Childhood vaccination: To vax or not to vax? Now there’s a question

I recently came across a post on Instagram that really took me aback and then get on my high horse of indignation….it was a post about the ‘perils, dilemmas and dangers’ of childhood vaccination.

I had been mindlessly scrolling through my feed on the train when the post jumped out at me. The post was from someone I had followed for a while and really liked. We shared many of the same views and outlook on life and all things parenting. She regularly made me laugh out loud with her stories of everyday life as a working mum and the realities of parenting versus the often portrayed Insta-perfection shared by many.

To find out that she was an ‘anti-vaxxer’ threw me completely. She wasn’t my vision of what an ‘anti-vaxxer’ should be. She was well educated and smart…and I couldn’t reconcile this with someone who didn’t believe in protecting her own children and not putting other more vulnerable members of society at risk. I ‘un-followed’ and realised how strongly I felt about the ‘anti-vax’ movement. I was angry that as an ‘influencer’ she was putting her, in my opinion, irresponsible views out there.

There have been a number of recent articles about the rise of anti-vax propaganda published on social media. A recent report ‘Moving the needle’ published by the Royal Society for Public Health has found that half of parents with young children are being exposed to anti-vax misinformation on social media. “We need to counteract health misinformation online and via social media”, said RSPH Chief Executive Shirley Cramer, adding that, “We call on the social media giants and platforms to look at what they could do around this because it is a breeding group for misleading information and negative messaging;. The report states: “This substantial exposure to negative vaccination messages may influence attitudes to vaccinations over time: repetition of messages is often mistaken for accuracy, a phenomenon known as the illusory truth effect.”

In a more rational and less ‘judgy’ frame of mind, I wanted to find out how much responsibility the anti-vaxxers should accept for the recent rise in infectious diseases such as measles now being at its highest level since its ‘eradication’. The World Health Organization this year ranked the anti-vaccine movement among its top 10 global health threats and UNICEF attributes low vaccination rates to a 30% global increase in measles infections in just one year.

I also wanted to understand more about the arguments and beliefs underpinning the anti-vax position. I realised that I couldn’t actually form an effective response to their arguments because I didn’t fully understand what motivates their beliefs – I was all just moral bluster.

Vaccination: More than personal choice

Vaccination is more than a personal choice; the inaction of others can affect even vaccinated children and adults. Community vaccination helps halt the spread of a virus, such as measles, and in turn protects the wider population. But here’s what’s so important – each outbreak of infectious disease is different and there are obvious and less obvious nuances to each one and can’t simplistically be attributed to a groundswell of anti-vax sentiment. Recent cases of measles outbreaks were linked to unvaccinated travellers returning home who had acquired the virus abroad and then infected their home communities with lower vaccination rates. Sometimes it’s a case of missed doctors’ appointments or children receiving just one dose of a vaccine instead of the required two.

Julie Leask, a social scientist and Associate Professor at Sydney University’s school of public health provides a sensible overview: ‘To be committed to the science of immunisation ideally comes with a commitment to the science of immunisation behaviour. Media often present this problem as a refusal to vaccinate. But the evidence is clear and it’s more complex; under vaccination is broadly about a lack of acceptance and a lack of opportunity to vaccinate fully or on time. It’s not just the haves, but the have-nots who do not fully vaccinate.”

She continues: “A typical measles outbreak will reveal this. There will be children whose parents refused vaccination, children whose parents were unwittingly not up to date for lack of access, affordability or awareness; adults and travellers who didn’t get a needed booster and babies who are too young to be vaccinated.”

There is no doubt that the anti-vax movement and its social media profile forms a small part of the reasons why some people in the developed world don’t choose to vaccinate their children but it’s also way more complex.

The bigger picture

Julie Leask, along with her fellow authors Harold Willaby and Jessica Kaufman, published a commentary in the journal Human Vaccines and Immunotherapeutics entitled ‘The big picture in addressing vaccine hesitancy’ and they stated that “Vaccine programmes are underpinned by a rigorous science determining their efficacy and safety in populations. There needs to be a similar level of commitment to identifying and testing the interventions designed to increase uptake of vaccines among vaccine-hesitant patients’.

At Aurora we have worked with a number of pharma companies to investigate how to increase the uptake of vaccine use through methods of behaviour change. We follow a robust approach to involve patients in our work. Our methodology recognises that listening is only the first step. We need to co-create with patients – providing multiple opportunities for them to make their voice heard and share experience if we are to design programmes that are aligned to their needs. By understanding the nuances of our patient audience and treating them as partners, we have built campaigns that have made a real difference to wider patient populations.

If you’d like to hear more about how you can involve patients, and represent them in your work, contact

1 Comment

| Sue Neilen

Interesting to see how some countries are tackling vaccine ‘hesitancy’ head-on. In Germany, parents who refuse to vaccinate their children against measles could face a fine of more than £2000. The draft law won’t take effect until 2022, and impact around 220,000 adults and 361,000 children. The German law comes just a few months after Italy reinstated £450 fines for parents who send their unvaccinated children to school.

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