Why vaccine rumours stick—and getting them unstuck

The Lancet
Aug 01, 2020 Volume 396 Number 10247 p291-360, e12


Why vaccine rumours stick—and getting them unstuck
Bruce Gellin
…Heidi Larson’s compelling new book Stuck: How Vaccine Rumors Start—and Why They Don’t Go Away looks at the dynamics of the evolving debate through the lens of an anthropologist who has been studying vaccine confidence for decades. Largely written before COVID-19 surfaced, this book is timely as the world has its eyes longingly set on a COVID-19 vaccine.
As Larson notes, ”the quality of life that most of us enjoy today is dependent on vaccines. In many ways it is one of the biggest worldwide social experiments in collectivism and cooperation in modern times. The challenge is that it depends on a social contract whose fabric is eroding in a broader context of anti-globalization, nationalism, and populism. Vaccines can, as they have in the past, serve as a form of soft diplomacy to keep at least a fundamental level of global cooperation alive and well.”
…Larson’s book draws from a vast array of findings from her Vaccine Confidence Project that has established an information surveillance system for early detection of public concerns around vaccines. From this large body of work, Larson explores several important themes in Stuck: rumour, dignity, distrust, risk, emotional contagion, choice, the power of beliefs over facts, and the power of stories over data. Her analysis of these issues covers a broad range of events, settings, and countries, including Ebola virus vaccine trials in west Africa, routine MMR vaccination in the Somali community in Minnesota, USA, human papillomavirus vaccination in Japan and Columbia, dengue vaccine introduction in the Philippines, and the ramifications of a CIA-inspired sham hepatitis vaccination campaign in Pakistan as part of the hunt for Osama bin Laden.
…But Larson asks that we do more because it isn’t only about getting the facts right. As she frames the core problem: “we don’t have a misinformation problem, we have a relationship problem”. The misinformation can be deleted, but the underlying distrust that has caused it and allowed it to stick remains. Rather than countering and dismissing rumours, Larson encourages the health community and other stakeholders to listen to these rumours and recognise what people are saying. These analyses can reveal deeper issues such as the feeling of being disenfranchised and not being heard. It is from these insights, she argues, “lie the cues to building new and more trusting relationships”…