Dr. Richard Feldman: Diagnosing the symptoms of vaccine misinformation

Vaccine misinformation and politicalization abound in America. Social media and internet sites are packed with both from vaccine critics. According to the Centers for Disease Control and Prevention and other public health entities, a significant portion of Americans are distrustful of vaccines and fear they commonly cause autism and other serious untoward effects. Some are convinced there is some kind of conspiracy between pharmaceutical companies, scientists, and the government. Others are vaccine hesitant from the diffusion of this misleading information into our society.

The very success of immunization — the relative nonexistence of diseases that once ravaged the world — has created complacency. One does not appreciate the absence of what one does not see; smallpox, polio, diphtheria, tetanus, and meningitis are good examples. Immunizations are indeed medical miracles that changed the world forever.

These factors result in very poor adult vaccination rates. CDC data reveal only a relatively small fraction of adults have received many recommended vaccines including COVID boosters, RSV, shingles, and influenza. Young children and adolescents are only saved by school requirements, and for those immunizations not required, vaccination rates are disappointing. Examples are human papilloma virus and influenza immunizations.

Sources of vaccine misinformation include the intentional or non-intentional misrepresentation of medical-study data. For instance, a report might state that there are a large number of deaths associated with a vaccine in a clinical trial. But what is not reported is that the placebo group had a similar number of deaths. Another major tool of antivaccine activists is to create concern using the Vaccine Adverse Event Reporting System. Most of what follows regarding VAERS is based on an excellent May 2024 Journal of the American Medical Association article.

VAERS is a passive national self-reporting system managed by the U.S. Federal Food and Drug Administration and the CDC. The system makes it evident that a reported potential adverse medical event occurring after an immunization does not signify that the vaccine caused the event. It collects such reports from clinicians, pharmaceutical companies, health systems, and the public. The agencies want all potential events reported on the chance, however small, that a causal relationship exists. As a result, many reports contain inaccurate, coincidental, and unverified information.

Aggregate data from a large number of these reports are paired with well-designed studies that investigate the case details. Background incidence of the medical condition in the general population must also be determined for context. This combined information can determine a potential association or likely causal relationship between a vaccine and a subsequent medical condition.

Information spreads quickly in the electronic era. Unfortunately, misinterpreted VAERS and medical-study information are used, frequently by design, as confirmation that immunizations are a significant cause of morbidity and mortality. This serves to diminish vaccine confidence and promote misconceptions and distrust, especially after the COVID-politicalization experience.

A 2022 Annenberg Public Policy Center survey found that 60% of Americans are unsure if VAERS confirms cases of vaccine harm, and that increasingly people believe that it does.

The JAMA article suggests that the name of VAERS be changed to more clearly and accurately reflect what VAERS is — “an early warning system and not a catalogue of confirmed cases”. It also suggests that VAERS contain more detail clarifying the nature of the data and how it should be interpreted.

Cast a critical eye on reports regarding VAERS and medical-study data, and carefully consider who created them. Many are deceptive.

Dr. Richard Feldman is an Indianapolis family physician and the former state health commissioner. Send comments to [email protected].