The Anti-Vaccine Movement: Where Are We Now?

In the realm of public health, few topics have garnered as much attention and sparked as much controversy as the subject of vaccines. In our post-pandemic world, the anti-vaccine movement has not only persisted but seemingly thrived, presenting challenges for public health officials, policymakers and communities worldwide. Despite advances in medical science and overwhelming evidence supporting the safety and efficacy of vaccines, skepticism and hesitancy persist, fueled by misinformation, distrust and ideological beliefs.

The anti-vaccine movement, which gained significant momentum in recent decades, is characterized by individuals and groups who question the value of vaccines. While concerns about vaccines are not new, the proliferation of social media and online platforms as sources of misinformation has significantly contributed to the growth of the movement. From conspiracy theories alleging government cover-ups to unfounded claims linking vaccines to autism or other adverse health effects, anti-vaccine rhetoric has permeated public discourse, sowing doubt and confusion among the general population. 

The Spread of Misinformation — and Disease

One of the enduring myths perpetuated by anti-vaccine proponents is the debunked link between vaccines and autism. Despite numerous studies discrediting this claim and the retraction of the original paper that suggested a connection, this misinformation continues to circulate widely, perpetuating fear and distrust among parents. In fact, Andrew Wakefield, the discredited United Kingdom physician who authored the original article linking autism to the measles, mumps and rubella (MMR) vaccine has seen a resurgence in his personal celebrity. Wakefield now resides in the U.S. and makes anti-vaccine film documentaries for a living.

In the face of persistent anti-vaccine propaganda, the scientific community continues to push back. A 2019 study from Denmark found no association between being vaccinated against MMR and developing autism. The work, published in the Annals of Internal Medicine, was conducted by researchers at the Statens Serum Institut in Copenhagen.¹ “The idea that vaccines cause autism is still going around, and the anti-vax movement, if anything, has perhaps only grown stronger over the last 15 years,” said Anders Hviid, one of the researchers involved in the study. “The trend that we’re seeing is worrying.”

That trend has caused a steady uptick in infectious diseases that were previously contained. In fact, measles cases in the U.S. continue to increase, so much so that this year’s numbers surpassed 2023’s total within the first three months of the year, according to the Centers for Disease Control and Prevention (CDC).²

Media’s Role in Public Opinion

The public health crisis created by the COVID-19 pandemic further fueled vaccine skepticism and provided fertile ground for anti-vaccine sentiment to flourish. The rapid development and deployment of vaccines to combat the virus were immediately met with suspicion and resistance by some segments of the population. Misinformation about the COVID-19 vaccines, including baseless claims about their long-term effects or their role in government surveillance, spread rapidly on social media platforms, undermining efforts to control the pandemic. Media outlets soon became powerfully influential when it came to shaping the public view of vaccine safety.

A 2023 report by researchers from several American universities found that vaccine-resistant people tend to mistrust mainstream media; they either turn to conservative news outlets such as Fox and Newsmax or they avoid traditional news media altogether. The study reported that as many as 36 percent of those who opposed the COVID vaccine relied on Facebook as their only pandemic information source in the first half of 2020.³

The study’s findings may be useful to public health officials who are trying to reach as broad an audience as possible, including those who lack trust in mainstream media, says one of the seven authors, Matthew Baum, professor of Global Communications at Harvard Kennedy School. “While we cannot make causal claims with these data, we do see a clear positive association between vaccine resistance and reliance on conservative media outlets, like Fox and Newsmax, or on social media — most notably Facebook — as sources of COVID-related information.”

To understand where vaccine-hesitant people go for their health information, the scholars looked back at data from several of the project surveys, as well as related surveys by other academic and political pollsters. The resulting paper, “Media Use and Vaccine Resistance,” was published in the journal PNAS Nexus in May 2023.³

The paper looked closely at Facebook as a source of virus information — and as a way to reach vaccine resistors. The data shows that respondents who rely only on Facebook are “consistently among the most vaccine-resistant” — between a quarter and a third of them resisted vaccination. Those who relied on the conservative news site Newsmax were the least likely to get vaccinated, but the number of individuals in this group was small, at just two percent of those surveyed, whereas Facebook was the sole source for between 12 and 16 percent of respondents.⁴

A Growing Political Ideology

There is increasing concern that the 2024 U.S. presidential election will fuel the fires of the anti-vaccine movement. Currently, candidates from both parties are leaning into a growing movement that marries traditional vaccine skepticism with a broader distrust of big institutions — be they the government, the pharmaceutical industry or the scientific community.

According to an article in Politico,⁵ it’s a movement focused on anti-vaccine and anti-science. The ideology is pro-medical freedom and pro-alternative medicine, but growth in the movement’s ranks has many in and out of government fearful that this campaign cycle will accelerate its spread, consolidate its strength and cement its place in the political milieu. “It’s going to get worse before it gets better,” said Jerome Adams, MD, U.S. surgeon general during the Trump administration. “Many of us in public health are deeply concerned that distrust in government and health entities, and a political campaign in which candidates are openly and vigorously arguing that people should ignore the advice of health experts, could have detrimental impacts for years to come — no matter who wins.”

While the anti-vaccine movement has historically found a home among both libertarians and the far-left, recent data is clear that mistrust in vaccines and science in general is significantly higher among Republicans than Democrats. An Associated Press-NORC study showed overall major declines in the public’s confidence in science in the wake of the pandemic.⁶

As a modern political force, the anti-vaccine movement has gained visibility and funding, enabling them to expand their public reach, sue federal agencies and organize like-minded activists at the state level, as well as expand their reach abroad. Last year, a lawsuit funded by the anti-vaccine group Informed Consent Action Network forced the state of Mississippi to allow religious exemptions for mandatory childhood vaccinations for the first time in more than four decades.⁷

Informed Consent Action Network was already one of the most well-funded anti-vaccine groups prior to the pandemic, pulling in $1.4 million in 2017. By 2021, its annual revenue topped $13.3 million, according to tax documents. And the group was not alone. Children’s Health Defense, a longtime anti-vaccine group launched in 2011 under the name World Mercury Project, also saw its revenue skyrocket, going from just over $1 million in 2018 to more than $15 million in 2021, according to the nonprofit’s federal tax filings.⁷

Public health experts believe groups that predated the pandemic have provided a “template” for newer anti-vax efforts, creating an environment in which such groups can proliferate and expand their reach. “Increasingly, there’s less and less difference between old school and new school anti-vaxxers,” said Dave Gorski, MD, PhD, a Michigan-based oncologist who has been tracking anti-vaccine efforts for two decades. “New anti-vaxxers are lapping up the same old conspiracy theories and pseudoscience.”⁷

The Erosion of Herd Immunity

The increase in vaccine hesitancy and vaccine resistance has not only caused an uptick in vaccine-preventable diseases such as measles and whooping cough, it has also led to the erosion of herd immunity. Herd immunity occurs when a large part of a population is immune to a particular disease due to vaccination or previously contracting the illness and developing antibodies. This indirectly also helps ensure the protection of the remaining population and offers a higher chance of combating and reducing transmission.⁸

In many cases, herd immunity ensures that while not everyone is immune to the disease, everyone can enjoy protection from it. Higher numbers of immune people within a population lowers the risk of contracting a disease or virus for everyone. In particular, herd immunity offers protection for a community’s most vulnerable demographics, including:

• Those with weak immune systems

• People undergoing chemotherapy

• Newborn babies 

• The elderly 

• People living with HIV

In every community, there are individuals who fall under the above categories, making herd immunity that much more important. These vulnerable populations depend on others getting vaccinated to be indirectly protected by them.

When it comes to the evolving coronavirus, researchers are increasingly worried that herd immunity is an unattainable goal. In an ideal scenario, reaching high levels of vaccination would mean new outbreaks of the coronavirus would die down quickly, as opposed to growing and spreading. “Vaccine hesitancy is a big problem for all of us,” says Ali Mokdad, who tracks coronavirus trends at the Institute for Health Metrics and Evaluation at the University of Washington. “We need to vaccinate as much as possible right now, stop the circulation of this virus in the U.S. and elsewhere. Then we can control it.”⁹

Finding a Path Forward

 Addressing the anti-vaccine movement requires a multifaceted approach that acknowledges the complex factors driving vaccine hesitancy and skepticism. It is essential to combat misinformation with accurate, evidence-based information and to engage with hesitant individuals and communities with empathy and understanding. Building trust in vaccines and the institutions that promote them necessitates transparency, accountability and open dialogue among public health authorities, healthcare providers and the public. Increasingly, it’s clear that addressing the root causes of vaccine hesitancy must extend beyond simply sharing scientific facts. Addressing underlying socioeconomic disparities, improving access to healthcare services and fostering community engagement are critical components of promoting vaccine acceptance. 

According to a recent Time magazine article, “It should be clear by now that neither persuasion nor coercion is sufficient to change the minds or the behavior of people who are determined to refuse vaccines. Education and research cannot defeat coordinated misinformation. And government efforts — at federal, state and local levels — are stymied by a combination of inadequate power, insufficient political will and a lack of perceived legitimacy by vaccine refusers. One of America’s core lessons from the COVID-19 pandemic is that a heavy-handed response to vaccine refusal can make things worse.”¹⁰

So where do we go from here? In a detailed piece by The Lancet, contributors recommend a networked approach in which public health agencies collaborate with diverse academic, civic and private sector stakeholders. The proposal suggests the development of connected communities capable of reaching the public at the right time, at the right place and with the right messenger about vaccine-related information — especially aimed at preempting well-funded and amplified messages disseminated by the anti-vaccine movement.¹¹

“This action entails a shift in approach for the U.S. public health communication model, from the use of one credible messenger (that is vulnerable to discrediting attacks), to a broad, diverse and coordinated network of expert messengers and influencers. These stakeholders — including leaders of local marginalized or faith communities — can simultaneously share similar messages of factual information to their specific audiences.”

The article’s authors acknowledge that building networked, coordinated initiatives will be challenging, but suggests the stakes are too high to ignore: “Without concerted efforts to counter the anti-vaccine movement, the USA faces an ever-growing burden of morbidity and mortality from an increasingly undervaccinated, vaccine-hesitant society.”¹¹