George Bernard Shaw said, “Beware of false knowledge; it is more dangerous than ignorance.” Shaw lived in a time before the emergence of the internet but certainly not without the circulation of false information.
Unfortunately, false information has always existed, but the emergence of online platforms has provided fertile ground for vaccine myths and untruths to take hold.
The Science Foundation Ireland (SFI) and Dublin City University ( DCU) project entitled “Voices for Vaccines” brought together parents and guardians from diverse groups with communications researchers to co-create messages that inspire confidence in the science behind vaccines and counteract misleading or false vaccine information.
Researchers translated these messages into health communication materials, including the “About Vaccines” website and health information resources aimed at parents, early-learning educators and health professionals. These materials provide simple, plain and accurate information on childhood vaccination.
When leading group discussions about vaccine safety, the researchers found, as expected, that most participants were concerned about one of the top vaccine myths that persists today – the spurious link between the measles, mumps, rubella (MMR) vaccine and the onset of autism.
The widespread fear that vaccines increase the risk of autism originated in a 1998 study by Dr Andrew Wakefield published in The Lancet.
Wakefield’s now-discredited work erroneously suggested that the MMR vaccine increased autism in children. Despite the retraction of the research paper that fostered the myth and the research wholly discredited due to serious procedural errors, undisclosed financial conflicts of interest and ethical violations, some still took the hypothesis seriously. Accordingly, several other major studies were conducted, with no one finding a link between any vaccine and the likelihood of developing autism.
To prevent the resurgence and circulation of vaccine-preventable illnesses such as measles, the vaccine uptake rate amongst the public must be 95pc. The 95pc rate is essential for keeping everybody safe from measles, but it is particularly vital to protect babies as they cannot receive the MMR vaccine until 12 months old and are vulnerable to infection.
In Ireland, following the initial panic attributed to the Wakefield vaccine myth and following a significant drop in vaccine rates, in 2000, there was a measles outbreak of over 1,600 cases in the Dublin area. While MMR vaccine uptake returned to high levels in Ireland, the legacy of Wakefield’s false claims continues. In 2018 a measles outbreak left a large proportion of adolescents and adults who were not vaccinated or only had one dose of the MMR vaccine particularly vulnerable to infection.
Fast-forward 24 years from the publication of Wakefield’s “research”, one focus group participant described the effect of the vaccine-autism myth as a “niggling doubt that is always in the back of your mind”.
The escalation of this doubt about the safety of vaccines or other drivers of vaccine hesitancy can result in delayed acceptance or refusal of vaccines, leading to parents’ low uptake of childhood vaccines. Vaccine hesitancy is the reluctance or refusal to have oneself or one’s children vaccinated despite the availability of vaccination. People can be hesitant about or refuse vaccines for several reasons. These include access to the correct information, peer influence, reasoning driven more by personal values than scientific fact, distrust in those responsible for rolling out vaccines, and the belief that the risk of vaccine-preventable diseases is low.
Vaccine hesitancy varies across individuals, regions, cultures, and time periods. In some cases, there may be emotional, cultural, social, or political elements to it.
The one thing that emerged from these group discussions is that vaccine hesitancy is real.
Before the measles vaccine’s introduction in 1963 and widespread vaccination programmes, an estimated
2.6 million people died globally each year of the disease. Even in the 1970s, an average of seven children died from measles in Ireland a year.
Irish vaccination programmes had eradicated smallpox, and the expectation was it would eventually eradicate measles. However, outbreaks of vaccine-preventable diseases such as measles have increased in Ireland due to falling vaccination rates.
With the emergence of social media channels, the proliferation of vaccine misinformation and disinformation, has undoubtedly contributed to the decline in vaccination compliance by undermining public confidence in scientific evidence. The accessibility of communication and social media platforms presents parents with a deluge of conflicting information about childhood vaccines. They profess to find it challenging to distinguish the wheat from the chaff.
For vaccine information campaigns to be successful, people need access to accurate and straightforward health information and, importantly, be able to evaluate what information is accurate and what is not. This is essential to vaccine uptake amongst parents and in protecting ourselves and our communities from vaccine- preventable illnesses.
Further, diverse public participant projects like “Voices for Vaccines” are essential to the success of health information campaigns. Including and representing all voices ensures evidence-based information is accessible and tailored to address all parents’ questions and concerns to help them make vaccine decisions and choices. False knowledge is dangerous but it is also dangerous to assume that vaccine-hesitant individuals are so as a result of ignorance, as the research shows this is rarely the case.
Without a doubt, we need to understand the complex and varied reasons people avoid or delay vaccination.
The public participant co-creation approach to the aboutvaccine.org website launched this month uses parents’ voices to understand and address childhood vaccine questions and concerns and goes some way to tackling vaccine hesitancy.
Barbara Gormley, MPRII, Pandemic Communications Researcher, Lecturer in Public Relations & Health/Science Communications