Increasing attention is being paid to the pervasiveness and ubiquity of “fake news”, unverified sources feeding misinformation with the intention to push agendas and spread paranoia and fear. Now, more than ever, seeds of distrust and skepticism in science and medicine are being sown into the public. Many people often find themselves on one side or the other in the hotly debated topic of vaccinations, and many people find themselves teetering in the middle, unsure of where a line should be drawn. This is not surprising. After all, along with Andrew Wakefield’s purported link between autism and vaccination, there seems to be an infinite supply of “studies” depicting all of the grisly effects that vaccines seem to cause, and in a time when it can be difficult to determine what is real or fake online, how do scientists make sure that real data is reaching the public, and how does the public discern true or false information?
The consequences of the evolving anti-vax movement are clear: this year, the Centre for Disease Control reported the highest number of new measles cases in the past 27 years with over 1,000 confirmed cases in 2019 alone. The World Health Organization (WHO) has declared vaccine hesitancy to be a top threat to global health in 2019 where vaccination rates have been dropping steadily. For example, the rate of vaccination against measles in 2015 was 89%, while the target for herd immunity against measles was 95%. This is a particularly unsettling statistic given that herd immunity relies on sufficiently vaccinated individuals within a community to ensure protection for more vulnerable populations like children, the elderly, and the immunocompromised. Corresponding to this drop in vaccination rate, there has been an increase in the number of reported measles outbreaks all over the world in recent years, including 31 states in the United States and several provinces in Canada, Europe, and Australia. Somewhere along the line, the public no longer seems to trust scientists and medicine in general, and that is the root of the underlying problem. According to an online survey conducted by the Angus Reid Institute in Vancouver, BC released in February of this year, a staggering 29% of those aged between 35 and 54, and 36% of those aged 55+ say that the science on vaccinations is not clear. What’s more concerning is that approximately 25% of Canadians surveyed across all age groups say they are concerned about serious side effects from vaccines. Even more surprising, individuals living in wealthier countries are more likely to be skeptical of the benefits of vaccines, says a study of 140,000 people conducted by the London-based organization Wellcome, with Japan and Ukraine having the lowest trust in vaccine safety.
In light of these findings, what is being done to address these issues? In Canada, only New Brunswick and Ontario legally require children to be vaccinated to attend school. Under the Immunization of School Pupils Act in Ontario, parents must provide proof of immunization against diseases such as measles and whooping cough for their children. The province has also introduced a mandatory educational course for parents who wish to obtain a non-medical exemption for vaccines. This attempt at active outreach was met with failure. Despite being educated on common myths about vaccines, the vast majority of participants still went on to seek vaccine exemptions. More optimistically, New York has passed a law that ends religious exemptions for vaccines and bars unvaccinated children from schools and daycares, in response to a measles outbreak that began in 2018. Children may only return to school if parents can provide proof of vaccination. Global entities such as the WHO, as well as the Government of Canada, provincial governments, and health care professionals provide abundant information for parents seeking information regarding childhood vaccinations. Clearly, there is not a lack of information for vaccine hesitant individuals. Perhaps, then, the reason why people can’t trust science is that they can’t interpret the results for themselves.
Scientists, who are publicly funded, have a responsibility to share and communicate their findings, not only within the scientific community, but also to the public. Unfortunately, this is easier said than done. Most scientific papers are locked behind paywalls and are written with an abundance of jargon and complicated language that is hard for other scientists, let alone the public, to understand. Dr. William Hedley Thompson’s group at the Karolinska Institute in Stockholm conducted a study of reading ease of over 700,000 published abstracts, and found that since 1881, scientific articles have become increasingly difficult to read. The organization Vaccinate Your Family, based in Washington, D.C., aims to address this by not only providing comprehensive information on recommended vaccines in different stages of life, but also teaches how to evaluate studies and determine whether they are using good science. Similarly, organizations across Canada are providing training for healthcare professionals to address patient concerns. However, anti-vaccine groups continue to promote pseudoscience that is made viral by numerous social media sites. This is a difficult problem to combat, and perhaps more active strategies are required to overcome it. In 2016, the Government of Canada began the Immunization Partnership Fund, which receives $3 million per year over the course of five years. Their goal is to increase access to vaccines, as well as to improve vaccine education. As of today, several projects have already been completed, such as an electronic immunization reminder system in British Columbia, and an assessment of Canadian vaccination policy to guide improvements. More projects are still ongoing; for example, the Canadian Paediatric Society has developed workshops to help healthcare professionals understand the reasons behind vaccine hesitancy and teach how to counsel those who are debating vaccinations. A company called CANImmunize Inc. is also developing an app that utilizes smartphones and web-based access to track immunization schedules for Canadians that is tailored to each individual and the province or territory in which they live. The success of these projects is yet to be determined.
The rise of social media has been key for individuals to find like-minded communities where they can share and propagate fake science. The danger of social media is especially evident when supporters against vaccines use social media to elevate baseless accusations about vaccines and utilize eye-catching images to increase the visibility of their rhetoric without any scientific data. This is further complicated given that a considerable amount of social media activity is pushed by automated bots. An analysis of data from Twitter in 2018 revealed that these bots were much more active than the average user and flooded the website with anti-vaccine content. While social media platforms have largely taken a hands-off approach to regulate anti-vaccine content, Pinterest and Facebook and its recently acquired sister company, Instagram, have implemented strategies to redirect individuals seeking vaccine-related information to official public health organizations. Facebook has also announced that educational pop-up windows will appear when people search for vaccine-related content. While we have yet to see the effectiveness of these policies, the scientific community should utilize the pervasiveness and ubiquity of social media to counter the spread of misinformation on vaccines. The insurgence of the anti-vaccine ideology is endangering the future of public health, and the scientific community and its supporters need to push back to ensure the safety of our communities.
- Who are the anti-vaxxers? Here’s what we know – and how they got there in the first place. (Mar. 27, 2019). Retrieved from https://nationalpost.com/news/canada/who-are-the-anti-vaxxers
- Measles quarantine issued at two California universities. (Apr. 28, 2019). Retrieved from https://www.cnn.com/2019/04/25/health/california-universities-measles-quarantine/index.html
- Ten threats to global health in 2019. Retrieved from https://www.who.int/emergencies/ten-threats-to-global-health-in-2019
- Vast majority of Canadians say vaccines should be mandatory for school aged kids. (Feb. 21, 2019). Retrieved from http://angusreid.org/mandatory-vaccination-canada/
- Ontario’s mandatory class for parents seeking vaccine exemptions has ‘zero conversions’. (Mar. 15, 2019). Retrieved from https://nationalpost.com/news/ontarios-mandatory-class-for-parents-seeking-vaccine-exemptions-has-zero-conversions
- Immunization Partnership Fund. (Aug. 19, 2019). Retrieved from https://www.canada.ca/en/public-health/services/immunization-vaccine-priorities/immunization-partnership-fund.html
- Broniatowski, D. A., Jamison, A. M., Qi, S., AlKulaib, L., Chen, T., Benton, A., Quinn, S. C., Dredze, M. (2018) Weaponized Health Communication: Twitter Bots and Russian Trolls Amplify the Vaccine Debate. Am J Public Health. 108(10):1378-1384
- Facebook debuts vaccine pop-up windows to stop the spread of misinformation. (Sept. 4, 2019). Retrieved from https://www.cnn.com/2019/09/04/health/facebook-vaccine-education-bn/index.html
- Malicious bots and trolls spread vaccine misinformation – now social media companies are fighting back. (Sept. 18, 2019). Retrieved from https://theconversation.com/malicious-bots-and-trolls-spread-vaccine-misinformation-now-social-media-companies-are-fighting-back-123430
- Plavén-Sigray, P., Matheson, G. J., Schiffler, B. C. Thompson, W. H. (2017) The readability of scientific texts is decreasing over time. Preprint on bioRxiv at http://doi.org/10.1101/119370
- New York Ends Religious Exemptions For Required Vaccines. (Jun. 13, 2019). Retrieved from https://www.npr.org/2019/06/13/732501865/new-york-advances-bill-ending-religious-exemptions-for-vaccines-amid-health-cris