used social and traditional media to amplify falsehoods related to COVID-19 vaccines, while also targeting to historically marginalized racial and ethnic communities.
These efforts contributed to hesitancy about the COVID-19 vaccine and expanded the movement, with early signs suggesting that these hesitations could now also be adding to pre-pandemic hesitancy toward other vaccines. It is important to understand the implications of this recent evolution of anti-vaccine activism on vaccination acceptance and the promotion of robust public health strategies. In this Viewpoint, we summarize the latest developments in US-based anti-vaccine activism and propose strategies to address them.
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A 21-person commission of public health experts convened by The Lancet calls for the development of networked communities that simultaneously share information with different audiences about the health and economic benefits of vaccines.
Public and private sector health officials and public policymakers must immediately partner with community leaders to more effectively disseminate accurate narratives about the life-saving benefits of vaccines and counter harmful and widespread misinformation. of anti-vaccine activists in the United States, according to a new opinion piece in The Lancet , led by authors from the Boston University School of Public Health (BUSPH), the University of California, Riverside (UCR), and the Stanford Internet Observatory (SIO) Cyber Policy Center at Stanford University.
Published in the leading international medical journal, it provides valuable information on recent developments in anti-vaccine activism in the US and proposes strategies to confront this dangerous message.
" Health freedom messages gained traction during the pandemic, turning members of the public against public health messages and prevention-focused activities, including vaccination," says second author Timothy Callaghan, associate professor of health law, policy and management at BUSPH, and who was one of Viewpoint’s three lead writers, along with lead author Richard Carpiano, professor of public policy at UCR, and third author Renee DiResta, technical research manager in SIO.
The authors and 18 other leading public health experts describe a perfect storm that allowed anti-vaccine activism, once a fringe subculture, to become a well-organized form of right-wing identity with narratives associating rejecting vaccines with personal freedom. . This narrative was constantly repeated and amplified by social media influencers, pro-Donald Trump political operatives, and right-wing blogs, podcasts, and other media as the COVID-19 pandemic spread around the world.
The authors emphasize the need to constantly expand accurate science and information through multiple communication channels, to avoid the spread of inaccurate or misleading information to people through limited sources.
“It’s a matter of life and death,” says Carpiano.
“People don’t always see it that way. “We have forgotten how many people have died, gotten sick, or continue to get sick from COVID-19, as well as many other vaccine-preventable diseases.”
The document is released at a time when more than 1.1 million people have died from COVID-19, with the global toll estimated at 6.8 million. The disease continues to spread as vaccines have been found to greatly reduce illnesses that require hospitalization or cause death.
Anti-vaccination activism has existed for as long as vaccines have existed. But the movement gained momentum in 1998 when British doctor Andrew Wakefield published a now-debunked study that falsely claimed a link between childhood vaccines and autism.
In more recent years, however, anti-vaccine messaging has largely shifted from concerns about health effects to conservative and libertarian political identity arguments for medical freedom and parental rights. This was due in part to legislative efforts in several states to eliminate personal belief exemptions from school vaccination requirements in response to declining childhood vaccination rates and outbreaks of vaccine-preventable diseases. But these arguments were limited to childhood vaccines and were somewhat contained.
Since the COVID-19 pandemic affected the entire population, it caused a huge expansion not only of anti-vaccine activism, but more broadly, of anti-public health activism as people faced the drawbacks of wearing masks, the social distancing, the closure of restaurants and bars and cancellations of concerts and other events that draw crowds.
Celebrities, wellness influencers, partisan experts, and certain scientists and doctors, among others, joined the fray, often spreading false and misleading claims about the vaccines. The growing number of voices found larger audiences, which meant more votes for right-wing candidates and greater monetization of right-wing social media and media outlets.
“As celebrities, influencers, and politicians began to speak negatively about vaccination, increasing segments of the American public became exposed to these messages, turning worrying proportions of the American public who had previously been vaccinated in other contexts against vaccination against COVID-19.” says Callaghan.
The result was that more people became ill.
“Political leaders were, unfortunately, particularly effective anti-vaccine messengers, and because of that, we now have clear disparities in COVID-19 vaccination rates between parties,” he says.
Meanwhile, pro-vaccine messages have been based on the statements of individual public health experts, such as former director of the National Institute of Allergy and Infectious Diseases Anthony Fauci and the director of the Centers for Disease Control and Prevention from the US Rochelle Walensky, who the authors say are overmatched.
Callaghan, Carpiano and DiResta were part of the Commission on Vaccine Refusal, Acceptance and Demand in the US that The Lancet convened to examine issues related to COVID-19 vaccine acceptance, uptake and hesitancy. The membership is comprised of 21 national experts in public health, vaccine science, law, ethics, public policy, and social and behavioral sciences.
The group recommends the development of networked communities that simultaneously share information with different audiences about the health and economic benefits of vaccines. This would preempt the well-funded messaging of the anti-vaccine movement.
“Without concerted efforts to counter the anti-vaccine movement, the US faces a growing burden of morbidity and mortality from an increasingly undervaccinated and vaccine-hesitant society,” the authors conclude in the article.
