Vaccinations and misinformation

A couple of years ago I was playing with different forms of writing (i.e., not just papers), and so wrote a few pieces responding to media events (including around ‘fake news’ and evidence evaluation). I pitched this one to The Conversation after Pauline Hanson had said something about vaccinations in Australia, but was 24 hours too late for the news cycle unfortunately. I see there’s a new report out on anti-vaxxers spreading misinformation on social media, so thought I’d share that original piece here if nowhere else.

On vaccinations, like climate change and smoking before that, we must not allow a minority of science denialists to create a false equivalence and set the terms of discussion.

In Australia, the parents of over 90% of children agree with the medical advice regarding the importance of vaccination, with their children receiving the full vaccine schedule. That should be the first response to anyone who attempts to shift the terms of debate to create a false equivalence between the majority, and the minority of parents who do not vaccinate. Action is needed to increase that percentage for the full benefits of vaccination, however when Pauline Hanson and others use parental choice as a buoy for populist anti-science attitudes, they ignores the fact that most parents do choose to vaccinate.

Unfortunately, as we have seen in a number of recent cases, it is entirely possible to manufacture anxiety, and to translate that anxiety into voter behaviour. Indeed, psychological research into the illusory truth effect indicates that repeated exposure to misinformation leads to people being more inclined to believe that misinformation. Perhaps most concerning, recent research by Lisa Fazio and colleagues indicates that even knowledgeable people – people who know that the information they are receiving is not true – are susceptible to this effect.

By repeating the misinformation – even in the context of debunking – that we should be concerned about the safety of vaccinations, we may inadvertently exacerbate exactly the anxiety we want to alleviate. In fact, strategies that leap to immediate dismissal through repeated debunking can lead to a backfire effect: the strengthening of the belief in misinformation. This is particularly true given the tendency of anti-vaccination proponents and climate change denialists alike to operate on a shifting sand of claims; no sooner is a myth about autism and the MMR vaccine debunked than the denialist moves onto the safety of mercury (which, in Australia, is not present in any vaccines in any case).

Politicians spreading misinformation does provide us with an opportunity to correct that misinformation, and expose politicians’ poor understanding of evidence. However, we must also recognise that even when we debunk, indeed even when politicians apologise (albeit conditionally), for their misinformation, such rhetoric has lasting impact.

In climate science, the excellent ‘Debunking Handbook’ resource guides science communicators to lead with facts, maintain focused arguments, warn people before restating a myth (not after), and provide an alternative with an overall message that aligns with person’s world-view.

The facts are, most people choose to vaccinate, with rates of over 90% stable. Of the remaining parents, over half face access barriers of some kind. The provision of greater support for these parents, from simple reminders, through to economic support, would support increases in vaccination rates. The ‘No Jab No Pay’ scheme, which removes various benefits from those who do not vaccinate their children, is a stick towards this ends. Understandably there has been some concern that the scheme may reduce trust in the system overall. The 2-3% of ‘conscientious objectors’ – those who reject all vaccines and their basis in science – may no longer register their objection in order to avoid this penalty. The concern is that the penalty may galvanize the skepticism of an overwhelmingly middle-class group, most able to absorb the financial penalty.

Instead, health groups have called for a greater focus on grass-roots community-oriented communications and health-care provider support. In the UK context, we have seen that as funding for health visitors and other community-based health providers fell, so did vaccination rates.

On vaccinations as on other areas of science, the terms of discussion must not be set by a minority who peddle denialism. We should instead lead with the enormous benefits of vaccination as a collective responsibility; one that most parents recognize, and only then mention politician’s misinformation. It is not good enough to denounce hesitant parents; more attention is needed on strategies to work with those who face barriers and to communicate effectively, at a local level. If politicians care about informed parental choice, they should advocate for programs that support immunization campaigns in local communities – particularly those with historically low rates.

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CC BY-ND 4.0 Vaccinations and misinformation by Simon Knight is licensed under a Creative Commons Attribution-NoDerivatives 4.0 International License.

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