Project Manager, Library and Knowledge Services, London and South East (Kent, Surrey and Sussex), Health Education England
Larson, Heidi J, Stuck: How Vaccine Rumors Start – and Why They Don’t Go Away, Oxford University Press, 2020, ISBN 9780190077242, 184 pages, £18.99
It actually happened. Vaccines against COVID-19, a disease scarcely anyone had heard of 12 months’ ago, are here. The cavalry, it seems, has arrived.
Only not everyone will welcome them. Why? Heidi Larson, Professor of Anthropology, Risk and Decision Science at the London School of Hygiene and Tropical Medicine, and director of the Vaccine Confidence Project, has spent many years trying to find an answer. Though no vaccine septic herself, the book is not yet another debunking exercise. As an anthropologist, she studies, in her own words, rumours – rumours around vaccines – why they arise, why they persist, why they stick.
Vaccine rumours are less about the facts than about their believability. They can arise against the background of failure to engage affected communities and their representatives. Concerns are not necessarily about safety but distrust of vaccine campaigns and the motives of those sponsoring them.
Conventional debunking can backfire. She cites the words of ethicist Stephen Pattison, who, writing of the MMR vaccine, cautions that scientists “must take care ‘not to treat fear and reservation as ignorance and then try to destroy it with a blunt rational instrument.’ Parental fears need empathy, not judgment. (p.28).” Andrew Wakefield and Donald Trump provided concerned parents with a listening ear, to believe their fear that their autistic child was living proof of the vaccine’s risks. Trump and Wakefield’s “parents know best empathy” launched them into “revered leader status” among their respective and overlapping circles (p.32).”
Later we in the book we read about spells of dizziness, nausea and fainting reported by girls receiving the HPV vaccine. Such reports came in from all corners of the globe. The link between symptoms and vaccine is almost certainly psychological but the symptoms are real enough. A brusque dismissal of this apparent link feels like a denial of the girls’ experience and pain and further fuels the alienation and anger felt by those affected, including their mothers and or others caring for them (p.88).
One of the key reasons why there will always be vaccine rumours – some more benign than others – is that vaccines will always have risks. There will always be uncertainty. The challenge is “in managing rumours and mitigating purposeful scare tactics while listening for important clues that need investigation (p.44).” Rumours have a genuine public health value – the WHO actively monitors them to sniff out something might be afoot on the ground, to detect possible new diseases before member governments realise or own up to it.
When reading this book, sometimes one despaired. Vaccination programmes have sometimes been suspended because the governments want to say “we are listening to you”, only to create more doubts and more rumours – as the French Government found when it suspended hepatitis B vaccines in response to unfounded concerns it caused multiple sclerosis. So showing empathy didn’t do the trick, then? Damned if you do, damned if you don’t.
Still, this book is an excellent resource and a mine of ideas for further reflection. The author convinces that vaccine rumours won’t disappear simply by replacing bogus information with “trusted” information. It’s more complicated than that. As the epidemiologist Stephen Ledeer points out: facts are not rejected because they are seen as being wrong, but because they are seen as being irrelevant. People believe in other approaches; they have different values (p.117).
The case is succinctly made, easy to read, and borrows from a variety of disciplines to present an informative, insightful and well-referenced account for a broad lay readership. It’s an essential read for any information professional interested in public engagement of science, health literacy or countering false information.