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Confronting Anti-Vaccine Activism with Counter Narratives

A 21-person commission of public health experts urges the development of networked communities

Boston University School of Public Health
Published:Mar 06, 2023
|3 min read
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Public and private sector health officials and public policymakers should team up immediately with community leaders to more effectively disseminate accurate narratives regarding the life-saving benefits of vaccines to counter widespread, harmful misinformation from anti-vaccine activists in the United States, according to a new Viewpoint piece in The Lancet, led by authors at Boston University School of Public Health (BUSPH), University of California, Riverside (UCR), and The Stanford Internet Observatory Cyber Policy Center (SIO) at Stanford University.

Published in the leading international medical journal, the Viewpoint provides valuable insight into the recent developments of US-based anti-vaccine activism and proposes strategies to confront this dangerous messaging.

“Messages of health freedom 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, & management at BUSPH, and who was one of three lead writers of the Viewpoint, along with lead author Richard Carpiano, public policy professor at UCR, and third author Renee DiResta, technical research manager at SIO.

In the Viewpoint, 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 that associate refusing vaccines with personal liberty. This narrative was consistently 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 worldwide.

The authors underscore the need to consistently amplify accurate science and information through multiple communication channels, to avoid the spread of inaccurate or misleading information to people through limited sources. 

“This is a matter of life and death,” says Carpiano. “People don't always see it that way. We've forgotten how many people have died, have been sick, or continue to get sick from COVID-19 as well as many other vaccine-preventable diseases.” 

The paper comes out at a time when more than 1.1 million people have died from COVID-19, and the worldwide toll is estimated at 6.8 million. The disease continues to spread as vaccines have been found to greatly reduce illnesses that require hospitalization or result in death.

Anti-vaccination activism has existed as long as there have been vaccines. But the movement picked up steam in 1998 when British physician Andrew Wakefield published a now-discredited study that falsely claimed a link between childhood vaccines and autism.

In more recent years, however, anti-vaccine messaging shifted in large part from health-effect concerns to conservative and libertarian political identity arguments of medical freedom and parental rights. This was prompted in part by legislative efforts in several states to eliminate personal belief exemptions from school vaccination requirements in response to falling child vaccination rates and vaccine-preventable disease outbreaks. But these arguments were confined to childhood vaccines and were somewhat contained. 

Since the COVID-19 pandemic affected the entire population, it brought on a vast expansion of not only anti-vaccine activism, but more broadly, anti-public health activism as people faced the inconveniences of mask-wearing, social distancing, closed restaurants and bars, and cancellations of concerts and other events that draw crowds.

Celebrities, wellness influencers, partisan pundits, and certain scientists and clinicians, among others, joined the fray, often spreading false and misleading claims about vaccinations. The increasing number of voices found larger audiences, which meant more votes for right-wing candidates, and greater monetization of right-leaning social and media outlets.

“As celebrities, influencers, and politicians started speaking out negatively about vaccination, growing segments of the American public were exposed to these messages, shifting troubling proportions of the US public who had previously vaccinated in other contexts against getting vaccinated for COVID-19,” Callaghan says.

The result was more people becoming ill.

“Political leaders were sadly, particularly effective anti-vaccine messengers, and because of that, we now have clear disparities in COVID-19 vaccination rates across party lines” he says.

Meanwhile, pro-vaccine messaging has 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 director of the US Centers for Disease Control and Prevention Rochelle Walensky, who the authors say are outgunned.

Callaghan, Carpiano, and DiResta were part of the Commission on Vaccine Refusal, Acceptance, and Demand in the USA that The Lancet convened to examine issues surrounding COVID-19 vaccine acceptance uptake, acceptance, and hesitancy. The membership is composed of 21 national experts from public health, vaccine science, law, ethics, public policy, and the 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 antivaccine movement.

“Without concerted efforts to counter the anti-vaccine movement, the USA faces an ever-growing burden of morbidity and mortality from an increasingly under-vaccinated, vaccine hesitant society,” the authors conclude in the paper.

- This press release was originally published on the Boston University School of Public Health website