The Vaccine Paradox: Why Public Trust in Vaccines is Crucial to Ending the COVID-19 Pandemic

On February 28, 1998, a study was published in one of the world’s oldest and most widely known medical journals, The Lancet, that reported on children who “lost acquired skills, including communication” that was “associated with the measles, mumps, and rubella vaccination” (Wakefield, 1998). When news broke that the MMR vaccine was potentially associated with the development of autism in children, an understandable widespread panic broke out across the globe. Parents, fearful of how vaccination against infectious diseases could negatively impact children, began to coalesce around a behavioral change that continues to carry unsettling implications about immunity in populations — especially in the United States — today.

This behavioral change was, of course, the decision not to vaccinate children at young ages against infectious disease. As a result, “immunization proponents have been forced into a defensive posture” to promote the health benefits of vaccination (Colgrove, 2005). In a hotly divisive political climate like the one we face today where the role of Internet communication faces increased scrutiny over its part played in spreading disinformation, it’s not hard to trace the early roots of the Internet’s role in disinformation back to the anti-vaccination movement that emerged at the end of the 20th century. A parent “seeking to inform themselves by searching online” for information regarding the MMR vaccine “[was] likely to find [web]sites that cast vaccines in a negative light” (Colgrove, 2005). Loss of public trust in immunizations against preventable infectious diseases has been a trend growing at an alarming rate. “This trend is often blamed on the viral spread of misinformation on the Internet, and it plays a role” (Anderson, 2020).

Perhaps most alarming is the fact that when conspiracy theories and misinformation surrounding vaccines can be credibly debunked with facts, scientific research, and widespread consensus among experts that would ideally set at ease any layperson’s hesitancies about vaccination, the facts just don’t work. The report published by Wakefield was ultimately redacted when further research “denounced assertions of a link between MMR and autism” and it was discovered that “Wakefield” had “misled the Lancet editor by concealing the fact that his research had been funded in part by the legal team for parents who believed their children had been injured by the MMR vaccine” (Colgrove, 2005). Yet, despite these facts and the public refutation of the study by the Lancet itself, the seed of distrust in public health had already been planted. Viral misinformation on the Internet is partly to blame. Once an idea gains traction, particularly one of great controversy, it is predictable, by way of human nature, that it will stick around for a while. And that is exactly what happened here.

Adding fuel to the fire were the “unsubstantiated press reports” in the United States spreading “erroneous information about vaccines” (Colgrove, 2005). Faced with unprecedented levels of distrust in public health officials and government agencies, the United States is on a predictable trajectory towards increased infectious disease transmission due to a lower number of immunized individuals in the population. According to the CDC, “the greatest number of cases [of measles] reported in the United States since 1992” was monitored in August 2019 (CDC, 2020). Unsurprisingly, “the majority of people who got measles were unvaccinated” (CDC, 2020). Now, with the COVID-19 pandemic taking the world by storm, the controversy surrounding the efficacy of a vaccine is spreading like wildfire across social media. Questions of a coronavirus vaccine’s safety are being discussed in far-reaching corridors of public discourse from fringe conspiracy groups organizing on Facebook all the way to The White House. None of this is particularly new given the history of distrust in public health and vaccination against infectious disease. But one is left asking how the implications of widespread misinformation will impact the eventual level of resistance to the COVID-19 virus and how a hesitancy to get vaccinated might negatively impact populations who have little control over their own healthcare decisions, such as young children. Wakefield’s erroneous publication set in motion sensationalism around vaccines. Robustly combating widespread misinformation is the only chance we have at rescuing the public from a disastrous immunocompromised fate when it comes to our handling of the coronavirus pandemic. This applies both within the scope of COVID-19 and outside of it; applicable to the recent resurgence of measles and other infectious diseases that are preventable with vaccination. Securing a future in which levels of public trust in government health agencies are at a reasonably high level depends a great deal on “the people’s continued willingness to receive existing and newly developed vaccines for themselves and their children” (Colgrove, 2005). The stakes are simply too high.

References:

Anderson, J. (2020, October 13). Trust in Vaccines (includes Heidi Larson). Retrieved October 23, 2020, from https://globalhealth.washington.edu/news/2020/10/13/trust-vaccines.

Colgrove, J., & Bayer, R. (2005). Could It Happen Here? Vaccine Risk Controversies And The Specter Of Derailment. Health Affairs, 24(3), 729–739. https://doi.org/10.1377/hlthaff.24.3.729.

Gerber, J., & Offit, P. (2009). Vaccines and Autism: A Tale of Shifting Hypotheses. Clinical Infectious Diseases, 48(4), 456–461. https://doi.org/10.1086/596476.

Measles Cases and Outbreaks. (2020, August 19). Retrieved October 23, 2020, from https://www.cdc.gov/measles/cases-outbreaks.html.

Rao, T., & Andrade, C. (2011, April). The MMR vaccine and autism: Sensation, refutation, retraction, and fraud. Retrieved October 21, 2020, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3136032/.

Wakefield, A. J., & Murch, S. H., & Anthony, A…, (1998, February 28). Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children. The Lancet, Vol. 351, 637–641. Doi: https://doi.org/10.1016/S0140-6736(97)11096-0