SEATTLE, Washington — Vaccine hesitancy is growing and vaccine-preventable diseases are reemerging. This is a worldwide phenomenon. More pressingly, polls show that significant portions of the populations in countries like the United States, Russia, France and India are unwilling to take COVID-19 vaccines, even after rigorous approval processes. In light of this, one may wonder how global vaccine hesitancy impacts the spread of COVID-19 and what measures effectively promote immunization among reluctant populations.
Vaccine Hesitancy Versus Anti-Vaccination
Vaccine hesitancy is a phenomenon that applies to people who are reluctant to receive vaccinations or vaccinate their children regardless of proven safety. People who are anti-vaccination, or “anti-vaxxers,” belong to a distinct group, though they may also experience vaccine hesitancy. Anti-vaxxers instead affiliate themselves with a movement and culture that politicizes public health measures in the name of personal freedom. Members of this movement argue that vaccinations aren’t safe and challenge laws mandating vaccines among schoolchildren.
Why are people hesitant?
One common reason for vaccine hesitancy is the widely circulated myth that vaccines cause autism. This originated from a 1997 study published by Andrew Wakefield, a British surgeon, which claimed that the measles, mumps and rubella (MMR) vaccine caused autism. The paper has since been retracted and discredited, and England’s General Medical Council stripped Wakefield of his medical license. Still, the effects of his study live on and compound the following reasons for vaccine hesitancy:
- Religious Reasons – Some vaccines use ingredients that people oppose for religious reasons, such as animal-derived gelatin or human fetal tissue. Working around this entails directing further research and innovation toward developing vaccines that align with diverse religious beliefs.
- Safety Concerns – With an abundance of information available, parents can be overwhelmed by research or anecdotes discussing vaccine safety. For instance, news articles occasionally spotlight stories in which a child becomes ill after receiving a vaccine. Stories of this sort often stick in the minds of vaccine-hesitant parents and influence their decisions.
- Personal Beliefs/Philosophical Reasons – Some parents believe that natural immunity is superior. Others believe that contracting a disease as a child will prove beneficial to the immune system in adulthood. Finally, some believe that vaccine-preventable diseases are no longer prevalent and that vaccinations are unnecessary.
- More Information Necessary – Another form of hesitancy develops from the lack of information available to parents regarding the benefits and risks of vaccines. Some parents don’t feel that their child’s pediatrician is accessible to discuss their concerns and fear ridicule. Others may find it difficult to access online or print resources on vaccines.
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In 2019, the World Health Organization (WHO) named vaccine hesitancy one of the top ten threats to global health. Statistics show that vaccine-preventable diseases are on the rise. For example, the WHO reported a 30% increase in global measles cases in 2019. The WHO’s designation is also partly due to the potential global impact of lapses in immunization. As the rapid development of COVID-19 has shown, infectious diseases can spread rapidly across borders. Vaccine hesitancy in one country or region can cause outbreaks in other places with vaccine-hesitant populations, amplifying the disease burden by orders of magnitude.
Vaccine Hesitancy and COVID-19
Researchers speculate that vaccine hesitancy could make herd immunity from COVID-19 and other diseases improbable. Herd immunity occurs when the majority of a population is immune to a disease, preventing the disease from reaching people not yet immunized. To significantly reduce the numbers of COVID-19 globally, the majority of the population would need to receive a COVID-19 vaccine. Despite this, roughly 50% of respondents to U.S. polls from June 2020 were open to receiving a vaccine. Should other vaccine-hesitant countries share similar data, it could mean that the end of COVID-19 is nowhere in sight.
Methods of Addressing Vaccine Hesitancy
The Vaccine Confidence Project (VCP) recently launched with the goal of tracking public sentiment surrounding COVID-19. By using population surveys and social media tracking, the VCP intends to uncover how the public truly feels about the measures governments are taking to contain and treat the coronavirus globally. This project may provide important insights into public sentiment when a vaccine arrives.
Additionally, the WHO routinely publishes the Guide to tailoring immunization programs, which provides countries with resources for diagnosing barriers and motivators to vaccination. More specifically, the guide helps countries identify populations at risk for vaccine-preventable diseases, provide accurate, evidence-based information to ensure vaccine acceptance and understand the vaccination supply/demand-side barriers and facilitators.
The WHO also promotes a ‘Missed Opportunities for Vaccination‘ (MOV) strategy aimed at improving immunization coverage. MOVs are situations in which an individual eligible for vaccination goes to a healthcare facility and completes their visit without receiving the vaccination(s) for which they are eligible. The strategy, which involves fieldwork and monitored interventions, typically reforms practices at existing healthcare facilities that could be providing more vaccinations, but aren’t for various reasons.
While some have valid reasons for their hesitancy, it is important to approach the topic with understanding, research and innovation. As a global community, a sense of urgency is required in resolving vaccine hesitancy, especially when a vaccine for the coronavirus is imminent. Fortunately, there are various organizations and projects that have been working tirelessly to combat vaccine hesitancy.
– Mary Qualls