--- title: Vaccine Deniers tags: live-v0.1, misinformation permalink: https://c19vax.scibeh.org/pages/misinfo_vaxdeniers --- <!---{%hackmd FnZFg00yRhuCcufU_HBc1w %}---> {%hackmd GHtBRFZdTV-X1g8ex-NMQg %} # Vaccine deniers ## From acceptance to hesitancy and beyond Attitudes towards vaccines span a whole range, from full endorsement to complete rejection: ![](https://i.imgur.com/65yyOWq.png) <sub>Source: [UNICEF](https://mfr.de-1.osf.io/render?url=https://osf.io/79yna/?direct%26mode=render%26action=download%26mode=render)</sub> --- People who are hesitant about certain vaccines because they have safety concerns or are lacking information should not be called "deniers." That does not mean, however, that deniers do not exist. On the contrary, there is a large and growing literature on people who deny science---and why they do it---and criteria to identify denial have been developed: ![](https://i.imgur.com/85GNJxG.png) <sub>Source: [SkepticalScience](https://skepticalscience.com/history-FLICC-5-techniques-science-denial.html)</sub> --- Although the number of people who deny science is small, they can be vocal and sometimes they can hijack public discussion through spreading disinformation online and false-balance reporting by the media. <span style ="color:green"> Vaccine denial is nothing new, but within the context of a global pandemic, having accurate information about vaccines is more important than ever. It has been established that disinformation decreases the likelihood of vaccine uptake, so much so that the World Health Organization has currently listed vaccine hesitancy as one of the world's [top 10 health threats](https://royalsociety.org/-/media/policy/projects/set-c/set-c-vaccine-deployment.pdf). ## Meet the vaccine deniers Vaccine deniers refuse vaccinations in general ([WHO, 2017](https://www.euro.who.int/en/health-topics/disease-prevention/vaccines-and-immunization/publications/2016/best-practice-guidance-how-to-respond-to-vocal-vaccine-deniers-in-public-2017)). They deny the scientific consensus on the effectiveness and safety of vaccination and thereby adhere to a form of pseudo-science known as *science denialism* ([Schmid & Betsch, 2019](https://doi.org/10.1038/s41562-019-0632-4); [Hansson, 2017](https://doi.org/10.1016/j.shpsa.2017.05.002)). <span style = "color:green"> Vaccine disinformation tends to come from many groups, ranging from liberterians, concerned about their protecting their freedom, to parents, worried about the health of their children [(Bernam, 2020)](https://books.google.co.uk/books?hl=en&lr=&id=DL74DwAAQBAJ&oi=fnd&pg=PR7&ots=8hqHqt-Jtu&sig=epcuOL6rhwo2oW3usBVKlmRoxM0&redir_esc=y#v=onepage&q&f=false). While these belief systems are varied, they are often difficult to sway. It is a common notion for humans to hold and defend their pre-existing beliefs, and dismiss evidence that contradicts those beleifs, no matter how strong ([Poland et al., 2021](https://www.sciencedirect.com/science/article/pii/S0264410X21001547)). This is known as belief-dependent realism. Vaccine deniers use tactics such as censorship and personal attacks to shut down critical voices ([Kata, 2012](https://doi.org/10.1016/j.vaccine.2011.11.112)) and they often use misleading rhetorical techniques and emotional appeals to justify their beliefs ([Gallagher & Lawrence, 2020](https://www.jmir.org/2020/12/e19504/); [Kata, 2012](https://www.sciencedirect.com/science/article/pii/S0264410X11019086?via%3Dihub)). The figure above identifies some of those misleading rhetorical techniques. They are explained in detail [here](https://skepticalscience.com/history-FLICC-5-techniques-science-denial.html). Vaccine deniers are a rather small group among the vaccine hesitant population. However, some of them become highly vocal and use media effectively to spread their messages among undecided indivduals ([Kata, 2012](https://doi.org/10.1016/j.vaccine.2011.11.112)), so-called *fence-sitters* ([Leask, 2011](https://doi.org/10.1038/473443a)). Fence-sitters have a hard time finding evidence-based information on vaccination because the amount of anti-vaccination webpages and platforms is disproportionately high ([Johnson et al., 2020](https://doi.org/10.1038/s41586-020-2281-1)). Moroever, messages of vocal vaccine deniers are higly persuasive. For example, research reveals that spending only five to ten minutes on vaccine denier webpages decreases individuals' intention to vaccinate and increases the perceived risk of vaccination ([Betsch et al., 2010](https://doi.org/10.1177/1359105309353647)). ## Motives of Vaccine Deniers The denial of scientific evidence on the safety and effectiveness of vaccinations is a form of motivated rejection of science ([Lewandowsky & Oberauer, 2016](https://doi.org/10.1177/0963721416654436)) rather than a lack of education or knowledge. Similiar to other science deniers, vaccine deniers are motivated by vested interests (e.g., they sell anti-science books), identity expression (e.g., their non-conformity is their preferred self-image), conspiracy mentality (e.g., they tend to think that every pro-vaccine advocate is in the pocket of big-pharma), social identity (e.g., vaccine refusal is the prevalent social norm in their community), worldviews (e.g., they have low levels of collectivistic thinking) or fears (e.g., they fear needles) ([Hornsey & Fielding, 2017](http://dx.doi.org/10.1037/a0040437); [Hornsey, 2018](http://dx.doi.org/10.1037/hea0000586)). Moreover, political partisanship can be a gateway to vaccine denial. For example, Donald Trump was the first president of the United States who campaigned against vaccination and publicly acknowledged vaccine deniers such as Andrew Wakefield ([Dyer, 2016](https://doi.org/10.1136/bmj.i6545)). Research suggests that this anti-vaccination sentiment increased concerns about vaccination among his voters ([Hornsey et al., 2020](https://doi.org/10.1016/j.jesp.2019.103947)). <span style = "color:green"> Social media has a large influence in the way vaccine deniers are able to meet, communicate and organise their community. For example, Facebook has been the platform most used to organise [anti-vaccine protests](https://www.washingtonpost.com/health/2021/02/01/dodgers-anti-vaccine-protest-facebook/). This is a serious concern amongst healthcare professionals as such meetings and attitudes undermine lockdown rules and increase the risk of transmission. ## Managing vaccine denial A common recommendation among practicioners and researchers is to focus on protecting the public against messages of vaccine denialism ([Schmid et al., 2016](http://dx.doi.org/10.1016/j.vaccine.2016.09.065)) instead of seeking to convince committed opponents of vaccination. This [_Handbook_](https://sks.to/c19vax), of course, is dedicated to facilitating that process. <span style = "color:green"> A useful approach to managing vaccine **hesitancy** is motivational interviewing ([Gagneur, 2020](https://www.canada.ca/content/dam/phac-aspc/documents/services/reports-publications/canada-communicable-disease-report-ccdr/monthly-issue/2020-46/issue-4-april-2-2020/ccdrv46i04a06-eng.pdf)). Motivational intervewing is a technique where there is a respectful and balanced discussion between two people. The aim is to encourage the individual to use logic and facts that would allow them to come to a conclusion themselves that aligns with the facts. This technique has been successful in numerous studies in Canada. <span style = "color:green"> Additionally, cognitive styles play a significant role when processing information ([Poland et al., 2021](https://www.sciencedirect.com/science/article/pii/S0264410X21001547)). When information is presented to an individual, the processing of this is dependent on which cognitive style they are employing. It has been found that current healthcare information and educational tools concerning the vaccine address a fact-based, "left-brain" cognitive style. Vaccine information that taps into more varied cognitive styles may increase the chances of vaccine acceptance. **Other resources are available at our [dedicated resource page](https://c19vax.scibeh.org/resources).** ---- <sub>Page contributors: Philipp Schmid, Stephan Lewandowsky, Marta Radosevic, Dawn Holford</sub> {%hackmd GHtBRFZdTV-X1g8ex-NMQg %} {%hackmd TLvrFXK3QuCTATgnMJ2rng %} {%hackmd oTcI4lFnS12N2biKAaBP6w %}