An Examination of the Anti-Vaccination Movement
Between June 2007 and February 2015, it is estimated that there were 8,973 deaths in the United States that could have been prevented through vaccination. (1) Since the advent of vaccines by Jenner and Pasteur, there has been opposition towards them, with a multitude of social and political reasons contributing to this. (2) However, the rising prominence of anti-vaccination rhetoric may have more severe consequences now than in any time in the past, due to an increase in global travel, the lack of subclinical infection due to previous vaccination successes and the close proximity of human contact on a regular basis. (3) These individual decisions are therefore more likely to have wide-reaching social consequences for epidemiology and the morbidity of otherwise-preventable diseases. (4)
A major catalyst in the current anti-vaccination trend is a1998 paper published in medical journal The Lancet by Wakefield et al. (5) Since the publication of the original article, multiple studies have attempted to replicate the findings; most recently, Jain et al. published a study of 95000 children, which found no harmful link between the MMR vaccine and autistic spectrum disorders, even in those children at higher risk of developing autism. (6) In the meantime, the conclusion of Wakefield’s publication was retracted by ten of its thirteen authors, until 2010, when the paper itself was retracted by The Lancet. (7) However, the widespread reporting of the original paper prompted a re-emergence of anti-vaccination rhetoric; a movement which has continued to grow with the increasing consumption of mass media, particularly the internet. (8)
Both Poland and Jacobson and Kata outline a number of key beliefs held by those who participate in the anti-vaccination movement. (9) It cannot be suggested that the movement is a homogenous one, but all its facets contain a theme of opposition to vaccination. Those against vaccinations may argue against the safety or effectiveness of the vaccine, and suggest that the risk of harm outweighs the benefits of immunisation. Proponents of this argument were also, according to Kata, likely to cite the ingredients in vaccinations as being harmful to humans, or else link vaccines to illnesses such as leukaemia, cancers and fibromyalgia. Another argument promotes the use of ‘natural’ alternative medicine as more effective; those using this argument were, on occasion, found to dispute Pasteur’s germ theory, and to ignore or criticise scientific literature concerning the safety of vaccines. (10)
A third argument that occurs frequently in anti-vaccination discussions is that of civil liberties; that higher societal powers do not have the right to go above the individual autonomy of the parents who choose not to vaccinate, and a fourth involves moral and religious objections. Other opponents of vaccination may cite either conspiracy theories or misinformed scientific knowledge, often in relation to Wakefield’s original paper, or that vaccines exist to bring financial gain to large pharmaceutical corporations. Finally, emotive, personal appeals are also commonly cited, often from parents who believe their children to have been “damaged” by vaccinations. (11)
The possibilities to create and upload personal content have never been seen on such a wide scale, and therefore a platform is created for such ideas to be shared, particularly with the rise of social media use. Alongside this, people are able to actively take charge of their own medical care through a variety of resources, shifting the locus of power to the individual lay person above the biomedical profession. The rise of the “informed patient” has also been aided by the internet, with a wealth of information that can be accessed from a variety of credible and non-credible sources. Therefore, the active seeking-out of information relating to one’s own health has provided a platform on which opponents of vaccination may share their own perspectives on the subject, as people consciously make efforts to inform themselves on issues affecting their personal medical care. (12)
As a result, the anti-vaccination movement has responded by utilising powerful and persuasive techniques with regards to their arguments as described above. An “us versus them” rhetoric is commonly seen, opposed to one advocating personal autonomy for parents; elsewhere, deceptive techniques are commonly used, with websites aiming to present themselves as neutral organisations within specific regions. Tactics of skewed scientific interpretation, shifting hypotheses and the censorship and attacking of critics were also frequently seen, alongside a number of tropes and fallacies used to frame arguments in sympathetic, knowledgeable or moral lights, with the aim of distorting the audience’s perception of vaccinations and to persuade them towards their particular rhetoric. (13)
The increase in the prominence of the anti-vaccination movement has correlated with an increase in outbreaks of vaccine-preventable diseases. California is currently experiencing an outbreak of pertussis, believed to have originated in 2010. (14) In 2012, there were 9,120 cases and ten deaths, all of children who had not been vaccinated either due to being too young or through parental choice. (15) Furthermore, the majority of these cases were seen in cluster-areas, where vaccine exemption rates are high , leading to a decrease in overall herd immunity and a close-proximity network through which the disease can spread. (16)
Responses to the anti-vaccination movement have been seen, or recommended, on a number of levels. The widespread use of social and mass media by the anti-vaccination movement has also been utilised as a response from the pro-vaccination movement to disseminate information. (17) Arguments used in pro-vaccination media include a cost-benefit analysis of vaccination based on scientific evidence, although not all websites cited sources, protection of children as an appeal to emotion and a discussion of vaccination as an unremarkable feature of normal life, as well as statistical data on the impact of vaccines on public health. The possibilities for those on both sides of the debate to access a wealth of scientific information and interpretation and to reconvey that data through easily-accessed media has served to advance the debate and allow parents to make choices based on the information presented to them. (18) Healthcare professionals are also vital in helping parents make informed choices, using a factual yet empathetic approach. (19)
There have also been governmental interventions. In April 2015, the Australian government announced financial penalties for parents who refuse to vaccinate their children for non-medical reasons, alongside incentive payments for doctors to keep to the recommended vaccination schedule. (20) This is in conjunction with a national awareness campaign dispelling perceived myths surrounding vaccination. (21) However, this has not been without major opposition, with campaigners suggesting that coercive, penalising measures remove their personal freedom of choice. The debate over whether governments have the right to enforce compulsory vaccination, and the outcomes of Australia’s policy, is likely to have major consequences on vaccination policies worldwide if it is shown to be a success. (22)
Despite opposition to vaccinations existing since their initial development, the possibilities presented by mass media and user-generated content online have contributed to a rapid spread of these ideas in recent years, and, as such, more widespread consequences. As Poland and Jacobson suggest, the resulting decrease in vaccination uptake may have more severe impacts on the fight against vaccine-preventable diseases than at any other time. (23) As such, the question must be asked whether it is morally acceptable to favour individual freedom and autonomy over what may be a wider social good: the reduction and eradication of harmful diseases.
(1)Anti-Vaccine Body Count, ‘Anti-Vaccine Body Count’, 2015, Available at:
http://www.antivaccinebodycount.com/Anti-Vaccine_Body_Count/Home.html (Accessed: 30th March 2015).
(2)G. A. Poland and R. M. Jacobson, ‘The Age-Old Struggle against the Antivaccinationists’. The New England Journal of Medicine, 364 (2011), pp. 97-99.
(4)Standen and Brooks 2013
(5)Poland and Jacobson, ‘The Age-Old Struggle’, pp. 97-99.
(6)A. Jain, et al., ‘Autism Occurrence By MMR Vaccine Status Among US Children With Older Siblings With And Without Autism’. Journal of the American Medical Association, 313(15) (2015), pp. 1534-1540.
(7)Anti-Vaccine Body Count, ‘Anti-Vaccine Body Count’.
(8)A. Kata, ‘A postmodern Pandora’s box: Anti-vaccination misinformation on the Internet’. Vaccine, 28(7) (2010), pp. 1709-1716.
(9)Ibid; G. A. Poland and R. M. Jacobson, ‘The clinician’s guide to the anti-vaccinationists’ galaxy’. Human Immunology, 73(8) (2012), pp. 859-866.
(14)B. Krans, ‘Anti-Vaccination Movement Causes a Deadly Year in the U.S.’ 2013 Available at:
http://www.healthline.com/health-news/children-anti-vaccination-movement-leads-to-disease-outbreaks-120312#1 (Accessed: 28th March 2015).
(17)J. Leask, S. Chapman, P. Hawe, and M. Burgess, ‘What maintains parental support for vaccination when challenged by anti-vaccination messages? A qualitative study’. Vaccine, 24(49-50) (2006), pp. 7238-7245.
(19)M. Eisenstein, ‘Public health: An injection of trust’. Nature, 507 (2014), pp. 17-19.
(20)BBC News, ‘Australia to stop welfare cash of anti-vaccine parents.’ (2015) Available at: http://www.bbc.co.uk/news/world-australia-32274107 (Accessed: 12th April 2015).
(22)M. Fine-Goulden, ‘Should childhood vaccination be compulsory in the UK?’., Opticon1826, 8 (2010), pp. 1-9.
(23)Poland and Jacobson, ‘The Age-Old Struggle’, pp. 97-99.