Vaccine confidence, public understanding and probity: time for a shift in focus?

Lack of vaccine confidence can contribute to drops in vaccination coverage and subsequent outbreaks of diseases like measles and polio. Low trust in vaccines is attributed to a combination of factors, including lack of understanding, vaccine scares, flawed policies, social media and mistrust of vaccine manufacturers, scientists and decision-makers. The COVID-19 crisis has laid bare societies’ vulnerability to new pathogens and the critical role of vaccines (and their acceptability) in containing this and future pandemics. It has also put science at the forefront of the response, with several governments relying on academics to help shape policy and communicate with the public. Against this backdrop, protecting public trust in scientists and scientific output is arguably more important than ever. Yet, conflicts of interest (CoI) in biomedical research remain ubiquitous and harmful, and measures to curb them have had limited success. There is also evidence of bias in industry-sponsored vaccine studies and academics are voicing concerns about the risks of working in a CoI prevalent research area. Here, we set out to challenge established thinking with regard to vaccine confidence, by shifting the gaze from a deficit in public understanding towards probity in research relationships and suggesting an alternative and perhaps complementary strategy for addressing vaccine mistrust. We argue that a concerted effort needs to be made to revisit the norms that undergird contemporary vaccine research, coupled with a willingness of all stakeholders to reimagine those relationships with an emphasis on demonstrating trustworthiness and probity.

Védőoltásokkal kapcsolatos kételyek és elkötelezettség a magyarországi egészségügyi alapellátásban dolgozók körében

Introduction: The attitude to immunization and the issue of vaccine hesitancy in health care workers (HCWs) have been studied in a former survey performed by ECDC (European Centre for Disease Prevention and Control). Aim: Our aim was to study the immunization attitude of primary care paediatricians, general practitioners and primary care nurses in Hungary. Method: We studied vaccine hesitancy in HCWs by way of a questionnaire, developed on the basis of a recent similar survey by ECDC in four countries. The online survey has been performed between May and July 2017. Altogether 765 questionnaires have been returned: 189 primary care paediatricians, 375 general practitioners working in adult or mixed practices, and 201 primary care nurses. The sample has been weighted to the country-specific features – e.g., location of the practice, residence and age of the HCWs – within each of the three groups, so from this aspect it can be considered representative. Results: Our results did not differ substantially from the international ECDC data. Approximately 2/3 of the primary care doctors and about 50% of the primary care nurses were convinced of the benefit and value of vaccines. Data on vaccine hesitancy were consolingly low, though the data on recommended vaccines were somewhat higher compared to the age related/NIP (National Immunization Plan) vaccines. The well-known vaccine scares – e.g., autism–MMR, etc., known also from the literature – could hardly been detected, and it can be explained by the voluntary participation in the study. The least supported vaccine is BCG, while the highest hesitancy rates are related to MMR in Hungary. Conclusion: The need to improve immunization-related communication among primary HCWs could clearly been detected – both in gradual and in post-gradual training programs. Orv Hetil. 2019; 160(48): 1904–1914.

The MMR debate in the United Kingdom: vaccine scares, statesmanship and the media

This chapter discusses the MMR vaccination controversy in the UK following the publication of a paper in Lancet which linked the MMR triple jab to childhood autism. We discuss the response of the British media to the paper’s claims, and its subsequent retraction, and the way that the actions of the then Prime Minister contributed to the debates. We analysed media reports from that time and draw on policy papers on science communication in order to show how a combination of events before and after the publication of Wakefield’s paper influenced public debates on science, trust and personal responsibility for health protection, and thus also had an impact on public health policy making. We follow a historical thread on actions of public figures on health policy issues and situate the debate in the context of British science policy in general to better understand vaccine controversies and debates in the British context.