Confidence Commentary: Blog archive

Politics and public trust shape vaccine risk perceptions

Heidi Larson | 29 Mar, 2018
Nature Human Behaviour  (Published online: 26 March 2018)
There is something about vaccines, and getting vaccinated, that touches nerves – personal, political and cultural nerves. It’s not natural; it hurts (“just a little bit”), and sometimes has side effects. Although these are mostly minor issues, they still provoke vaccine anxiety, reluctance and refusal. Vaccines are regulated, and sometimes mandated, by government, and vaccination is resisted by those who feel their personal freedom is being imposed upon. And those who do not trust the government – often for reasons unrelated to vaccines – sometimes extend their distrust of government to distrust of vaccines, as well as towards the people and systems that deliver them. In addition, vaccines are produced by the pharmaceutical industry, which – even in its most generous and humanity-driven moments – aims to generate profit, provoking public concerns about motives. Finally, adding to these other multiple levers of influence on public trust is a mix of cultural, religious and philosophical views on health and disease prevention. Together, this complex mix of human behaviours shapes the Achilles’ heel of vaccination, mediating and disrupting the potential to leverage the full ‘power and strength’ of vaccine technology.
It is, in many ways, a formidable achievement that local and global immunization efforts over the past four decades have managed to navigate these challenging external factors to achieve relatively high vaccine coverage, at least of basic childhood vaccines. But the tide is changing. What were once isolated, local pockets of vaccine resistance or refusal, whether for political, cultural or other reasons, are now becoming more mainstream, more connected and more complicated to address. The radically changed communication environment allows social media and the Internet to fuel the viral spread of vaccine sentiments globally, as well as allowing organizations of like-minded individuals to connect across remote locations.
It is revealing to look at how memes of quickly spreading vaccine questions and concerns find fertile ground in some settings, and gain little traction in others. In other words, politics and distrust in one setting can fuel a vaccine panic, while the same issues raised in another context can wither and die, with little impact on the vaccine programme.
Consider the recent saga around Dengvaxia, the first promising vaccine against dengue fever, a disease that afflicts millions of people globally. In early 2016, the World Health Organization issued a statement supporting this new vaccine for countries with high burdens of dengue. In April 2016, the Philippines was the first country to introduce the vaccine, and in August 2016, Brazil also approved their Dengvaxia vaccine programme. Both countries were facing serious outbreaks of dengue and the new vaccine was a glimmer of hope to mitigate the individual and social distress caused by the disease…...See full article in Nature Human Behaviour
From the Center for Vaccine Ethics & Policy
Vaccines and Global Health: The Week in Review
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Literature Literature archive

Akseer, Nadia et al. The Lancet , 2018 Lancet Vol 391 (10129):1493 - 1512
Boulton, Matthew L. et al. s 2018 International Journal of Infectious Disease Vol 69:35 - 40
T Chantler et al. 2018 International Journal of Environmental Research and Public Health 15 (4) DOI: 10.3390/ijerph15040667

Videos Video archive

Key figures share their perspectives on a controversy that led to the suspension of Ebola vaccine clinical trials in Ghana.

Drs. Heidi Larson and Pauline Paterson of the Vaccine Confidence Project join episode 50 of the Public Health United podcast with Nina Martin, November 2017.

Drs. Larson and Paterson join a discussion on vaccine confidence at Hong Kong University.  September, 2015.

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