Coronavirus is the day of reckoning for the anti-vaccine movement – Wired.co.uk

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Stefanie Miller* is worried. Ive read that when they gave the Sars / CoV vaccine, it actually caused lesions on the lungs in mice, she wrote in a Facebook group where parents share alternative health advice for themselves and their children. Who knows what damage this one will cause? Soon the post has dozens of replies, with other people most of them young mothers sharing their own fears about a potential vaccine for Covid-19, the disease that has now killed over 376,000 people since it first appeared in Wuhan at the end of 2019.

For most people, the relentless focus on vaccines weve seen over the past four months is a departure from the norm. While for decades vaccines were simply another part of growing up, the race to create a vaccine is now front page news, with progress updates making a regular feature in the UK governments daily press briefings. Conversations about the long-term impacts of coronavirus inevitably veer into the unknowns around a vaccine. How long will it take? Where will it be developed? Who will be the first to benefit if we do get one?

But for a vocal minority, vaccines have always been something to fret about. The Covid-19 pandemic and the subsequent hunt for a vaccine comes at a time when confidence in vaccines is at worryingly low levels in many countries. In a 2018 study for the European Commission, the Vaccine Confidence Project found that in France just 70 per cent of people thought that vaccines were generally safe. In August 2019, after several years of declining MMR coverage, the UK lost its status as a country that has eliminated measles. In late 2018, Brooklyn, New York City saw the largest outbreak of the disease in nearly 30 years.

For many who either delay or refuse to be vaccinated something that the World Health Organisation classes as vaccine hesitancy a rapidly-developed vaccine for a novel disease is precisely the kind of situation they had been discussing in Facebook groups and on YouTube videos for years. In an era of doubt, and amid a soup of online misinformation, confidence in vaccines is under threat like never before.

We need to recognise that there is a general public who have very valid questions and concerns, and we need to engage them because were losing, says Heidi Larson, a professor at the London School of Hygiene and Tropical Medicine and the director of the Vaccine Confidence Project (VCP), which tracks public confidence in vaccines. The VCP has already started measuring public sentiment around Covid-19 and Larson has been sending regular briefings to Public Health England about attitudes in the UK.

The battle over vaccine confidence is most visibly waged online. An analysis of Facebook data from scientists at the George Washington University in Washington, D.C. found that anti-vaccine groups were more effective at spreading their message to neutral Facebook pages than those groups that were explicitly pro-vaccine. As an analysis by WIRED found, anti-vaccine disinformation is often catapulted from more ideologically-driven Facebook pages onto local community pages. There, conspiracy theories jostle for attention alongside posts about church gatherings, local restaurants and road closures.

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Larson says that public health authorities will need to shift their thinking in order to engage with people who are hesitant towards vaccines. For decades public health has largely seen under-vaccination as a problem of access, a matter of making sure that everyone who needed a vaccine has access to one. Indeed, it is a cruel side effect of the Covid-19 pandemic that almost 40 million children in Pakistan missed their polio vaccination after nationwide programmes were halted.

But the nature of vaccine hesitancy is very different. As well as people who are ideologically opposed to vaccination, Facebook groups promoting alternative treatments are full of people who teeter on the edge of vaccine hesitancy and find a responsive audience of committed vaccine doubters armed with reasons why they should shun vaccinations for their children. We're afraid to get out of our traditional box and go into that messy, emotional space. But that's where they all live, says Larson. We need a whole bucket of new tech savvy, smart people who know the current dynamic.

What people see and hear on the news matters as well. In the UK press, and at the government daily briefings, a lot of focus has been put on the speed with which vaccines are being developed. While the government is trying to strike a tone of optimistic reassurance, for some vaccine hesitant people this has the opposite effect. So they are fast-tracking a coronavirus vaccine, one woman wrote in a Facebook post to a group about alternative medicine. No studies of safety or guarantees if indeed it will in fact work.

Several people we spoke to expressed their own versions of these fears. One woman worried about the speed with which vaccines were being developed, and the motivations of companies developing them. Another wondered whether a vaccine would be effective or not, and why some countries had been less affected by the coronavirus than others. One consistent point of worry is whether a coronavirus vaccine will be mandatory or not. On May 4, health secretary Matt Hancock said it was unlikely that any vaccine would be compulsory.

Larson says that the government needs to take more care to keep the public engaged in what is happening with a potential vaccine and to be realistic about the odds of the development efforts succeeding. We don't even know what will happen, she says. There could be all this expectation and nothing. Remember HIV? The vaccine we were definitely going to have in five years, 30 years ago?

There is also an opportunity here to demonstrate the value of vaccines beyond the obvious health benefits. We wouldn't be in lockdown if we had a vaccine. We wouldn't have this total economic disaster if we have a vaccine, Larson says. There could be a generation of people for whom vaccines are not just a momentary childhood inconvenience, but the road that returned us back to normality after an unprecedented level of disruption all over the globe.

Its too early to tell whether Covid-19 will be the moment that arrested the rising tide of vaccine hesitancy, but if that is to be the case, public health authorities will have to find a way to engage those who are already preparing for a fight over a Covid-19 vaccine. So heres the plan, one person wrote on the alternative health Facebook page. Once this coronavirus vaccine comes out us anti-vaxxers need to lie low. [...] it looks like anyone who doesnt comply will be treated as an untouchable.

*Name has been changed

Matt Reynolds is WIRED's science editor. He tweets from @mattsreynolds1

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Coronavirus is the day of reckoning for the anti-vaccine movement - Wired.co.uk