By FELICIA D. GOODRUM STERLING, PhD and HEIDI L. POTTINGER, DrPH, MPH, MA
The measles outbreak in Washington state this week has brought new attention to the anti-vaccine movement. In fact, the World Health Organization recently identified “vaccine hesitancy” as one of top threats to global health. In the US, the number of unvaccinated children has quadrupled since 2001, enabling the resurgence of infectious diseases long-since controlled. In fact, the WHO claims a staggering 1.5 million deaths could be prevented worldwide by improved vaccination rates.
Amidst the media and public health outcry, a mystery persists: Why has vaccine hesitancy continued, despite years of vigorous debunking of shoddy science? The answer may lie in a deeply-rooted distrust of doctors and science.
One of the authors of this article, Dr. Pottinger, surveyed hundreds of Arizona parents, from schools with exemption rates greater than 10%, about their perceptions on vaccines. Pottinger and colleagues found the vast majority of the parents surveyed who delayed or chose not to vaccinate their children did so because of true personal beliefs and not convenience. Specifically, they tended to distrust physicians and information about vaccines or held misperceptions about health and disease, including the idea that immunity by natural infection is more effective or that vaccine-preventable diseases are not severe.
These beliefs, stoked by a fraudulent 2010 study, have proven almost impossible to shake—despite the fact that the debunked study, based on 12 children, was retracted due to serious ethical violations and scientific misrepresentation; authors cherry-picked and fabricated data, and the first author had undisclosed business interests in the vaccine industry.
The failure of many interventions to dispel misinformation demonstrates the power of a complex interaction of confirmation bias, cognitive dissonance, distrust in data sources, and personal experiences and narratives. Taking them on requires that the healthcare community effectively spread the following messages.