Is There a Growing Divide Between the Medical Community and the People They are Trying to Treat?
Despite the fact that in 2020, many of us were locked away in our homes as COVID froze our lives to a standstill, we still saw the rise of movement. The Black Lives Matter movement gained traction again, following the murder of George Floyd. As the pandemic wreaked havoc on peoples’ livelihoods, discussions of income inequality were brought back into the forefront. And as cities and states tried to do all that they could to curb the rising death tolls, the movement against vaccination rose once more. Even in the face of a deadly and contagious virus, there seemed to be an equally growing number of people who had a deep distrust of medical science and an even deeper distrust of any kind of recommended vaccinations, even if it meant putting their lives at risk. According to the New England Journal of Medicine, only 23% of Americans report a great deal or a lot of confidence in our healthcare system. There seems to be a growing divide between the medical community and the people they are trying to treat.
With the pandemic still on everybody’s lips, it’s impossible to also avoid discussing the number of people who are refusing to be vaccinated. And seeing celebrities and even former presidents endorsing the protest, the whole movement can feel like a very recent phenomena that’s owed to the age of misinformation and constant communication. But in fact, anti-vaccination movements have been around nearly as long as the birth of vaccinations. In the early 1800s in England, widespread smallpox vaccinations began after Edward Jenner’s successful experiments with cowpox. Known as “the father of immunology,” Jenner discovered that people who were infected with cowpox were immune to the deadly smallpox virus. At the time, smallpox killed around 10% of the population, sometimes getting as high as 20%. Jenner’s vaccine undoubtedly saved countless millions. But when mandated vaccinations were implemented, people immediately protested. Despite knowing how dangerous and prolific this disease was, people argued that this vaccine went against all sanitary (the vaccine was derived from cowpox pus), religious, scientific, and political rationale. Many people objected to vaccination because they believed it violated their personal liberties. The Vaccination Act of 1853 mandated vaccination for infants up to three months old and the Act of 1867 extended this age requirement to fourteen years, adding penalties for vaccine refusal. Immediately, the Anti Vaccination League and the Anti-Compulsory Vaccination League were formed in response to the mandatory laws. And towards the late 19th century, when smallpox outbreaks in the United States led to similar vaccine campaigns, just as many anti-vaccination groups formed stateside as well.
But despite anti-vaccination movements’ long history, these recent protests have felt different. Certainly louder. With the internet, the world has shrunk and global connectedness can happen at a finger’s touch. While many good things can be shared and passed along through this platform, so can misinformation and dangerous rhetoric. We have seen, especially within the past year, a small movement quadruple in size overnight because of the reach the internet can provide people. And today’s anti-vaccination movement seems to be a perfect storm of multiple factors. The first being, the internet allows small conspiracies to grow. Conspiracies in general need just one believer to stay alive. With the internet, one theory can be told to thousands, or even millions, with one blog post or tweet. With the blurring of lines between journalists and bloggers and the average Joe Twitter, it is becoming harder to distinguish between credibly, sourced information and the heavily biased opinion post. And these theories can really take hold, especially in parents, when they claim to offer information that can potentially save a child from autism. Parents might see their pediatrician a handful of times per year but they spend all day, every day online and sometimes, it can become an echo chamber.
A second factor in today’s anti-vaccination movement is the distrust towards Big Pharma. Despite making vaccines that save countless lives every year, many pharmaceuticals have earned the reputation of being very much bottom-line focused. Whether it’s shoddily made vaccines or exorbitantly priced life-saving medications or encouraging doctors with a free hand towards prescribing addictive pills, Big Pharma has done as much harm as good for a community within the last several decades. And because of this breaking of trust, many find it hard to believe what these company’s then recommend for our own “safety” and “well-being.” Many anti-vaccination believers argue against the idea of corporate drug makers having their best interests at heart, and there is evidence to prove their point. And with the deeply lined pockets of pharmaceutical lobbyists, many people also find their governments totally useless in keeping Big Pharma in check. It seems if they don’t take a stand against Big Pharma, no one else will protect them. This kind of all-or-nothing mentality that was created in part by many pharmaceuticals engaging in ethically gray practices only hurts the anti-vaccination believer by denying themselves any kind of drug, even the life saving kind.
Another reason is tied simply to the successfulness of past vaccines. For many western nations like the US or UK, it’s just simply been a long time since we’ve seen a deadly virus running rampant in our streets. Measles, mumps, and polio have been eradicated for a long time and because of this long absence, many people have forgotten just how deadly these viruses were and how desperate people were for a cure. (Although recently, we have seen an unfortunate rise in measles cases thanks to the anti-vaccination movement. In 2018, 371 cases of measles were confirmed in the US. In 2019, 1215 cases across thirty states were confirmed, the largest number of cases in one calendar year since the disease was declared eliminated. This led to the World Health Organization considering rescinding our status as a measles-free nation.)
A final reason for why this anti-vaccination movement feels so deadly and different may sound a little far-fetched and removed: our lack of proper funding and focus for education, specifically in the sciences and math. This might seem trivial but in the age of misinformation and deep fakes, the best resources for someone to deduce whether something is true or not is through good foundational knowledge. Funding and focus over the last few decades for the math and sciences in the US has been steadily going down and it’s showing. In 2015, out of the biggest cross-national tests, Programme for International Student Assessment (PISA), which every three years measures reading ability, math and science literacy, and other key skills among fifteen year olds in dozens of developed and developing countries, the US placed 38th out of 71 countries in math and 24th in science. Among the 35 members of the Organization for Economic Cooperation and Development (OECD), which sponsors the PISA initiative, the US ranked 30th in math and 19th in science. Science illiteracy in childhood can cause misunderstanding or mistrust in the scientific process in adulthood.
Another very important arm of the anti-vaccination group that is often overlooked is Black Americans. The traditional medical establishment has a long history of mistreating Black Americans—from gruesome experiments on enslaved people to forced sterilization of Black women to the infamous Tuskegee syphilis study that withheld treatment from hundreds of Black men for decades to let doctors track the course of the disease. And this kind of inequality in treatment still carries over today. Studies have found Black Americans consistently underrated for pain relative to white patients and with medical students entering medical school still believing stereotypes such as Black biology allows for higher pain tolerance than White biology. In an Oct 2020 poll, 7 out of 10 Black Americans say they’re treated unfairly by the health care system and 55% say they distrust it. Medical mistrust is not just related to past legacies of mistreatment but also stems from people’s current and contemporary experiences of discrimination in health care.
This kind of mistrust is particularly deadly for Black Americans during the age of COVID. Black Americans are more likely to get seriously ill and die from COVID but are less willing to take the COVID vaccine. According to the Pew Research Center in Nov 2020, just 42% of Black Americans said they would be willing to get vaccinated, compared to 63% hispanic and 61% White. But it’s not just their mistrust medical organizations must fight; it is also the inequities in outreach. Black Americans in the US are less likely than their White counterparts to have reliable internet access to make online vaccination appointments. They are also less likely to have flexible enough work schedules to take any available vaccine appointment or to have access to dependable transportation to vaccine sites, among other factors. With a history of medical mistreatment and a lack of access, many Black Americans are forgoing and mistrustful of any medical advice.
With so many people deciding to interpret their own medical findings or to ignore medical recommendations altogether, it is putting a crucial strain on how quickly our country can reopen and reemerge from this pandemic. Without achieving a high level of nationwide vaccination, it leaves many people still susceptible to the virus and can make the current vaccine obsolete if newer, stronger variants arise. Which has already been happening. The B117 variant from the UK, known to be more easily transmissible, has now become the dominant strain within the US. And most recently, the Delta variant from China has put the city of Guangzhou on high alert. The variant seems much more aggressive and targets a wider age range, putting school aged children in danger. This variant has wreaked havoc in India and has also reached the UK shores. It is unclear yet how well the current vaccines can hold up against this and any other future variants. To curb these strains and the spread of the virus, all of us need to vaccinate ourselves as quickly as possible. The faster people are vaccinated, the better protected we all will be.
Much of the resistance against vaccination and in particular the COVID vaccine is due to an onslaught of misinformation. And while fighting misinformation in its entirety might be too large a task for any one organization or government to take on, fighting misinformation against COVID and the COVID vaccine is possible. And that is exactly what the Biden administration is working to do. In April of 2021, they announced an ambitious advertising campaign intended to encourage as many Americans as possible to be vaccinated. Working with 275 organizations—including NASCAR, the Catholic Health Association of the United States, and the North American Meat Institute—the Biden administration plans to push awareness for harder to reach communities. The administration has also announced it was allocating close to $10 billion to increase vaccine access and confidence in minority communities that have been hardest hit by the pandemic. And the evidence so far is saying this kind of outreach is making a difference. A new poll by the Kaiser Family Foundation found that the number of Black adults willing to be vaccinated had increased substantially since Feb 2021.
While there can be historical evidence for some to distrust medical experts and to want to avoid medical treatments, we also cannot put ourselves or our communities in danger when life-saving and very necessary drugs are available to take. The best thing any of us can do at this moment is, if possible and eligible, to go get vaccinated as soon as we can and to encourage those around us—family, friends, coworkers—to also get vaccinated as soon as possible.