Vaccines, values and science

Reiss, M. J. (2021) Vaccine hesitancy: Why trust science and science education? In: The Nature of Science in Biology: A Source for Educators, McCloughlin, T. J. J. (Ed.), Graphikon Teo, Dublin, pp. 83-98., 2021

There is a long history of attempts to prevent the spread of infectious diseases through the use of inoculations. Unfortunately, school students are rarely taught much of this history, too often being given the impression that nothing was known or done before the time of Jenner and his development of vaccination to tackle smallpox. A bigger problem, though, with school vaccine education is that it generally fails respectfully to take account of vaccine hesitancy. While the basic science of vaccines can indeed be trusted, many people have moral and other objections to vaccines that science cannot dismiss. A good vaccine education can draw on the frameworks of worldviews and controversial issues to help learners engage with the issues that vaccination raises, and develop their knowledge and understanding of them.

Perspectives On Science, 2016

Public resistance towards scientific claims regarding vaccine safety is widely thought to stem from public misunderstanding (or ignorance) of science. Repeated failures to alleviate this ignorance make the problem of vaccine hesitancy seem intractable. I challenge this presumption of knowledge deficit and reinterpret vaccine hesitancy to be a problem of public mistrust of scientific experts and institutions. This finding invites new corrective measures: self-scrutiny by our scientific and governmental bodies regarding their own credibility as well as investment in dialogical rather than didactic communicative outreach to vaccine hesitant members of the public. Without the oppositional framing of the problem as a conflict of science versus ignorance, there is more room for conciliation of public health agendas with the concerns of the lay publics.

Vaccines

This paper examines possible causes, consequences, and potential solutions for addressing vaccine hesitancy in the United States, focusing on the perspectives of academic scientists. By examining the experiences of scientists, who are arguably a critical community in US society, we gain deeper insights into how they understand the complexities of vaccine hesitancy and whether their insights and opinions converge with or diverge from the current literature. We present findings from a national survey of a representative sample of academic scientists from the fields of biology and public health regarding vaccine hesitancy and related topics. Empirical analysis using descriptive, bivariate, and multivariate analyses covers multiple topics, including vaccine controversy, trust in science, causes of vaccine hesitancy, preferred policy and regulatory approaches, risk perceptions, and scientists’ ethics and perceived communication roles. The results highlight a diversity of opinions within ...

2020

While many attribute vaccine hesitancy to a lack of understanding science and a decrease in the acknowledgement of facts presented by those with expertise, this paper argues vaccine hesitancy depends on other factors, primarily a lack of trust in the pharmaceutical and governmental sectors and a set of priorities that is not always aligned with those of the scientific community. While vaccine hesitancy is often propelled by protective instincts, it also reflects the plurality of views surrounding medicalization, the role of science in people's family and personal choices, and the appropriate goal of demanding industry accountability. Derogatory language for those who are vaccination hesitant is not respectful or effective and furthers the distrust and reputational problems associated with pharmaceutical companies, government, and medicine.

Acta Médica Portuguesa, 2023

The story of anti-vaccination: a déja-vu Before the advent of safe vaccines, smallpox was a dreadful condition that occurred in epidemic waves with casefatality rates around 30% (variola major). 1,2 In the 10 th century, Chinese and Indian physicians rubbed the fluid from smallpox pustules into a scratch on the arm of healthy individuals. This process was called variolation: the inoculation with low doses of smallpox aimed to induce a mild infection that would lead to immunity against the disease. However, variolation could cause disease and even death (1%-2%) and was also related to outbreaks. 2 In the 18 th century, this practice spread throughout Europe, although many physicians considered it ineffective and were afraid to adopt it. The first movements of vaccine hesitancy appeared due to fear of the side effects of variolation (including possible death). More organized antivaccine sentiments were often based on religious antagonism, considering it a violation of divine providence. 1,3 Variolation was replaced by the much safer vaccination process, which Jenner developed from 1796 to 1798, and selfpublished (Variolae vaccinae). 2,3 Between 1840 and 1853, pro-vaccination laws were enacted, for example, the English government made vaccination compulsory for children and the poor and determined fines and prison for heads of families refusing to vaccinate their offspring. 2,3 This situation generated a widespread antagonistic reaction from the population. While the main concern was the perceived infringement of individual freedom and the fear of establishing medical tyranny, social and economic aspects caused by the fines and imprisonment were also rife. All this led to the creation of the antivaccination league and in 1867 a new law was passed giving freedom to parents to take responsibility for not vaccinating their children (which is when the term 'conscientious objector' originated). 1-3 Spectrum of vaccine hesitancy: from bizarre ideas to plausible economic concerns Vaccine hesitancy is often detached from scientific reasoning and a rational risk assessment of efficacy and possible side effects. Many reasons, reminiscent of the historical anti-vaccination movements, are subjectively important concerns of a religious, social, cultural, or political nature; frequently guised as fear of persecution of minorities. In the shape of rumours, where central aspects are often factually incorrect, they may spread widely and rapidly. 4 One example is the fear of population control, such as alleged sterilization or intentional decimation with an infectious disease: the 'North', ex-colonizers versus African populations (i.e.: tetanus vaccination in Kenya) or Western civilization versus Muslims (i.e.: polio-vaccination in Pakistan). 4 Potentially more rational reasons of an economic nature may be important as the whole-cell pertussis vaccine scare during the 1970s in the United Kingdom (UK) may illustrate. Media reports abounded about an increase in alleged severe neurological sequela after vaccination, which epidemiological studies could not confirm. However, a large aspect of this was the perceived lack of social support to those potentially affected which led to a considerable drop in vaccination rates. The UK government passed the Vaccine Damage Payments Act, with a payment of £10 000 to those affected, to restore trust. 5 The bumpy road of vaccine development: genuine misfortunes Vaccines are arguably the biggest success story in medicine, with huge reductions in cases and associated mortality. 2 Healthcare workers (HCW) may often be unaware that the development was a bumpy road with several high-profile misfortunes or accidents (Table 1). 2,6,7 Undoubtedly, when comparing the dimension of these incidents with the overall beneficial public-health effects of these vaccines, the administration of vaccines largely outweighs any damages caused, as the example of the polio vaccine illustrates particularly well (Table 1). Despite some misfortunes, like the polio cases and even

The mere mention of a possible link between vaccines and disorders such as autism will instantly elicit a visceral response from many pediatricians. In most cases the response is to point out that the paper linking the MMR vaccine to autism authored by Dr. Andrew Wakefield and colleagues has been discredited, with Wakefield, vaccine advocates whipping boy losing his license to practice medicine in the UK. The implication being that anti-vaccine groups are relying on flawed or fraudulent data or that this is only study to ever make a connection between vaccines and autism, so the issue has been put to rest. Medicine has a history of exercising its cultural authority to suppress opposition opinion. These include Dr. William Coley, who observed one of his patients began recovering from cancer after he was infected with Streptococcus pyogenes. This led Coley to theorize that post-surgical infections helped defeat cancer by mobilizing the immune system, but almost all his scientific peers rejected the idea, writing it off as " crazy and dangerous ". Coley died in 1936, and with his death his theory and work which were looked down on as " quack medicine " died too. Coley's theory of immune system stimulation to fight cancer was " surpassed " by " scientific " chemotherapy and radiation. Francis Peyton Rous was a pathologist who discovered that certain viruses were linked to the development of certain cancers was ostracized by his peers and both he and his findings were largely discredited. However, in 1966, over 50 years after his initial findings, he was awarded the Nobel Prize in Physiology or Medicine. This paper is not about Wakefield nor is it a defense of him or his research, it is however intended to point out that there has been an organized attempt to silence vaccine opponents, both professionals and parents who, backed with valid research as defined by pro-vaccine's definition of " real science " have raised legitimate concerns as to the safety and efficacy of certain vaccines. Before latching onto the Wakefield case as the holy grail to prove that vaccine opposition groups rely on fraudulent or weak data to advance their agenda, vaccine advocates need to examine their own science and those who are supplying it. " It is dangerous to be right in matters on which the established authorities are wrong. "

Frontiers in Public Health, 2019

Despite scientific evidence supporting the fact that vaccines are fundamental tools for preventing infectious diseases, a percentage of the population still refuses some or all of them. Vaccine hesitancy has become a widespread issue, and its complexity lies in the great variety of factors that can influence decisions about immunization, which are not just vaccine-related concerns, but also involve personal and societal levels. Our research group performed an extensive literature review to analyze: (1) different age groups, their relation to the problem and their characteristics; (2) the most important information (key messages) about immunization that could be used to counteract hesitancy; and (3) best approaches to transmit the messages to the target groups. We propose a long-term approach to overcome vaccine hesitancy that involves the education of children and adolescents on the basics about immunization and critical thinking, using different communication channels.

Science & Education, 2022

The issue of trust in science has come to the fore in recent years. I focus on vaccines, first looking at what is known about trust in vaccines and then concentrating on whether what science education teaches about vaccines can be trusted. I present an argument to connect the phenomenon of vaccine hesitancy to the issue of trust and then argue for what an education about vaccines in school science might look like that takes seriously the notion of respect for students, including students who hold views about vaccination with which science teachers might disagree. Trust in others (people and institutions) varies greatly, both between countries and within countries, and depends on the characteristics of both trustor and trustee, and there are great differences in the extent to which people trust vaccines. However, it is a mistake to think that people who do not trust vaccines are simply ill-informed. There are a range of reasons for rejecting what is often an unexamined narrative about vaccines, namely that vaccines are always desirable. Many people come from communities that have sound reasons for being suspicious of what they are told by governments, business and the medical establishment. COVID-19 and earlier reactions to vaccination health scares show how important high-quality education about vaccines is. Much of that education can take place out of school, but the foundations are laid in school. Vaccine rejection and hesitancy have major global public health implications. Good quality vaccine education should help students understand about relevant biology and the nature of science; it should also be respectful of all students, including those who come from families that reject vaccines or are hesitant about them.

Περιβαλλοντική Εκπαίδευση για την Αειφορία, 2019

Η παρούσα μελέτη έχει ως στόχο τη διερεύνηση των παραγόντων που επιδρούν στην πρόθεση του εκπαιδευτικού να επιλέγει διδακτικές θεματικές σχετικές με τις Ανανεώσιμες Πηγές Ενέργειας (ΑΠΕ). Τετρακόσιοι πενήντα τέσσερις (454) εκπαιδευτικοί της δευτεροβάθμιας εκπαίδευσης από τα Δωδεκάνησα απάντησαν σε ερωτηματολόγιο που δομήθηκε με βάση τη θεωρία της Προσχεδιασμένης Συμπεριφοράς (Ajzen, 2002). Τα δεδομένα αναλύθηκαν με πολλαπλή γραμμική παλινδρόμηση προκειμένου να εξεταστεί ποιοι παράγοντες επιδρούν στην πρόθεση του εκπαιδευτικού να διδάσκει θεματικές για τις ΑΠΕ. Το μοντέλο βρέθηκε να είναι στατιστικά σημαντικό (p < .001), ενώ το 62,8% της διακύμανσης της πρόθεσης διδασκαλίας εξηγήθηκε από τις μεταβλητές του μοντέλου. Οι στάσεις του εκπαιδευτικού απέναντι στις ΑΠΕ βρέθηκε να είναι ο πιο ισχυρός παράγοντας πρόβλεψης της πρόθεσης διδασκαλίας, ενώ ακολουθούν οι αντιλήψεις του για το κατά πόσο θεωρεί τον εαυτό του ικανό να διδάξει τη συγκεκριμένη θεματική και για το ποιες είναι οι στά...

2024