Health and Healthcare Systems

Why we need to start a new pro-vaccine movement

A medical staff member holds a bottle of anti-typhoid vaccine to be given to children during the immunisation campaign at a school in Karachi, Pakistan November 20, 2019. REUTERS/Akhtar Soomro - RC21FD92TBS6

A bottle of anti-typhoid vaccine given to children at a school in Karachi, Pakistan Image: REUTERS/Akhtar Soomro

Thomas Breuer
Chief Medical Officer, GSK Vaccines
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We are living through extraordinary times. Yet, just as it’s difficult to notice whether your hair has grown when you see it every day, it is easy to underestimate the nature and scale of the societal changes we are experiencing globally. Can you remember the exact moment when getting into an unmarked car with a stranger transformed from risky behaviour to lift-sharing and a reliable way to get from A to B? And when did you stop waiting until the morning newspaper or evening news to get an accurate update on what’s happening in the world and start checking online news outlets? Finally, when was the last time you went to a doctor without first checking your symptoms with Dr Google or your friends on Facebook?

There are other more concerning changes too. We are experiencing a slow and subtle downward shift in society’s reliance on and trust in governmental and non-governmental institutions, traditional industries, experts and even science itself – a shift being amplified, expedited and complicated by modern technology.

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On the flip side, trust between individuals is blossoming in this new reality; interestingly, this is whether the individuals (notably, many digital influencers) have authority or knowledge on a particular topic or not. In today’s digital age, an individual voice can quickly and efficiently be amplified to rally support and awaken a collective voice that can lead to positive or negative changes on a global scale. With some popular digital influencers calling science into question through the promotion of conspiracy theories, such as flat earth, and alternative medical treatments like the celery juice cure, those of us trying to advance and communicate about science must get back into the conversation. We have a role to play in a transparent, pro-science collective voice, with expertise and tools supporting behaviours that are beneficial to society as a whole. In so doing, we can help re-establish trust in science.

A great example of a pro-science communicator is Greta Thunberg. One year ago, on her own, the young Swedish activist skipped school on a Friday to protest for action to be taken on climate change; today, she is inspiring millions worldwide, young and old, to advocate for what scientists have long been saying – our climate is in crisis and action is needed. Some may dismiss the real impact she is having, calling her too young to have an influence on the decisions being made by those in charge. But we are living in a new reality and her voice is being heard, all the more so after her passionate speech to the UN General Assembly during the recent Climate Summit.

Thanks in part to the “Greta Effect”, very real changes in behaviour are starting to take place. The most visible action may be the climate strikes, but behind the scenes the marching schoolchildren are also urging their parents to make changes to energy, water and plastic usage in their households. Businesses who serve those families have taken notice and are making changes as well, such as supermarkets reducing the use of plastic bags and packaging.

Greta goes to show that a single voice, with a powerful pro-science message, can be amplified worldwide using modern technologies. Furthermore, she shows that an awakened collective voice can start to affect everyday behaviours and inspire real changes for the benefit of our society as a whole. We have, indeed, only just begun to see and experience the changes needed to safeguard a future for our climate.

However, not all individuals have goals as altruistic as Greta’s and some movements are detrimental to the health and well-being of the communities in which they operate and we live. Working in the vaccine business, I am referring to an infamous former-physician (who I will not name to avoid giving him more attention) and the vocal anti-vaccination advocates that look to him for inspiration.

Steps have been taken in defence of vaccine science since 1998, the year that saw the publication of his damaging study on vaccines. The publication was later retracted, the man in question lost his licence to practise medicine, numerous studies were conducted to disprove his alleged findings and efforts were made to increase vaccination rates after they dipped in the late 1990s/early 2000s, which in some countries took years to achieve. In hindsight, not enough was done to address the growing collective voice of those who listened to the former-physician and subsequently questioned vaccines, including the celebrities who adopted and amplified his messages.

Unfortunately, over the years, the anti-vaccine movement has been slowly and steadily planting the seeds of doubt among parents and communities and raising concerns about vaccines. They also showed a talent for using traditional and social media to spread fear, all while offering easy and misleading answers to the very questions they raised, that exceeded that of the institutions or scientists, like myself, working in the field of vaccines. The result? Localized drops in vaccination rates and the outbreaks of vaccine-preventable diseases, such as measles, that we see today.

Unfortunately, our collective reaction has been to put the anti-vaccination community, and the damage they are causing, into the spotlight. This has the potential to introduce a new danger (one raised by several attendees at the recent Global Vaccination Summit in Brussels): intense coverage amplifies the voice of anti-vaccination advocates, makes the anti-vaccination movement look much larger than it is and further plant seeds of doubt in the minds of others. After all, the great majority of people continue to get vaccinated.

A new approach is needed. To impact behaviours and reinforce trust in vaccines, it is not enough to fight against (and thereby risk legitimizing) the anti-vaccine movement. Instead, we need to start a new pro-vaccine movement, taking inspiration from what we see in the fight against climate change. I don’t mean that if we find the vaccine equivalent of Greta Thunberg, the problem will solve itself (although, there are some impressive young people already advocating for vaccines). Greta herself has been clear that it is unfair to put the full burden of hope and change on one individual, let alone the youth. It is on all of us to start working together – individuals, communities, industry, institutions, and experts – and highlight the fact that science around vaccines and vaccination is mostly clear and vaccination is accepted by the vast majority of people worldwide because vaccines work.

The vast majority of parents get their children vaccinated; country-specific recommendations are usually followed by the majority of citizens. The term “vaccine hesitancy” also needs to be rethought. Being hesitant means one is curious about a topic or has concerns or questions and this is absolutely legitimate. Those who are hesitant are raising questions and they deserve answers. It would be a fundamental mistake not to appropriately address those questions in a transparent and respectful way.

Institutions, social media networks, experts and a science-led vaccine industry have a clear role to play in this. Institutions have the mandate to provide the frameworks to curb bad behaviour (or reward good), social media networks can help slow the spread of viral misinformation by increasing access to factually accurate information (Pinterest, Facebook and Instagram have already gotten started); and experts, both in and outside of the industry, can help provide the information required by advocates working at the local level, working together with and supporting them as they answer the questions asked by those with doubts.

I am aware that real change happens slowly and steadily, and the road ahead of us might be long. But our destination is a healthier society in which questions about vaccines are met with accurate, clear and transparent answers; where the understanding of and trust in vaccine science is boosted, and vaccination is recognized as and remains the norm. The journey is certainly worth our collective effort and is one we must hasten without further delay. As an individual, a doctor and an expert in the vaccines industry, I am ready to play my role to help get us there – are you?

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