Over one year after the onset of the coronavirus (COVID-19) pandemic, the United States faces the new challenge of achieving herd immunity through mass vaccination. Yet, last month, over 800 Massachusetts State Police officers and other employees — prioritized in the first stage of the vaccine rollout — declined to receive the COVID-19 vaccine at the department’s clinics. While they could have opted to receive the vaccine at non-departmental clinics instead, many chose to abstain from receiving the vaccine entirely. The State Police are not alone in their refusal: similar hesitation is prevalent nationwide. Indeed, a national survey conducted by the Pew Research Center shows that as of early March 2021, around 30% of the general public did not plan to receive the vaccine.
Who, or what, is to blame for vaccine hesitancy, if anything? As easy as it may be to point fingers at former President Donald Trump, who received his vaccination in secret and only gave a delayed, lukewarm endorsement of it after hundreds of thousands of deaths, vaccine hesitancy spans beyond partisan lines and dates back further than this health crisis alone. Issues involving information dissemination are constant across all health crises involving vaccine skepticism. The more that we understand about how scientific information has been historically communicated, the better we can combat vaccine hesitancy in the age of COVID-19.
Pew Research Center reports several reasons for vaccine hesitancy and fear across the population, ranging from citizens’ concerns about side effects to distrust regarding the development timeline. Others, who do not generally receive any vaccines, such as the annual flu shot, do not plan on making an exception for COVID-19.
Pew also found that willingness to receive the vaccine slightly varies between socioeconomic, racial, gender and ultimately partisan groups. Most notably, a New York Times analysis found that many lower-income areas, which exhibited higher rates of hesitation, are also rural regions with lower educational attainment: “the same characteristics found in counties that were more likely to have supported Mr. Trump” in the 2016 presidential election.
It’s clear, then, that like mask-wearing and social distancing compliance, getting the vaccine has reflected America’s partisan divisions, but not quite in the way some may assume. As the Times’ analysis clarifies, it is not an inherent difference between Democratic and Republican voters that drives this disparity in vaccine willingness and compliance; rather, people and regions that tend to vote Republican — and especially did so for Trump — also tend to exhibit income-based and educational demographic patterns that affect ideas about vaccines. Indeed, as exemplified by the case of the State Policemen in Massachusetts, vaccine hesitancy persists even in relatively liberal and heavily Democratic states. Partisan boundaries may, thus, be insufficient to explain all instances of skepticism and must be understood in the context of concurrent demographic trends.
Additionally, in a year that has been partly characterized by the brawl between real and “fake” news, misinformation and political polarization, state mandates and government recommendations such as masks and vaccines are easily politicized and taken out of their scientific contexts. As Arkansas Governor Asa Hutchinson told The Hill, vaccine hesitancy is “a natural resistance to government and skepticism of it.”
Endorsements and messages from public and political figures are important to their supporters, so part of the onus of imparting accurate public health information lies on politicians and extreme wing media in both directions of the political spectrum. Aside from Dr. Anthony Fauci, whose position has become somewhat political, medical and scientific experts themselves do not necessarily have the platform or public influence to impact hesitancy and compliance. In addition to acknowledging the responsibility to inform citizens borne by politicians and political media, the history of the scientific communication and dissemination of medical knowledge may also be able to inform us about hesitancy trends today.
Paula Larsson is a historian of medicine who claims that, though vaccination practices, sanitation, and medical technology are incomparable between now and centuries past, anti-vaccination movements have existed since the first inoculation against smallpox in 1796. According to Larsson’s conversation with The Guardian, “white knights who harness popular concerns to drive their own agenda and paint themselves as heroes” surfaced during times of medical crisis. Larsson described one author of these pamphlets, who, during a late-1800s outbreak, “assured his readers that vaccination did not prevent smallpox, but that it did cause other nasty diseases such as syphilis and smallpox itself, and it killed children ‘outright.’” Much like today, in the age of the smallpox epidemic, prominent political and social figures were also strong influences in the spread of information, and often blended scientific and political news in pamphlets to drive fear, doubt and other misinformation.
With the amount of data and knowledge available from the scientific community today, justifications for vaccine hesitancy and refusal should be far less acceptable and common than they were during a 1796 smallpox outbreak. That said, it is impossible to disentangle the reliability of scientific knowledge from the fact that the majority of Americans are heavy consumers of media constantly. And as confidence in the media wanes, distrust in the information they report, especially regarding vaccines and the pandemic at large, grows in lockstep.
Today, in 2021, many of the 18th century’s public health struggles with power and information-sharing persist, only now through rapid news cycles, left- or right-leaning talk show personalities and statement headlines from disparate sources. As one example, conservative political commentator and Fox News host Tucker Carlson recently stated, “If the vaccine is effective, there is no reason for people who have received the vaccine to wear masks or avoid physical contact … So maybe it doesn’t work and they’re simply not telling you that.” Statements like this can carry public weight. Business Wire reports that Tucker Carlson averages 3.4 million viewers on “Tucker Carlson Tonight,” which continues to be one of the nation’s most-watched news programs. That’s 3.4 million people who might hear Carlson’s unfounded suspicions and take them as gospel.
Now, instead of 1796 smallpox pamphlets, news spreads with unprecedented speed and divisive potential by way of provocative broadcast journalism or through hourly updates from major networks. Politicians can also engage with social media platforms such as Instagram and TikTok to share information, engage with constituents and build their platforms. Senator Jon Ossoff (D-GA), for example, has gained over 500,000 followers on TikTok, and Senator Ed Markey (D-MA) has created over 100 TikTok videos. Representative Alexandria Ocasio-Cortez (NY-14) often hosts Q&A sessions and discusses current congressional issues on Instagram Live to connect with her constituents and 8.8 million followers. Social media has become a key source of news, especially for the younger generations in the United States. As of June 2020, “over a quarter of respondents [aged 18-24 years old] used Instagram to access news content.” It’s clear, then, that the people and figures that the general public follows on social media can play a role in spreading both reliable news and less reliable falsehoods.
In short, COVID-19 vaccine hesitancy owes its rise to numerous players: history, media moguls, politicians, social networking outlets and even average people. But can we really blame consumers for their responses to a product — information — that is designed to polarize and feed them doubts? News outlets, while quick to latch on to the pandemic’s most dramatic headlines, are struggling to convey tangible scientific information in a way that is digestible and well-received by bipartisan audiences. Social media often creates information echo chambers as people follow and like posts that confirm their own beliefs. Politicians are backing further and further into their respective camps. Meanwhile, citizens are left to independently process dozens of far-flung and often contradictory narratives. In turn, Americans struggle to access and apply the vaccine information, public health realities and safety guidelines so pivotal to the nation’s ongoing pandemic battle.
So what’s the solution? We must learn to leverage the resources that the media puts at our fingertips to expand information accessibility and facilitate knowledge acquisition. Better understanding how search engines feed results and interact with users’ internet activity, assessing interventions that social media sites and apps are taking regarding user content and continuing to dismantle stigma about scientific information are all important steps to take to ensure that public health crises do not always become information crises. We can’t necessarily expect the media to bridge the gaping divide and distrust between the United States government and the people it is intended to serve, but with accountability and agency, it can be a tool to prevent that divide from growing.
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