“You can only form the mind of reasoning animals upon Facts: nothing else will ever be of any service to them.”
– Charles Dickens, “Hard Times,” 1854
The anti-vaccine movement shows no signs of abating and is contributing to the resurgence of COVID-19 in both the U.S. and Europe.
Propagated by television personalities, entrepreneurs on social media and, in some instances, elected representatives, vaccine hesitancy has maintained a stronghold and placed all of us at risk of health consequences, economic hardship and interruption of our children’s education and development.
Vitriol continues to escalate on both sides, with those who have gotten vaccinated frustrated with the apparent selfishness and ignorance of those who have refused vaccines. The solution to this impasse is as complicated as the continued evolution and mutations of the COVID-19 virus.
The infrastructures supporting the current stage of the pandemic are misinformation, mistrust and social inequity. Those who decline vaccines, commonly referred to as “anti-vaxxers,” have been found to read more than their vaccinated counterparts and consider themselves more knowledgeable on the subject than health care professionals. There is frequently no hesitancy in those who oppose the vaccine in trying to educate those around them, including physicians, about the truth behind vaccinations, in particular the claim that the vaccine was not studied long enough.
The seeds of this populist argument have been sown by many who financially benefit from these contrarian views, either by selling and promoting natural remedies or generating revenue through increased engagement with their Facebook pages and primetime TV shows.
Attempts to counter this misinformation with facts, which often involve detailed arguments of science and statistics, are simply no match for anecdotes and soundbites such as, “What aren’t they telling us?” Countering misinformation requires establishing trust or availing of the sources already with their circle of influence.
Pithy counterarguments shared by those whom the vaccine hesitant trust can overcome some of this misinformation
As with any infectious illness, the prevention of one infected individual can have a benefit, even lifesaving, to those further down the transmission chain. Although for many the die has already been cast, advocating for the merits of vaccines with the same fervor and conviction as those who offer alternative ideologies remains a valuable tool in this fight against COVID-19.
In addition to anti-vaxxers, those who are socio-economically disadvantaged continue to have high unvaccinated rates. In both the U.S. and Ireland, where vaccine hesitancy is far less prevalent, those with lower household income, food insecurity and job instability face steep challenges in getting vaccinated. Low health literacy levels and mistrust in health care are common among these groups.
In service industries, in agriculture and among those who work more than one job, the economic impact of being away from work for one or two days due to the side effects of the vaccine is a significant deterrent. These populations have also had the highest rates of prior COVID-19 infection, and ongoing debate regarding the immunity associated with a prior infection, also contribute to low vaccination rates. Overcoming these socio-economic barriers would require significant government support and restructuring of large sectors of the economy.
It is ironic, although not surprising, that the challenges of overcoming misinformation and social inequality are much greater than the difficulties in creating a vaccine against a novel virus. As the pandemic enters a new phase, we must target everything that is transmissible, including opinions, wealth and viral DNA.
John J. Ryan, M.D.
John J. Ryan, M.D, is an associate professor in the Department of Medicine, and director of the Pulmonary Hypertension Comprehensive Care Center, at the University of Utah.
Julie Ryan
Julie Ryan, M.D., is a family physician in Tipperary, Ireland, with a special interest in occupational medicine.
They are brother and sister.
