Vaccine hesitancy, and what we can do about it

Guest blog by Dr Daniel Allington

Delaying or avoiding vaccination costs lives, and yet, for many years, increasing numbers of people have been doing one or both of those things. My colleagues and I have spent much of the last year using surveys and online data collection in the attempt to figure out why some people are less than enthusiastic about COVID-19 vaccination. But people smarter than me have been researching attitudes to vaccination for much longer than that, so I’ve compiled this report in an attempt to pull all the wisdom they’ve produced together.

If you’ve got time, I’d recommend reading it in full. If you haven’t, here are some of the main things that I’ve learned.

First world problems?

Vaccine hesitancy is mostly a problem of the developed world. Negative attitudes towards vaccination are far more prevalent in France and Japan than they are in India or Nigeria. It may be that vaccines have become victims of their own success: thanks to vaccines, fewer and fewer of us in the developed world have direct personal experience of the devastating effects of diseases such as polio, and – lacking that experience – we may find it easier to imagine that the risks of vaccination are comparable.

However, the lamentable rise of online misinformation has undoubtedly also played a role. Indeed, there is a considerable body of evidence to suggest that exposure to online misinformation about vaccines can reduce people’s intentions to be vaccinated. So it’s probably no coincidence that vaccine hesitancy is highest in those parts of the world where people spend the most time online.

Don’t get into arguments

There’s probably no point in arguing with anti-vaxxers. This definitely applies to ordinary people with doubts about vaccines, most of whom do not believe in lurid conspiracy theories about Bill Gates and George Soros. So if you know someone who’s opposed to vaccination, don’t make them feel stupid or defensive – but equally, don’t do anything to affirm them in their false beliefs. We can all do our bit to support vaccination by talking about it as something normal and uncontroversial, and by not saying or doing anything that might help to create an impression of vaccination as something that people might argue about.

(The same principle applies to high profile anti-vaccine influencers such as David Icke and Robert F. Kennedy, albeit in a different way. People like that should simply be denied a public platform. This isn’t a free speech issue, by the way. Nobody thinks that it threatens free speech to punish false advertisers, and these charlatans fall into the same category. They have built a business model around falsehoods that put human life at risk. ‘Debating’ them gives them a dignity they don’t deserve.)

Selling the idea of vaccination

Lastly, there’s a real need for good public health communication. Compulsory vaccination works – but that doesn’t mean that we should resort to such authoritarian measures while viable alternatives remain. In fact, the best approach may be good old marketing. The commercial marketing industry knows how to promote specific products to specific demographics. Social marketing works in the same way. When it comes to vaccines, effective social marketers identify the barriers to uptake of specific vaccines among members of specific social groups, and then work to overcome those barriers through carefully targeted communication campaigns.