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Overcoming vaccine scepticism

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THERE has been an explosion of medical misinformation since the pandemic began. It perhaps shouldn’t come as a surprise. As a health crisis of epic proportions plays out before us, people want fast access to the latest news on vaccines and all other developments. But an abundance of information can make for confusion, misunderstanding and bad faith.

  Some of the problems of misinformation seem very new and inextricably connected to social media, where falsehoods can thrive and spread through an absence of editorial gatekeeping, a lackadaisical approach from tech companies in limiting the reach of questionable stories, and the ease with which users can share them. But the issue of how medical news is reinterpreted or even altered has a much longer history.

  In Britain, cheap magazines and daily newspapers arrived on a mass scale in the late 19th century. Much like today, medical news was seen to make good copy.

It allowed an increasingly literate public to engage with current debates on medicine, and learn about the latest innovations in public health like never before. Magazines of a semi-medical nature, aimed at a general audience, were set up to cater for anxious readers, who solicited advice on everything from acne and insomnia to hair loss and indigestion.

  Doctors, professionalised but still anxious about their societal status, struggled to adjust to the new powers of the press. Many feared the consequences of medical knowledge in the public’s hands, including the possibility that patients would simply self-diagnose or even self-treat without professional advice, with disastrous results.

“All endeavours to inspire the public with medical knowledge and power are false, and must fail,” proclaimed one editorial in the Lancet in 1887. Doctors who wrote for the “lay” press were warned off doing so by institutions such as the Royal College of Physicians, for fear the profession would be seen to be engaging in “advertising” their services.

  Public attitudes to vaccination were a prevailing concern for doctors. Increased resistance to compulsory smallpox vaccination during the 1870s and 1880s exposed the fragility of trust in both the political and medical establishment.

The most radical opponents to vaccines used demonstrations and publishing to rally their cause. From their perspective, journalists, rather than challenging medical power, were propping it up. Much like today, the “mainstream” media was cast as the enemy and some opposed to vaccines claimed newspapers were misleading people about the safety of the procedure.

“If we had fair play in the Times but for a single month, the medical evil and parliamentary falsehood against which we are contending, would receive their death-wound,” pronounced one campaigner in 1876.

  Anti-vaccination journals were set up by activists in the face of their perceived exclusion from public discourse. Their editors relied on emotive content to make their case, filling pages with reports of reluctant mothers coerced into vaccinating unwilling children, and of people who had been “poisoned”. One title, the Vaccination Inquirer, only ceased publication in 1972.

  By the early 20th century, the medical establishment had softened its stance on the public being involved in discussions of medical matters. Doctors increasingly saw the value of an engaged citizenry, and the role the media could play in encouraging people to implement sanitary and hygienic measures at home.

After the Second World War, with the growing influence of broadcast television and a fast-changing medical and cultural landscape, which saw the legalisation of abortion, a growing patient activist movement and the world’s first heart transplant, more effective engagement between medics and journalists was required. The Medical Journalists’ Association, founded in 1967, heralded the increased power of newspaper journalists with a specific medical beat and generated greater interaction between the two professions.

  But having open public engagement with health issues that is grounded in scientific fact requires constant work. Things do not always go right. We still feel the tremors of the MMR vaccine scare, provoked by Andrew Wakefield’s (since retracted) research paper of 1998, which falsely suggested a connection between autism and the MMR jab.

The ensuing tabloid frenzy helped to cause a significant dent in public confidence in the vaccination and a drop in take-up. The controversy also revealed the vulnerability of medical research infrastructures to fraudulent data; scientific journals are not impermeable to misinformation.

  The headlines media outlets choose when reporting a developing event can make all the difference as to whether a health story spirals into misinformation on social media.

Medical journals can also play a more active role in countering misinformation, by providing more accessible lay summaries of research – while we humble retweeters might think twice before we share.

  However, it is also about changing the nature of these discussions, which so often become polarised. Vaccine hesitancy is a complex issue, and it is not necessarily helpful for it to be framed in terms of #antivax versus #vaccineswork (not least because such a dichotomy often overstates the power of an organised anti-vax movement).

Neither do such discourses usually reflect on the long and difficult history of vaccination – and medicine more generally – nor why that has left some communities more hesitant to receive vaccines.

  Nineteenth-century doctors tried to maintain boundaries between scientific journalism and the media, but were unable to prevent the public and journalistic demand for health information. That desire remains with us today. The flow of medical knowledge works best when researchers, journalists and the public are better connected and considerate of one another. Preventing misinformation is a shared responsibility.

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