Anti-Vax: A Crisis of Trust

If there’s one thing we all know, it is that anti-vaxxers are personae non gratae. The anti-vaccination movement is filled with poorly educated, scientifically illiterate, and intellectually dishonest individuals who pose a major risk to public health. Right?

This last point certainly stands: the scientific consensus is overwhelmingly in favour of vaccines as a public health good. However, the trope that anti-vaxxers lack scientific knowledge or even a basic education is wrong, unhelpful, and deeply counterproductive.

There is admittedly some merit to the stereotype. An analysis of 2017 education data from the United Nations Development Program Human Development Reports demonstrates a very weak correlation where “vaccine hesitancy” decreases by 2%, on average, per extra year of education.

However, the correlation is weak, and there are significant outliers. They reported that 51% of people sampled in France — a highly educated, affluent country — disagreed with the statement “Vaccines are safe”, compared to just 13% in Azerbaijan.

Other researchers have focused on the socioeconomic distribution of vaccine hesitancy within the US, a hotspot for anti-vaxxers online. This study, for instance, analyses rates of “conscientious vaccine objection” (CVE) across Texas. It was found that anti-vaxxers cluster in urban and suburban centres, that they are affluent (private schools were epicentres of vaccine refusal), and that the proportion of CVE in a population correlates well with the level of College education.

Yes, you read that right: in certain areas, the more College education you have, the more anti-vaxxers you get.

“Yes, you read that right: in certain areas, the more College education you have, the more anti-vaxxers you get”

Our common assumptions about anti-vaxxers are thus often wrong. It’s true that we often see anti-vaxxers online who fit our stereotyped view of them, but this might be an artefact of confirmation bias, or the Internet making only the most outrageously ignorant videos go viral. We need to radically re-assess who we think anti-vaxxers are, and why they are anti-vax, if we want this rapidly increasing phenomenon to disappear.

It is not down to education, then. More likely, it is a crisis of trust — a crisis the House of Lords saw coming over 20 years ago. If people do not trust their government, nor will they trust the medical interventions they mandate. As just one example, a Colombian nurse, Maria Pito, recently told NewScientist: “[she] and many others do not trust this untransparent government […] We have very little information about [the vaccines]. We must protect our elders, but we prefer to trust our traditional medicines.”

Perhaps there is an epistemic dimension to this — perhaps they simply don’t understand the vaccines. However, this is underwritten by a failure to engage, which in turn is down to a simple lack of trust. This is at least part of the reason that our science communication strategies to increase public engagement, disseminate information, and build trust, are failures. Why?

My opinion is that it is the vitriol and fury of scientists and science communicators which forms much of this barrier to communication — something of which I myself am admittedly guilty. Consider the wealth of YouTube videos “debunking” pseudoscientific “myths”. Consider this climate change misinformation “Debunking Handbook of 2020” which is co-authored by “22 prominent scholars of misinformation and its debunking”, or this article entitled “This Is Why You Have No Business Challenging Scientific Experts”. Even click-bait websites like Gizmodo are publishing scientific “smackdowns”.

“It is the vitriol and fury of scientists and science communicators which forms much of this barrier to communication”

If your views were challenged so belligerently, so focused on “debunking” and not “conversing”, on “smackdowns” and not “pick-me-ups”, would you be open to changing your mind?

Cailin O’Connor of UC Irvine is a philosopher of science who has mathematically modelled the spread of false beliefs. These false beliefs spread optimally in clustered, mutually-trusting subpopulations. It doesn’t matter if the beliefs are true — you just need to be a part of the same tribe. And it is this tribalism that contemporary science communication is enforcing, not resolving.

This goes a long way to explaining the adoption of unrelated scientific views down pre-existing political fault lines, for example. At a time when evidence either way was ambivalent, hydroxychloroquine was rapidly adopted by the political right and almost entirely shunned by the political left, who preferred Remdesivir. The political community had made up their minds long before the scientists had.

Right-wingers trust right-wingers and left-wingers trust left-wingers; nobody is surprised by this. The spread of information happens almost exclusively inside, and only rarely between, the different tribes. Why, then, do we assume that we can reach anti-vaxxers by simplistic, aggressive information dumps? Evidence overload may even make them more hardline in their position. In our current rhetoric, we have opted for neither education nor diplomacy — merely self-assurance.

To be clear here, I would never argue that we shouldn’t try to disseminate consensus positions, such as the efficacy of vaccines. I am merely arguing that to communicate science through assertive, aggressive articles misses the point entirely — not least because they will not be read. Anti-vaxxers are oftentimes intelligent and highly-educated individuals who know the primary literature far better than the vaccine compliant — we who rarely question our own faith.

I don’t have a silver bullet — and I strongly doubt one exists — to reinstill the trust required to reinstate a constructive dialogue. If there is such a panacea, it would doubtless involve a rewriting of modern science journalism and a rethinking of science education. Open public discussion of meta-science, about the scientific method and philosophy of science, would also be crucial.

I am hopeful for our prospects; there is plenty of common ground to recover. After all, anti-vaxxers are anti-vax because they want as much health and as little disease for their kids (and for the population at large) as possible. They simply do not trust the government to deliver this for them, nor the opaque processes of science and vaccination. Their science is wrong, perhaps — but their goals are the same as ours, and we should treat them as such.

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