Vaccine Hesitancy

From the Introduction: "Vaccines are one of the most consequential, safe, efficient and effective medical discoveries in history. Few other inventions have saved so many lives. And yet today, amidst the Coronavirus pandemic, vaccination finds itself undermined as never before. It is another of mankind's inventions - social media - that has subverted public confidence in vaccines, by empowering ideologues, hucksters and the perhaps well-meaning but misinformed - people trying to make sense of the severity and complexity of the scientific issues being discussed - to identify and communicate with potential converts at zero cost. Conspiracy theories proliferate where there is deep epistemic anxiety, that is, when people feel uncertain about what is true or false. Covid-19 [coronavirus disease 2019] is new and unfamiliar. The scale of its impact is immense and yet when it comes to our best hope for vanquishing the disease, many have little understanding of how vaccines actually work or of the role they have played historically in eliminating diseases that once crippled and killed. Our health authorities have, understandably, focused on acute management of the Coronavirus threat and its spread. Out of sheer necessity, as they try to comprehend the disease, the message has been 'trust our best guess'. This has given anti-vaxxers an opportunity to exploit subtle shifts in recommendations as scientific knowledge grows and position themselves in opposition to an aloof, fallible medical establishment in the same way that political 'populists' define themselves in part by contrasting their authenticity to a real or imagined political 'establishment's' failures."

From the Introduction: "This report, 'The Anti-Vaxx Playbook', is based on in-depth analysis of speeches and presentations by leading digital anti-vaccine advocates at a meeting they recently held in private over three days; investigation of private anti-vaccine digital spaces; and other intelligence gathered by our researchers. It reveals how anti-vaccine networks are systematically planning to suppress uptake of the Coronavirus vaccine by exploiting digital platforms. These malignant actors have developed their strategic understanding over years of advocacy and practice. Their strategy is simple. Exploit social media algorithms' predilection for controversial and engaging content to hammer home three key messages - Covid [coronavirus disease] isn't dangerous; vaccines are dangerous; and mistrust of doctors, scientists and public health authorities. Despite the variety of styles, tones and themes employed by the anti-vaccine movement, every meme they share is in service to one of these three messages. Our response must be equally simple: to inoculate against misinformation by ignoring the individual memes generated by the anti-vaxx industry and instead focus on communicating our core message - one that has the benefit of being true: 1. Covid is deadly; 2. Vaccines are among the safest, most effective, most consequential human inventions in the past two centuries, saving countless lives from disease, disability and even death; and 3. Doctors, scientists and public health professionals chose those professions because they want to help people and better understand the world."

From the Introduction: "The measles virus is a 'simple contagion' that is transmitted through contact between an infected person and a susceptible person. When someone who is newly infected becomes contagious, that person can transmit the disease to someone else who is susceptible, who in turn can transmit it to another, and so on. The result: One highly connected person can trigger an epidemic. Information can act like a simple contagion as well. If I tell you recent news about the availability of a new measles, mumps, and rubella (MMR) vaccine, you can easily repeat it to someone who can then repeat it to someone else. Each new contact and repetition leads to more transmission of the information. The result is the same: One highly connected person can accelerate word-of-mouth transmission of news, allowing it to spread 'virally' across a community (Centola & Macy, 2007). But anti-vaccine sentiment is different. It is a 'complex contagion.' Simply hearing a piece of anti-vaccine propaganda does not change a person's beliefs. Rather, people need to be convinced--the hallmark of a complex contagion--through contact with several peers who can reinforce the legitimacy of a point of view. That kind of social reinforcement confers credibility to the idea that vaccines may be harmful (Centola, 2018)."

From the Background: "As the COVID-19 [coronavirus disease 2019] pandemic forced countries into lockdown, several medical research laboratories began expedited clinical trials in a race to develop a COVID-19 vaccine that would limit the infection rate, death tolls and allow societies and economies to return to some normalcy. More than 150 coronavirus vaccines are in development across the world, including in the United Kingdom, the United States of America, Germany, China, Brazil, Australia, Russia and Israel. For many governments and populations, the ability to vaccinate against COVID-19 would be considered a celebration for public health. Whilst clinical trials usually take between ten and fifteen years to bring a vaccine into public circulation, the global spread of COVID-19 has required vaccine manufacturers to speed up their clinical trial process, before the vaccines are sent to health regulatory agencies such as NICE [National Institute for Health and Care Excellence] for approval. Whilst many remain hopeful for the development of a functioning vaccine, decisions to compress the clinical process by running trial phases simultaneously has generated anxiety about the vaccine's safety among segments of the population. Country-wide and regional lockdowns have exacerbated some individual's levels of anxiety, mental health issues and loneliness, in addition to an increasing amount of time spent on the internet and social media. For many with concerns about public health measures, Facebook groups promoting conspiracy theories provide easy answers to users desiring certainty."

From the Foreword: "Nothing in recent memory has underscored the urgency of a strong vaccine enterprise more than COVID-19 [coronavirus disease 2019], the coronavirus that struck with such force in early 2020. While development of an effective vaccine to control the resulting pandemic is likely at least a year away, the danger of infectious diseases has been made shockingly real across the globe, and the gift of effective immunization has once again become apparent. Yet COVID-19 arrived at a time when hesitancy about long-established vaccines has become a real and present danger. Although vaccination remains a well-accepted social norm worldwide, a combination of factors--including misinformation spread on social media; decreased trust in institutions including government, science, and industry; and weaknesses within health systems--has emerged to diminish confidence among some populations."

From the Document: "We surveyed 21,196 individuals across all 50 states plus the District of Columbia. The survey was conducted on 7-26 August 2020 by PureSpectrum via an online, nonprobability sample, with state-level representative quotas for race/ethnicity, age, and gender. [...] In addition to balancing on these dimensions, we reweighted our data using demographic characteristics to match the U.S. population with respect to race/ethnicity, age, gender, education, and living in urban, suburban, or rural areas. This was the ninth in a series of surveys we have been conducting since April 2020, examining attitudes and behaviors regarding COVID-19 [coronavirus disease 2019] in the United States."

From the Introduction: "In the history of public health, drinking water and vaccines are recognized as two great contributions toward for disease prevention for humanity. Without a doubt, vaccination considerably reduces morbidity, disability, mortality and inequality around the world, reducing poverty and closing gaps in social inequality. However, some skeptics, with no scientific basis, have become part of an anti-vaccine movement. [...] The World Health Organization (WHO) has classified anti-vaccine movements as a threat to the progress attained to date in fighting preventable diseases. Despite the scientific evidence that proves the efficacy and need for vaccines, the anti-vaccine movement has attracted great attention by promoting unfounded theories that some people find credible. For these followers and others, fear of mortal diseases has been replaced by fear of vaccines' secondary effects and the mistrust inspired by vaccination conspiracy theories. In fact, in a recent communication, the WHO and United Nations Children's Fund (UNICEF) warned of an alarming decline in vaccine use and the corresponding negative impact on public health."