A woman holds a sign voicing various conspiracy theories believed by QAnon followers out of the sunroof of a car at the "Reopen Virginia" protest in Richmond on April 22nd, 2020. Three Percenters are a movement that advocates for constitutional rights, and takes its name from the belief that only three percent of America took up arms against the British during the Revolutionary War. (Photo by Matthew Rodier/Sipa USA)
Nay-sayers: a woman holds a placard out of a car sunroof during a 'Reopen Virginia' protest on April 22 © SIPA USA/PA Images

On the morning of Thursday April 16, various anti-vaccination Facebook groups based in the US began to light up.

“Let’s GO California!” read a post on the Californians for Vaccination Choice group. “#OperationGridlock Friday, May 1st at noon”.

The posts were part of a semi-coordinated effort by activists, mainly on the political right, to protest against what they see as the overly onerous lockdowns imposed in most of the country to fight the coronavirus pandemic.

But they also highlighted something of concern to scientists: that even as drug companies around the world race to find a Covid-19 vaccine, some people will still refuse to receive it.

“Our organisation is very concerned about fast-tracking the vaccine without proper study,” says Barbara Loe Fisher, co-founder of the National Vaccine Information Center, one of the most prominent US groups campaigning against mandatory vaccines. “We are worried that corners will be cut and the proper human and animal trials won’t be carried out.”

Academics will be paying close attention to the broader anti-vaccination movement over the coming weeks. Will the deadly reality of a pandemic without a vaccine persuade more people of the importance of vaccinations to guard against any type of preventable disease? Or will the rush to develop one fuel concerns among a minority of people about the safety of inoculation?

Spectrum of doubt

“There is a small, highly organised group of people who are implacably against vaccinations,” says Heidi Larson, director of the Vaccine Confidence Project at the London School of Hygiene and Tropical Medicine. “But there is a whole spectrum of people who are concerned, or are on the fence, about them. This outbreak has the potential to change their minds.”

Initial research by Ms Larson’s group bears this out. A poll it conducted in late March showed that just 5 per cent of people in the UK say they would not take a Covid-19 vaccine if it were available, down from 7 per cent the week before.

But in some places, the opposite seems to be happening. In Austria, where far more people have concerns about the safety of vaccinations, 18 per cent said they would not take a Covid-19 jab, compared with 16 per cent three weeks previously. The figure is similar in France, where 33 per cent — the highest proportion in the world — disagree with the statement “vaccines are safe”, according to a 2018 survey by health research organisation the Wellcome Foundation.

T1K927 Southfield, Michigan, USA. 27th Mar, 2019. Abraham Gontovnik, 72, gets the MMR vaccine at the Oakland County Health Department to protect him against a measles outbreak. Twenty-two measles cases have been confirmed in the area since the visit of an infected traveler from Israel. Nurse Fran McClish administers the shot. Credit: Jim West/Alamy Live News
Better safe than sorry: a nurse administers the MMR vaccine during a 2019 measles outbreak in Michigan © Alamy

In the US, recent outbreaks of diseases such as measles have focused attention once more on the anti-vaccination movement, and have prompted changes in the law. Last year, there were more than 1,200 cases across the country, mostly among people who had not been vaccinated.

In response, states such as New York and California have in recent years changed their laws to prevent people using religious beliefs as a reason not to vaccinate their children. Several of last year’s outbreaks originated among New York’s ultra-Orthodox Jewish communities.

Subsequent studies showed the California rule change in 2016 had not changed people’s attitudes towards vaccinations, but, crucially, had increased their take-up by just over 3 per cent.

“Even this small percentage change means tens of thousands of kids were vaccinated who would otherwise not have been,” says Brian Bloom, professor of public health at Harvard University.

A partisan pandemic

For a population to achieve “herd immunity” against measles, 90 to 95 per cent must have been vaccinated. Researchers warn that if the same turns out to be true for Covid-19, governments around the world will need to adopt the kinds of stringent measures taken by states such as New York and California.

The concern is that while the numbers of people expressing doubts about vaccinations in the US is lower than in many parts of Europe, it is also fast becoming a politically partisan issue.

Some Republicans have been at the forefront of the fightback against stricter state vaccination rules, and now many anti-vaccination groups appear to be taking inspiration from the president himself.

Several anti-vaccination Facebook groups have been posting videos of President Donald Trump’s daily press conferences, praising him for cutting funding to the World Health Organization, for example, while pouring scorn on American public health organisations.

U.S. President Donald Trump speaks during a news conference in the White House in Washington, D.C., U.S., on Thursday, April 23, 2020. Trump’s handling of the coronavirus pandemic and the economic collapse has shaken voters’ confidence in him, with the percentage of undecided voters more than doubling in the last two weeks. Photographer: Michael Reynolds/EPA/Bloomberg
Anti-hero: President Trump's stance on the World Health Organisation has won praise from anti-vaccination campaigners © Bloomberg

Michigan for Vaccine Choice said in a statement to the Financial Times: “The failings of the Centers for Disease Control and Prevention top the list of blunders that have resulted in . . . strategies that have had a catastrophic effect on our nation.”

Whatever progress or setbacks occur in the fight against coronavirus over coming months, some individuals will remain philosophically opposed to the kind of state-led action that researchers say will be needed as and when a Covid-19 vaccine becomes available. “We are against the use of coercion and force in public health policy altogether,” says Ms Loe Fisher.

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