In an age when public understanding of science has never been better, you would be forgiven for thinking that belief in supernatural beings and conspiracy theories had had their day. Public trust in science is steadily rising, as Ipsos’ regular study on science shows,1https://www.ipsos-mori.com/researchpublications/researcharchive/3357/Public-Attitudes-to-Science-2014.aspx and 90% of people are happy to place their faith in doctors.2https://www.ipsos-mori.com/researchpublications/researcharchive/3504/Politicians-trusted-less-than-estate-agents-bankers-and-journalists.aspx A growing proportion of us react positively to breakthrough developments such as stem cell research and GM crops. But think again. Another Ipsos MORI survey has 46% of UK adults saying they believe in guardian angels and three quarters of those are convinced that these ethereal presences have helped them out in daily life.3https://www.ipsos-mori.com/researchpublications/researcharchive/2471/Almost-half-of-us-believe-in-Guardian-Angels.aspx What other surprises are lurking behind our society’s otherwise enlightened façade?
The topic of vaccinations provides an unlikely answer to this question. In the 21st century, the value of vaccinations seems all but assured, but the reaction to the United States’ first confirmed death from measles in twelve years and the ensuing debate, was perhaps surprising to many. Dr Mark Schleiss of the University of Minnesota noted that the death happened in a hotspot for religious and philosophical exemptions to vaccines and pointed to the ‘anti-vax’ movement as a possible contributing factor.
Anti-vaccination advocates seem to have little relevance for society at large. A 2006 study conducted at the University of Durham showed that 98% of parents in the UK believe that immunisations are important to the health of their child and in a recent Ipsos study 84% said they believed the benefits of vaccination outweigh the risks.
Nevertheless MMR coverage is only at 92.5%, with lows of 80% of in some parts of the United Kingdom. Although rates are slowly rising from a 15 year low of 80% in 2004, there is still a hesitancy over inoculation, which could be attributed to people’s latent preference for guardian angels over the scientific method, but the shift taps into troubling, and much more widespread trends. Public misunderstanding of the science of vaccination and indifference to the consequences of disease resurgence, combined with feelings of disenfranchisement from health decision-making, gives credence to anti-vax rhetoric and in turn raises challenges for the entire healthcare system, from the pharmaceutical industry to policy makers. How has the anti-vax movement affected public opinion? And what can be done to reduce its impact?
On a basic level, many people currently having children have no direct experience of the kind of diseases that vaccines have now made obsolete. Cases of measles have dropped to around 3,000 a year (with only 3 deaths between 2011-2013) in England and Wales since the vaccine was introduced in 1968, a pattern which is repeated for other former causes of child mortality including polio, whooping cough, diphtheria, mumps and rubella.
Simply put, the impetus to vaccinate has disappeared. But in its place has grown a dangerous complacency, as the measles death in Washington state shows. Isolated fatalities may seem to be of little consequence but ‘herd immunity’, the idea that a population is protected against an infectious disease if around 90-95% are vaccinated, is under threat. The actions of a few have ramifications for the many.
Distrust of government, international organisations and, perhaps most important of all, pharmaceutical companies has a role to play as well. Juniper Russo, a former anti-vax devotee, explains that she “thought that the government wasn’t to be trusted. I very much believed in the idea that there was this big organisation called Big Pharma and I thought that people would be willing to make my child sick to make a dollar”. Anti-vax websites and message boards are littered with similar sentiments challenging the right of governments to impose vaccinations and lambasting “complete, abject fraud and failure” in the pharmaceutical industry.
Given that trust in pharmaceutical companies and big business in general is low, not helped by recent allegations of widespread corruption and data security breaches, it doesn’t take much for the suspicions stirred up by anti-vax conspiracy rumours to become entrenched in the public imagination. Out of the previous sample of parents who almost unanimously agreed on the importance of vaccination per se, 83% say that they do not believe that the MMR vaccine is completely safe. This points to a ‘David and Goliath’ theory of anti-vax popularity: if people see pharmaceutical companies accused of, for example, bribery in China, it’s not much of a leap of faith to believe that they could be systematically selling harmful products for their own monetary gain. It is clear that part of reversing the trend lies in pharma companies communicating more openly and effectively and in a way that restores public trust.
Distrust of medical manufacturers and elites, the rise of conspiracy and ‘alternative’ theories of health spread by the internet, plus low incidence of disease as a result – ironically – of previous generations’ adoption of vaccines, have fed into a wider trend of societal disengagement from health systems in general. As a result, measles is now on the rise in England.
This multifaceted view of the anti-vax trend shows that is not an isolated problem. So the solution must also be multifaceted: effective campaigning has to take into account the myriad drivers of anti-vaccination sentiment and work on breaking down the barriers that have been constructed by public perception of the pharmaceutical industry and widespread disengagement from health infrastructure.
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