BY RICHARD M. CARPIANO and JASON CHUNG (12)
It’s a scary time for many parents and their children in Washington, Oregon, and New York, which are currently experiencing measles outbreaks. The vaunted herd immunity that has kept Americans safe for the past few decades is being eroded—via lower child vaccination coverage in communities throughout the US due to an increase in vaccination exemptions.
For years, fingers have been pointed at discredited doctor Andrew Wakefield for starting the spread of the now-debunked link between autism and the measles vaccine. Likewise, social media misinformation campaigns from so-called mommy blogs and anti-vaccination (often termed “anti-vaxxer”) activist groups have been effective in propagandizing pseudo-science ignorance among parents and politicians alike through websites, online ads, phony-expert panel talks, celebrity allies, online and in-person “word-of-mouth,” and aggressive political lobbying.
But blaming anti-vax zealots for spreading misinformation only points the finger at part of the problem. Americans should also be pointing the finger at state politicians and their public health officials for their generally tepid responses to the anti-vaccination movement and the conditions it has helped create, all the while leaving undervalued and underinvested local public health agencies to play “whack a mole” in responding to the latest disease outbreaks.
Much like co-author Jason Chung wrote about in Canada, our public health leaders have done little to rouse the general public (the vast majority of whom, as surveys show, value vaccinations) in the face of extensive and aggressive misinformation efforts targeting parents who may, understandably, have questions or concerns about safe, effective vaccines for their children.
This lack of response highlights how the public health field has failed to adapt to a changing reality. Doyens of public health appear to believe that remaining calm and appealing to rationality is the way to combat coordinated misinformation. In our media-saturated, “information age,” this is inadequate.
Instead, our elected officials and senior public health leaders should be adopting a more proactive approach to combating anti-vaxxers. Here are just a few ideas:
1. Stop treating a Public Health Problem as a Primarily Clinical Medicine Problem
Public health, with its specific focus on prevention and community health, has a unique, multi-disciplinary toolkit at its disposal to better understand and effectively intervene on this pressing, complex problem. These tools can be leveraged in conducting mass media education or social marketing campaigns, interventions in clinical and community settings, and policy-level actions.
But this array of tools has been underutilized in favor of clinical approaches. While it’s true that improving clinical encounters is an important method for ensuring vaccination uptake, this approach has received far too much focus over other, perhaps more effective, complementary population-oriented approaches.
2. Focus on How Disease Reality is Far Scarier than Vaccine Myths
Public health needs to better emphasize the serious risks posed by vaccine-preventable diseases. Anti-vax propaganda has set the narrative about (miniscule) vaccine risks trumping the substantial disease risks that vaccines prevent (measles especially). That means public health officials are constantly playing defense – debunking dubious vaccine risk claims, at the expense of emphasizing the true, substantial dangers that vaccine-hesitant parents accept by deciding to delay or avoid vaccinations for their children. It’s time to go on offense and highlight dangers posed by childhood diseases among children and adults in our communities.
Of course, in stressing the risks of a disease, there is the risk of spreading fear. This is an understandable concern. But, when based in truth, fear can resonate with parents susceptible to anti-vaccination messaging. As found by psychologists, fear-based campaigns are effective in helping change both attitudes and behavior. That, combined with the right motivator, may be effective. Likewise, fear-based public health campaigns can also be ethical, provided appropriate considerations are taken.
3. Up the Online Prevention Game
Public health can’t be fighting this problem only in the arenas it chooses. The time that parents spend in a medical office is scant compared to their time spent online. Search engine results and social media sites with anti-vax propaganda have come to dominate website search results and social media spaces that parents turn to for information. Thus, simply referring parents to government websites for accurate vaccine-related information is inadequate. Politicians and public health officials need to be engaging with companies like Facebook and Google (which owns YouTube) to develop solutions to not only better promote the spread of accurate information, but limit the ways that parents are steered online toward anti-vaccination ads, videos, and sites. Due to public pressure, these companies have begun scrutinizing misinformation that can lead to “real-world harm.” Political pressure can help ensure that they effectively follow through in efforts—especially with respect to anti-vax propaganda.
4. Spotlight the Pro-Vaccination Majority
Currently, the anti-vax movement enjoys media airtime and influence far beyond what their numbers dictate. The truth is that while there are pockets of “intense anti-vaccine activity” which are threatening key counties and metropolitan areas, the vast majority of Americans support vaccinations.
It’s time for our politicians and public health officials to recognize this and coordinate effective PR and media campaigns to highlight the good that vaccination campaigns provide. Increased pressure should be placed on media members to get the story right and counter news stories showcasing anti-vax parents—a small, but highly vocal minority. Perhaps this can stem declining public support for vaccinations.
These are just four of many ways that public health could be pushing back against anti-vax propaganda. But amidst increased exemptions and outbreaks, politicians and public health leaders appear content to sit back and do the same old routine that isn’t working—or ignore it entirely in the face of lobbying by small groups of misguided activists.
Without more assertive action from politicians and public health leaders, preventable disease outbreaks will be increasing in frequency and severity throughout the US, risking lives and costing tax dollars needed to be directed to other issues. To prevent this future, the best defense is a good offense.
Richard M. Carpiano is Professor of Public Policy and Sociology at the University of California, Riverside. He is also a faculty affiliate of the Center for Healthy Communities in the UCR School of Medicine.
Jason Chung is the Co-Founder of The Deductible and a faculty member at New York University’s Tisch Institute for Global Sport.