There are few issues as inflammatory as vaccinations, and this week the UK government took a decisive stance by revealing it wants to ban anti-vaccine posts from social media. Health Secretary Matt Hancock announced plans to introduce legislation that would force social media companies, such as Facebook, to remove posts promoting false or misleading information about jabs including MMR (measles, mumps and rubella), which is typically given to babies within a month of their first birthday, and considered safe and effective by medical professionals.
Social media is awash with anti-vaccine – or anti-vaxx, as it's also known – content from around the world, and links have been drawn between the burgeoning worldwide movement and a rise in measles cases in many parts of the world in recent years. Measles is a highly contagious disease with potentially life-threatening ramifications, and doctors are concerned about the drop in MMR vaccine uptake in many countries, including England.
Doctors in Greater Manchester reported a sharp rise in measles cases between January and March this year, while the number of people who contracted the disease in Europe in 2018 hit a record high, with more than 82,500 reported cases and 72 deaths. Parts of the US have also reported outbreaks, with one county in New York City declaring a state of emergency on Wednesday after a severe outbreak. Rockland County has banned unvaccinated children from public spaces and will punish those who contravene the order with up to six months in prison and a $500 (£378) fine.
While the anti-vaccine movement is far larger in the US than the UK, the movement – which the World Health Organization named as one of the biggest threats to global health in 2019 – appears to be gaining traction on this side of the Atlantic, according to the All Party Parliamentary Group of MPs on vaccination, which recently launched an inquiry into the phenomenon.
Anti-vaxxers believe certain vaccines are unsafe, with their chief worry appearing to be that the MMR vaccine causes autism, a claim which stems from research by British former doctor Andrew Wakefield in the late 1990s, which drew a link between the two. Wakefield was struck off the UK's medical register in 2010 and his work was widely discredited, withdrawn by The Lancet which published it, and described as "a small case series with no controls... [which] relied on parental recall and beliefs" and "fatally flawed both scientifically and ethically" by the British Medical Journal. But that hasn't stopped anti-vaxxers, particularly in the US, from embracing his theory.
The scientific and medical community is unanimous and clear that vaccines are the safest and most effective way to protect children from contracting diseases, and agree that they're vital in safeguarding and improving public health (known as herd immunity); but the strength of the anti-vaxx movement suggests something is amiss with public trust in science and evidence-based research. Why are some people so adamantly against vaccines? And what role does social media play in promoting the anti-vaxx movement and other alternative medical theories?
For most of us, who understand the importance of vaccines, the idea that anyone would consider not vaccinating their children is unfathomable. To put your child in danger based on the words of a discredited doctor like Andrew Wakefield or some people on the internet, dismissing the opinions of qualified doctors, makes no sense. Clearly though, shouting down anti-vaxxers online is doing little to help the situation. So we decided to try and understand why someone would be against vaccinations. How have we found ourselves in a situation where heavily disproven beliefs have resurfaced and people are dying?
To better understand the thinking of anti-vaxxers, Refinery29 spoke to 31-year-old Laura* (who requested that only her first name be used), a full-time foster carer in west London who is 34 weeks pregnant with her first child, due in May. Laura doesn't believe in the efficacy of vaccines and says that she and her husband don't intend to vaccinate their baby once she is born. We sought to understand how she came to hold her beliefs and see if there’s anything we can take from the interaction to promote a 100% pro-vaccine world going forward. We also spoke to Dr Samantha Batt-Rawden, 30, chair of The Doctors’ Association UK and an intensive care medicine doctor in West Sussex, who is passionately pro-vaccine. Her decision to give her 21-month-old son, Joshua, all available vaccinations was, as she puts it, "a no-brainer".
How would you sum up your attitude towards vaccinations, including the MMR jab?
Laura: From the various research and reading that we've done, both since and before being pregnant, my husband and I have decided not to vaccinate our baby once she's born. Specifically, [we don't want her to have] the MMR jab. The idea of vaccinating a child with the same dose that an adult would receive at the age of 12 months is preposterous to me.
Dr Batt-Rawden: As an intensive care doctor, seeing a child suffer needlessly from the complications of an illness which could have been prevented by vaccines is not something you ever forget. It’s heartbreaking and soul-destroying.
Why did you decide to vaccinate, or not vaccinate, your own child?
Dr Batt-Rawden: My son Joshua was born 13 weeks early, at just 27 weeks, weighing 900g. He spent nearly three months in intensive care and came on oxygen, as spending so long on a ventilator damaged his lungs. Premature babies, especially those with chronic lung disease, are incredibly vulnerable to infection. Joshua was too young to be vaccinated, so we were relying on everyone else around us to be vaccinated and protect him. That winter there was a measles outbreak where I live. I was terrified to take him outside. Measles is so contagious that you can catch it by just being near someone who is infected. The tragic outbreak that occurred at Disneyland in California in 2014 shows how quickly measles can spread. I felt so helpless as a mother knowing I couldn’t protect him, and relied desperately on other mothers to provide him with herd immunity knowing it was out of my hands.
Laura: I've worked in the care industry for many years: from elderly care to childcare to mental health, autism and Asperger's. In particular when it comes to autism, which is in my own family, and after speaking to several parents with autistic children, I've concluded that, despite general practitioners’ disagreement, parents noticed an immediate change in their child's character, and the signs of autism first appeared almost moments after they received the MMR vaccine. I understand that "professionals" state that there isn't enough evidence to link MMR with autism (of course, why would they admit it does? Pharmaceutical companies are some of the largest money-making businesses going). I strongly disagree based on the firsthand evidence I've gathered working in that sector.
Another concern of ours is that when doctors are asked what's in each of these vaccines, they're unable to answer. Is it not their job as health professionals to know the answer to this simple question? And to know what each ingredient does?
I was vaccinated as a child and I was, my mother told me, a very sickly child, often with sickness and diarrhoea, which is usually brushed under the carpet by doctors as a normal part of a child's development, as well as rashes, a continued snotty nose and asthma. If these side effects are what's to come for my child once she's vaccinated then I will not be responsible for that. A healthy diet, vigilant monitoring of her health and regular exercises will be enough to boost her immune system to fight any infection she may get, including measles, mumps and rubella, which a number of close relatives and friends have contracted and got over perfectly well with the right treatment.
Why do you believe the anti-vaccine movement has gained so much traction around the world, including in the UK?
Laura: People are becoming wiser and braver, linking the side effects and symptoms to their current circumstances. Even health professionals are now starting to challenge the education given to them, doing their own research and not just relying on what they are being taught directly.
[The British Medical Association, which represents around 160,000 doctors in the UK, says it "has long highlighted the importance of immunisation for population health".]
Dr Batt-Rawden: Sadly, some of the blame for the anti-vaccination movement has to lie squarely at the door of former British doctor Andrew Wakefield, whose research linked the MMR vaccination to autism; this has now been widely debunked and discredited. The journal which published his paper, The Lancet, retracted it, and Dr Wakefield was struck off the medical register and is no longer able to practise. But the damage had already been done. I am so ashamed that this came from my own profession.
Since then we’ve seen a shift, we’re told that people no longer want to hear from "experts". This, in part, hasn't been helped by the UK tabloid press. I would say: please don’t think of us as "experts", people like me are just ordinary doctors, who witness firsthand the impact of not vaccinating children, and desperately want to protect our patients. Trust us.
What do you think about the government's intention to remove content promoting false information about vaccines from social media?
Dr Batt-Rawden: It's a bold move and a much-needed step. Social media has given a platform to those spreading false information about vaccination and undoubtedly this will have contributed to many parents' decision not to vaccinate their child. Several "anti-vaxx" Facebook groups are highly active and entirely one-sided, not allowing anyone, let alone doctors, to give an alternative view or have a reasoned conversation with those thinking about not vaccinating their children. We've recently seen reports of doctors being hounded on social media in what appears to be a coordinated attack, when trying to address some of the concerns around vaccination. This just isn't right, no one should be the subject of threats and abuse online, especially not when trying to protect the health of our country.
Laura: When they [the government] say "false information", it leaves me wondering if they have already decided on what's right and wrong. Are they suggesting that it is wrong to not vaccinate children? Who's to say that they are right to promote this? I'm a smart and logical individual who should be able to make that decision for myself, not be told what to believe. It's disturbing knowing that I may be told that the research I did for myself on the pro- and anti-vaccination arguments could be completely dismissed. As long as I choose to do not what the government tells me to do, I could be considered a bad or neglectful parent. The people who post the articles that are against vaccination have every right to share their thoughts and "evidence" via social media, as well as the pro-vaccination activists.