The Explainer: Vaccine Hesitancy

Kirstin R.W. Matthews studies regulation and ethical issues associated with emerging biotechnology, including vaccines, stem cells and genomic medicine. We asked her to explain what factors lie behind vaccine hesitancy and anti-vaccine rhetoric.

How long have vaccines been used to prevent contagious (or once-common) diseases?
Scholars believe vaccines date back as far as 1000 B.C. in China. The most notable example of early vaccine use was by Edward Jenner in 1796, when he used material from cowpox blisters to prevent the deadlier smallpox. At the time, smallpox was a devastating disease, but now it is only found in historical references as it was eradicated through vaccination in the 1970s.

Is mistrust in vaccines a new phenomenon, or has it been around since the days of Edward Jenner?
Vaccine hesitancy likely started soon after vaccines were first used. Some believed it was against God’s will. Others just found it unnatural. It can also be an odd concept to give someone medicine when they are not sick. Therefore, it isn’t surprising that some people might fear that the vaccine
itself makes you sick instead of protecting you.

You’ve been researching public testimony against vaccine bills in the Texas Legislature. What have you learned?
Our research found five top myths perpetuated by anti-vaccine advocates in Texas:

Myth 1: Vaccines are ineffective.
Fifty years of data demonstrates that vaccines prevent disease, and the World Health Organization estimates that approximately 4 million deaths each year are saved due to vaccines.

Myth 2: Herd immunity is not real.
This is also false. By making sure the overwhelming majority of individuals are vaccinated, we are able to protect the few who cannot be.

Myth 3: Vaccines shed disease.
Only live vaccines shed disease, like the oral vaccine for polio, and these are no longer being used. The COVID-19 vaccines by Moderna and Pfizer, for example, use mRNA and not the virus, so your body is never exposed to the actual COVID-19 virus.

Myth 4: Vaccines are more harmful than the disease it prevents.
This is a common misconception. Looking at current events, before COVID-19 vaccines were widespread in the U.S., more than 600,000 people died of COVID-19. Now, the overwhelming majority of COVID-19 cases (more than 95%) are from unvaccinated individuals.

Myth 5: Unvaccinated kids do not spread disease.
While vaccinated kids can still get vaccine-preventable diseases, almost all cases of outbreaks originate in unvaccinated individuals. An example is the 2015 measles outbreak at Disneyland, which was traced to an unvaccinated person.

What does your research reveal about changing hearts and minds around this issue?
Our goal is less to argue and debate with anti-vaccine advocates, but to inform legislators, policymakers and concerned parents and help dispel myths and misinformation about vaccines. We want to impact the people who are being bombarded with misinformation and help them make more informed evidence-based decisions, which is probably not reaching them with the same intensity. Providing clear, reliable and updated information is fundamental.

Are there any trends that lead you to be more optimistic about raising vaccine rates?
I always try to stay optimistic. We have high COVID-19 vaccine rates in the highest-risk groups, including the elderly and health care workers. The vaccine is now available for anyone in the U.S. 12 years and older to obtain it, and soon for kids under 12. We’ve increased access and availability — you can get it at the grocery store or pharmacy now. Now that Pfizer has received full approval — versus just emergency use — from the FDA, I’m optimistic that Moderna will receive the same very soon, leading more people to get the vaccine now.

Kirstin R.W. Matthews is a fellow in science and technology policy at Rice’s Baker Institute for Public Policy and a lecturer in the Department of BioSciences. Her research focuses on ethical and policy issues at the intersection between traditional biomedical research and public policy.