In November 2012, the Welsh city of Swansea was hit by a unusually destructive measles outbreak. Sparked off by a handful of children who picked up the virus after returning from a holiday camp, over six months the epidemic would would infect at least 1,202 people and lead to the death of one 25-year-old man.
But the seeds of the Swansea measles epidemic were sown 16 years earlier. In July 1997 a local Swansea newspaper, the South Wales Evening Post, ran the first article in a campaign questioning the safety of the MMR vaccine, which protects against measles, mumps and rubella. In areas where the Evening Post was distributed, the number of people receiving the MMR vaccine declined from 91 per cent before the campaign to 77.4 percent afterwards. While it is impossible to draw a conclusive link, one thing was certain: by November 2012 the number of young people in Swansea who had no protection against measles at all was dangerously high.
“It was well known that Swansea had been sitting on this ticking bomb, and it just happened to be that particular year that it took off,” says Sebastian Funk, associate professor of infectious disease epidemiology at London School of Hygiene and Tropical Medicine. Twenty years after the Evening Post’s campaign the influence of local newspapers has waned, but a steady stream of new players has stepped in to fill the misinformation void, and vaccine scepticism seems to be on a worrying rise.
Type “vaccine” into Facebook’s search bar and you’ll be steered towards a plethora of anti-vaccine groups, each with its dedicated community of so-called anti-vaxxers. First you have the groups that are straight-up about having an axe to grind: Rage Against Vaccines (35,000 likes), Stop Mandatory Vaccination (127,00 likes) and Learn the Risk (80,000 likes). Once they’ve answered three questions signalling their vaccine scepticism, followers are invited into an echo-chamber where parents share tips about avoiding vaccinating their children and memes deriding “pro-vaxxers”.
Other groups couch their anti-vaccine stance more subtly. The National Vaccine Information Center (212,570 likes), is a US non-profit with a Facebook page dedicated to sharing articles warning about the health impacts of vaccines. On its “related pages” sidebar, Facebook points followers towards a page called Dr Tenpenny on Vaccines and Current Events (230,000 likes) – where a self-described holistic health specialist implies that vaccines are unsafe, are based on flawed research and have nothing to do with the eradication of disease.
On Amazon Prime Video a search for “Vaccine” directs people to Vaxxed: From Cover-Up to Catastrophe – a pseudoscience documentary directed by Andrew Wakefield, a former doctor who, in 1998, released a fraudulent and widely-debunked paper asserting a link between the MMR vaccine and autism. Since being struck off the UK medical register, Wakefield has embarked on a second career as a vocal anti-vaccine “truther”. Amazon’s “customers also watched” bar directs Vaxxed viewers to other pseudoscientific films with names such as Injecting Aluminum, Anthrax-Smallpox Vaccinations and the Mark of the Beast and Man Made Epidemic. A campaign to make a sequel, called Vaxxed II: The People’s Truth has already raised $86,500 (£66,000) on the crowdfunding site Indiegogo.
“I hear it in all corners of the world – this anxiety against all the evidence,” says Heidi Larson, an anthropologist and co-founder of The Vaccine Confidence Project – a group that monitors public confidence in immunisation globally. “Now things aren’t at a panic situation, though maybe they should be. But this is kind of a slow burn - a growing kind of hubris.”
Vaccine skepticism is mounting, and the effects might already be starting to show. In the first 10 months of 2018, Europe saw 54,000 confirmed measles cases – twice the 2017 total and a 20-year high according to the World Health Organisation. Between 2000 and 2017, the percentage of children receiving the first dose of a measles vaccines decreased in nine EU member states and as of 2017 eight EU member states – including the UK, France, Italy and Greece – don’t have high enough first-dose vaccination rates to ensure herd immunity. Of the 17 states that do have high enough vaccination rates, eight of those are also witnessing declining vaccine uptake.
The factors behind vaccination scepticism are complicated, Larson says. Parents, for example, might feel overwhelmed by information, or ill-informed about the vaccine options out there. But some anti-vaxxers are also part of a wider movement of people who deliberately shun scientific consensus in favour of a conspiracy-laden worldview. “There is a very strong and I think, growing movement of it almost being an identity thing,” says Larson. On Twitter and Facebook the fitness guru Ben Greenfield, founder of the supplement firm Kion, often points his followers towards anti-vaxxer material. On Facebook pages, vaccine sceptics readily swap alternative medicine tips and conspiracy theories.
For Larson, the anti-vaxxer movement is another sign that something is seriously broken when it comes to public trust in science. “I think we need clear and good evidence and to be ready with it, but it’s not going to fix this. We’ve waited way too long. This is about broken relationships. It’s about deep distrust. It’s about alternative beliefs that are stronger than their belief in the vaccine.” And divide between the people with faith in science and sceptics is carved even deeper by Russian bots pushing anti-vaxx content on social media.
So how do we tackle this mounting distrust? Larson says it’s key that we keep building the confidence of the majority of people who do still have confidence in vaccines. As Funk notes, overall European vaccine rates are close to their historic highs – and despite recent blips they have steadily been increasing since the 1990s. “What really matters is what are called pockets of susceptibility,” he says. “You can have high coverage nationwide, but if you have population groups or age group in which the coverage is low, you can still have large outbreaks even though the overall level of vaccinations is comparatively high.”
Facebook is making the first murmurings that it’s about to take anti-vaccine content more seriously. In a statement provided to WIRED the social media firm said: “We’ve found that anti-vaxx content doesn’t get relatively broad distribution in [news feeds] or on the platform generally, but it can surface in groups and in search, so we’re exploring additional measures to best combat the problem.” Pinterest, however, has gone much further – making it impossible for people to search for vaccine content on its platform altogether.
But it’s also important to keep an eye on where misinformation will crop up next. At the Vaccine Confidence Project, Larson has helped developed the Vaccine Confidence Index – a tool that monitors public confidence in immunisation in the hope of detecting early warning signs if vaccine confidence dips in a particular area. For Larson and her colleagues, stopping more people from falling into the trap of vaccine scepticism is vital to help us inch towards herd immunity levels. “We need to build the confidence of the majority of the population that still take their vaccines and still believe that this is the right thing to do.”
This article was originally published by WIRED UK
