Covid-19: why vaccine mistrust is growing | The Economist

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A vaccine is the world's best hope of overcoming the covid-19 pandemic
More than 20 vaccines are in development, globally...
...but as scientists move closer to success...
Possible breakthrough in the development...
...of a coronavirus vaccine
...there's a problem
Freedom
A growing number of people say they won't take a vaccine
I don't want to inject anything like this into my body
This is linked to declining trust in scientific experts and political leaders...
Hypocrite
...problems brought into even sharper focus by the pandemic...
I call it covid bollocks
...and fuelled by a spiralling infodemic
Take off your mask
Anybody who has trusted the president has been lied to...
...and many people like my dad have paid with their life
This crisis of trust could have catastrophic consequences
So, what can be done to rebuild trust in vaccines...
...and to protect the world from future disasters?
All vaccine advocates need to be more tech savvy
We have science and evidence and right and fact on our side
This is the front line in the race to find a covid-19 vaccine
Professor Jonathan Heeney is one of those leading the charge
It has very much been a race against time...
...and sometimes I wish time could stand still
The professor has been developing vaccines for over 25 years
Now we have representatives of those viruses...
...that are closely related to SARS-1 or SARS-2
But finding one to fight a virus...
...which has brought the world to its knees, feels different
I do know people who've had covid and it's a terrible, terrible death
It is an agonising disease
This project in Cambridge is about to begin clinical human trials...
...and the stakes could not be higher
If we don't have a vaccine, we will be stuck in this lifestyle of isolation...
...social distancing, masks for a long, long time
For a vaccine to immunise populations effectively against covid-19...
...around 70% of people need to be willing to take it
Trust is absolutely critical
If only part of the population is onboard...
...we're never going to bring this virus to its knees...
...and control this epidemic
Choose your side, choose your side
But, in the rich world especially...
...polls suggest that persuading people to take vaccines...
...may be as difficult as producing them in the first place
Are you gonna take it?
No
Are you gonna let your kids have it?
No
What are they?
Liars
Many of these protesters belong to a growing minority...
...who believe a covid-19 vaccine...
...would actually be harmful to their health
Do I worry about vaccinations, this one in particular?
Yes, definitely
It's been rushed and imposed on us...
...and I know I want to have my choice...
...and I don't want to inject anything like this into my body...
...and into my children's body
Some here see a vaccine as part of a wider government conspiracy...
...to exaggerate the dangers of covid-19
We do not consent
Many of these people have lost trust in their government
Take off your masks
I call it covid bollocks, what do you call it?
Covid bollocks
We want the truth
And we will not give up until we get the truth
We're not going to stand for being lied to by our governments...
...by people that we should trust
They want us to trust but we can't trust them
The views being expressed here are extreme and belong to a minority
The proportion of the global population opposed to vaccines generally...
...is estimated to be well under 10%
But anti-vaxxers, as they are often called...
...are a vocal minority and their views are increasingly...
...influencing broader society
Distrust can be infectious
A poll carried out in America in September...
...found that only 36% of adults said they would take a vaccine...
...when one becomes available...
...with 64% saying they wouldn't take one or weren't sure
In another survey under four-fifths of people...
...in 16 countries responded positively to the idea...
...of taking a covid-19 vaccine, if proven safe and effective
In the context of covid, I think empathy is absolutely crucial
Professor Heidi Larson is an anthropologist...
...and a leading expert on why significant sections...
...of the global population feel hesitant about vaccines
She says a failure to confront the root causes of “vaccine hesitancy”...
...as she calls it...
...is driving more of these people towards anti-vaccination views
The majority of the public that is questioning...
...they're hesitant, they're anxious
These are people who have genuine questions...
...who are open to vaccination...
...but are feeling they're not getting their answers...
...and then migrate more to the more anti-end...
...that seem more acknowledging their concerns...
...endorsing their concerns
Professor Larson argues that one of the historic problems...
...has been a failure by the medical establishment to listen...
...to the concerns of parents who have doubts...
...about inoculating their children
A lot of parents feel like they're being judged...
...called names for even asking questions
And that's not at all been helpful...
...in trying to support people in their decision-making...
...and positive sentiments towards a vaccine
It's really fundamentally about trust, relational trust
Breaking news...
...testing has been paused for one of the leading...
...candidates developed by Oxford University
In September a volunteer from a leading...
...covid-19-vaccine trial was admitted to hospital...
...and the project was temporarily halted
Professor Larson says an opportunity was missed...
...to build trust with the public
I wish in the news instead of just this is normal process...
...safety events happen, we're taking care of it...
...that the voice of a participant said...
...I appreciate the care and the attention...
...that the clinical team gave to me during this uncertain time
The message is sent that there is a caring team
That they're not just putting vaccines in people to count numbers...
...and get to the perfect vaccine
That there is human empathy in this
The medical and pharmaceutical professions...
...have been far from immune to missteps...
...during the history of vaccines...
...and this has helped fuel today's climate...
...of vaccine hesitancy and opposition...
...not least the legacy of a British doctor...
...named Andrew Wakefield
In 1998 he published research in a highly respected medical journal...
...claiming there was a link between a measles vaccine and autism
Wakefield and colleagues altered facts about patients in their studies
But his research turned out to be highly compromised
Studies have shown no connection between the MMR vaccination and autism
The journal eventually retracted the research...
...and Wakefield was struck off the medical register in the UK in 2010
But, many members of the public continued to see Wakefield...
...as a credible expert
This guy has been set up, it's nothing but lies
And millions across the world still have reservations...
...about taking the measles vaccine
It's symptomatic of a wider decline in trust in traditional experts...
...and governments in rich-world countries
Dr Jonathan Kennedy is an expert in global public health...
...and has investigated the link between trust in government...
...and authorities and hesitancy about vaccines
In this class we're going to talk about...
...the question of how to think critically about global health
Dr Kennedy analysed voting data and surveys on public confidence...
...in vaccines across 14 countries
He found a broad pattern
Where levels of electoral support for populist parties were higher...
...levels of mistrust in vaccines also tended to be higher
Populist sentiment, this distrust of elites and experts...
...isn't just isolated in politics
The forces driving scientific populism...
...are all very similar to those that drive political populism
Dr Kennedy argues there's a strong relationship...
...between vaccine hesitancy and political, social and economic crisis
At a time when trust between people and politicians...
...has been breaking down...
...a number of countries have seen a resurgence of measles
You trying to punch me sir?
I did not
How dare you
Yes, you racist
It certainly wasn't a coincidence that the UK last summer...
...lost its measles-free status
How about that
At a time where there was massive conflict over Brexit
During the covid-19 pandemic...
...the response of governments has further decreased trust...
...in public-health experts and politicians...
...not least in some countries with populist leaders
If test and trace isn't improved significantly...
...there could be a second wave
In Britain, under Prime Minister Boris Johnson's leadership...
...public-health guidance has changed constantly...
...and confusingly
We're constantly working to improve that delivery system...
...buying PPE from around the world
Creating a sense that the government is failing and incompetent
In a huge policy reversal affecting hundreds of thousands of pupils
What's more, senior political figures...
...have failed to follow their own health guidelines
Trust in the British government as a reliable source of information...
...about coronavirus fell from 67% in April to 44% in August
Don't let it dominate you, don't be afraid of it
In America, false information about the virus...
...has flowed from a president...
...whose contempt for truth has done more than anything else...
...to sow distrust in politicians and experts
One month ago today President Trump said...
...that the coronavirus was “dying out”
I've read a lot about Hydroxy, I happen to think that it has an impact
And then I see the disinfectant, it knocks it out in a minute
Researchers at Cornell University analysed...
...38m English-language articles about the pandemic
They found President Trump was the single largest driver...
...of misinformation around covid-19
This is me and my mum and my dad in New York...
...where I graduated from college
For some this has had lethal consequences
In June, Kristin Urquiza lost her father Mark to covid-19
65-year-old Mark was a life-long Republican voter...
...and Trump supporter from Arizona
He died after Arizona's governor reopened the state...
...encouraged by the president
When the governor and the president went around...
...pushing a reopening strategy and saying to the public...
...it was safe if you didn't have an underlying health condition...
...it was safe to go out, resume normal activities...
...my dad listened and thought it was safe
Mark contracted covid-19 after visiting a karaoke bar
His daughter says placing trust in his political leaders...
...proved a fatal mistake
Both the president and the governor of Arizona...
...are on record through that time, downplaying the virus
Anybody who has trusted the president has been lied to...
...has been misled and many people...
...like my dad, have paid with their life as a result
While the actions of populist politicians have undermined trust...
...in public-health advice and institutions
There is another factor which has driven this trend...
...the unprecedented speed at which misinformation can spread
In February, the World Health Organisation warned of twin dangers...
...a global pandemic but also an infodemic
A crisis in accurate public-health information
These insufferable globalist elitists like Bill Gates
He tells us we need a nationwide shutdown for months
This foundation is leading the charge to lower the world's population
Much of this infodemic is concentrated online
Social-media users...
...who may not hold strong views about particular issues...
...can rapidly be exposed to misleading and extremist content
Folks, I think they're trying to force a vaccine on all of us
Neil Johnson is a professor of physics...
...at George Washington University
His research shows how fake news can gain the upper hand...
...in the online battle for hearts and minds
What we expected to find was that there'd be a core of communities...
...maybe public-health agencies...
...that were promoting vaccines and establishment-health thinking
And that around this central strong core...
...there'd be other opinions, sort of extremes
But that's not what we found
We found that that was actually sort of inside out
Professor Johnson's team mapped conversations on Facebook...
...about vaccines between 100m people all over the world
They discovered that misinformation...
...was exerting more influence than accurate information
In some sense it's almost like a network of trust...
...and if they flipped either way of course...
...they could become red, they could become blue...
...and that completely changes the battlefield
On this battlefield map...
...red represents Facebook pages and members...
...with anti-vaccination views and their spread over time
Blue represents pages and members with pro-vaccination views
While green signifies the all-important groups of people...
...who are undecided
The undecided greens are more engaged...
...with the red anti-vaccination clusters...
...than the pro-vaccination blues
The reds, they are completely entangled with the greens...
...the not sures, the communities of pet lovers...
...parents groups, organic-blueberry lovers...
...the ones that can tip the balance one way or the other
The worry is, as we see the greens and the reds entangle...
...what we're really seeing is a beginning of an entanglement...
...of trust away from establishment science
Trust is the glue
Because in the end, when we trust the community...
...if they happen to start talking about vaccines...
...which is something that I don't ordinarily think about...
...I will follow them in their thinking
This entanglement matters
Research has found that online exposure to recent misinformation...
...about a covid-19 vaccine may significantly affect intent to take one
And Professor Johnson believes this kind of content...
...will continue to spread online with the result that...
...anti-vaccination sentiment could become the majority view
Within a few years, red with the concerned greens, will rise...
...to essentially dominate that space
And it'll be very hard to reverse that
So something different needs to be done now
Social-media platforms have increased their efforts...
...to stop the spread of untruths about vaccines and covid-19
In April, Facebook put warning labels...
...on about 50m pieces of content related to the virus
The platform partnered with reliable sources...
...like the WHO and the NHS
And in October, Facebook banned anti-vaccine ads
Yet campaigners argue the platform isn't going far enough...
...and is failing to take down...
...the majority of harmful content about vaccinations
More broadly, Facebook's own algorithm...
...undermines efforts to stem the tide of the infodemic...
...says Fadi Quran, from the online political campaign group, Avaaz
Facebook's algorithm is sabotaging the efforts...
...of the platform to fix the misinformation problem
It cares about keeping individuals engaged, interested and online
Sensationalist, outrageous content, not the CDC guidelines...
...but QAnon, for example, gets more engagement...
...and hence the algorithm pushes it up in your news feed
One solution might be to detoxify the algorithm
What Facebook isn't doing is redesigning its algorithm...
...redesigning its business model...
...to ensure that it's not continuing to amplify this content
And this does not mean that the algorithm...
...should be designed to censor content
It just means that the algorithm would downgrade...
...instead of putting this malicious content...
...at the top of one's news feed...
...the platform would make sure that it is at the bottom of the news feed
Social-media platforms could save lives
They have the power
This is a problem that Mark Zuckerberg...
...and Jack Dorsey could literally say...
...we're going to solve this right now
Yet redesigning algorithms and tightening regulations...
...on tech companies is unlikely to get to the root causes...
...of mistrust in vaccines
To do that health bodies and experts...
...will need to be proactive about building relationships...
...with the public, in person, and especially online
According to doctors at this paediatric practice in Pittsburgh...
...the key to tackling distrust, and misinformation...
...is to fight fire with fire
Hello, it's a yucky doctor coming in
How are you guys doing today?
Good, how are you?
I'm doing ok
While it might look like any other children's surgery...
...the Kids Plus practice has its own in-house video production suite...
...getting messages out to patients constantly and quickly
Vaccine advocates are online using our voices...
...not the same way we are in the office...
...we're saving lives, we're protecting them against mistruths...
...and disinformation that can literally kill people
I think all vaccine advocates need to be more tech savvy
Kids Plus routinely post evidence-based videos...
...and information about vaccines on all major social-media platforms
I'll start things off until we see our questions start rolling in again...
...hello to TikTok, hello to Facebook live
And this presence allows them to respond to questions...
...from parents and families, who feel uninformed and concerned
Our parents, our families are living their entire lives right here...
...on their phones, on their tablets, on their laptops, their desktops
If people hear good evidence-based information...
...before they hear the mis- and disinformation...
...that mis- and disinformation is much less likely to affect them
What you're essentially doing is inoculating them against that bullshit...
...before it can take root in them
These doctors also argue that it's vital to take on the stream...
...of highly organised and targeted viral attacks from anti-vaccine forces
The reality of online vaccine advocacy right now is if you post it...
...they will come, the anti-vaxxers will find you and they will attack you
They want to terrorise providers into silence
It's a challenge the practice knows all about
Together we can prevent cancer in your children
In 2017 Kids Plus released a video...
...promoting an HPV vaccine that prevents cancer...
...and faced a barrage of hostility
They attacked our posts
They attacked our Facebook page
They attacked the private pages of our families...
...and our patients who defended us on our post
They came right after our reputation
Kids Plus has since created a toolkit for health professionals...
...and built a digital cavalry of global-vaccine advocates...
...who can quickly come to the aid of those under fire...
...from anti-vaccine forces
Now, as a vaccine for covid-19 grows closer...
...Kids Plus and its self-styled “keyboard crusaders”...
...are steeling themselves for a bitter, but all important new fight
There is no vaccine yet
There's no herd immunity for covid
And look, this is what life is like without herd immunity
This is what life is like without vaccines
Past evidence suggests some people could end up taking vaccines...
...after saying they might not
But herd immunity to covid-19...
...may require around 70% take up of a vaccine...
...and just a six percentage point decline in acceptance...
...could endanger this goal
And for many, alarm bells are ringing
We're losing in large part...
...because the anti-vaccine forces are much more passionate...
...and organised than we are
There are far fewer of them than there are of us
We have science and evidence and right and fact, on our side
That's how we win