The World Health Organization has named vaccine hesitancy, which the organization defines as a "reluctance or refusal" to vaccinate even when vaccines are available, as one of the top 10 health threats of 2019.
Today considered one of the greatest public-health achievements in modern history, vaccines have been met with skepticism and opposition since they were first introduced in the 18th century. Back then, the disease of the day was smallpox, and inoculation involved placing a slice of smallpox sores into the open wounds of healthy individuals to prevent outbreaks from spreading.
To many, the idea that exposure to an illness might confer protection seemed counterintuitive, but the mechanisms and benefits of vaccinations have been borne out by science. The WHO notes that vaccination is one of the most cost-effective ways to ward off disease, preventing between two and three million deaths every year.
But skepticism persists, thanks in large part to a fraudulent 1998 study from a researcher named Andrew Wakefield. The attorneys representing parents in a lawsuit against measles vaccine manufacturers paid Wakefield to fabricate evidence showing that the vaccines were linked to autism. Despite the fact that the paper was quickly retracted and Wakefield was found guilty of professional misconduct and had his medical license revoked, anti-vaccination sentiment has only become more entrenched in the years since.
Last year in the United States, anti-vaccine "hot spots" cropped up in a dozen states including Arizona, Oregon, Pennsylvania, and Texas, and, as a result, measles outbreaks are also on the rise. And it's not just a problem in the U.S.: Around the world, there was a 30 percent rise in measles cases in 2017 from the year before, according to the WHO, with the disease making a resurgence in countries that were on the verge of eradicating it.
So what can be done?
As Nathan Collins reported for Pacific Standard in 2015, trying to correct false beliefs about vaccines and autism has little impact on anti-vaxxers, but confronting skeptics with the reality of vaccine-preventable illnesses can be more convincing. "[T]elling the stories of children sick with measles, mumps, or rubella using words and pictures did have an effect, especially on those most skeptical of vaccines' safety and effectiveness," Collins wrote. "On average, people were about a quarter of a point more pro-vaccine after seeing those stories, while the most skeptical—those in the bottom third on the initial vaccine attitudes score—were about six-tenths of a point more in favor of vaccination."
It makes sense that a better understanding of what vaccines prevent might change minds. As Pacific Standard reported in 2015:
[Vaccines'] success in eliminating deadly and disfiguring diseases has in part contributed to the recent push-back against childhood vaccinations. Parents worry less about the horrifying symptoms of measles that they've never witnessed than the dozens of inevitable pin pricks and potential fevers their children will endure during the vaccination process.
One of the biggest reasons that more and more parents are choosing not to vaccinate their children could be a lack of trust in physicians, according to Dennis Rosen, a pediatric specialist:
The ongoing erosion of trust in the medical establishment as a whole is also to blame, as frequent reports of dubious financial relationships between physicians, professional medical societies, and the pharmaceutical industry leave many questioning whether or not physicians can be trusted.
Unsure of what to do and whom to listen to, many seek answers to their questions elsewhere, or simply rely on their gut feeling, without speaking to those one would presume to be the most qualified to provide science-based guidance specifically tailored to the patient's own values and cultural sensitivities.
That's why the WHO is dedicated to supporting health workers on the ground all over the world as it confronts this and other top health threats of 2019. "Health workers, especially those in communities, remain the most trusted advisor and influencer of vaccination decisions," the organization writes, "and they must be supported to provide trusted, credible information on vaccines."