F. Perry Wilson, MD, MSCE, of the Yale School of Medicine talks with Peter Hotez, MD, PhD, of the Baylor School of Medicine about the rise in vaccine refusal and the backlash against scientists.
F. Perry Wilson, MD, MSCE, Yale School of Medicine, Yale School of Public Health
In 1777, a Revolutionary War General faced a grim threat – smallpox. The disease had ravaged the British troops and had a 30% mortality rate. There was no good treatment. But there was something you could do – inoculation. Take a small sample from an infected person and inoculate an uninfected one. They'd get sick, but not as sick. The death rate was about 1-2%. But then they'd be immune.
The General mandated inoculation of the entire United States Army – a difficult decision that, according to some historians, saved America from losing the war.
That General, of course, was George Washington. There was immediate pushback when he made that decision. This was 19 years before the actual smallpox vaccine, which carried virtually no risk of death. That was developed by Edward Jenner.
Religious leaders at the time complained that inoculation interfered with the will of God. Libertarians railed against the mandate, even when applied to troops. Doctors of the time debated whether this inoculation process would even work.
That story is history, but it doesn't sound all that unfamiliar to me. The concept of vaccine hesitancy is as old as the concept of vaccines.
I'm Perry Wilson, a physician and researcher at the Yale School of Medicine and the Yale School of Public Health. Today, we're looking at a Health Day Harris Poll of over 2,000 American adults that tried to drill down on their opinions about vaccines.
To help me parse through the data and tease out what is going on with vaccine hesitancy, I'm joined today by Dr. Peter Hotez. Dr. Hotez is Dean of the National School of Tropical Medicine and Professor of Pediatrics and Molecular Virology and Microbiology at Baylor College of Medicine, where he is also the co-director of the Texas Children's Center for Vaccine Development and Texas Children's Hospital Endowed Chair of Tropical Pediatrics.
Dr. Hotez, thank you for joining me.
Peter Jay Hotez, MD, PhD, Dean of the National School of Tropical Medicine, Professor of Pediatrics and Molecular Virology and Microbiology, Baylor College of Medicine
Thanks for having me. Great to be here.
F. Perry Wilson, MD, MSCE, Yale School of Medicine, Yale School of Public Health
So, we have multiple news outlets now, PBS, Washington Post, reporting on NIH cuts to previously approved grants that were already being funded and the goal of the grants was to study the concept of vaccine hesitancy, you know, the drivers of it and whatnot. What do you think is going on here? Is there value to studying the very concept of vaccine hesitancy at all?
Peter Jay Hotez, MD, PhD, Dean of the National School of Tropical Medicine, Professor of Pediatrics and Molecular Virology and Microbiology, Baylor College of Medicine
Well, there certainly is because I don't think we really fully understand all of the social determinants of vaccine hesitancy. And the problem is, it's vaccine hesitancy is now a lethal force in America. My last book, The Deadly Rise of Anti-science, shows that 200,000 Americans needlessly died, including 40,000 in my state of Texas, because they refuse COVID vaccines. And it wasn't misinformation or infodemic, as we commonly call it.
It was a targeted organized disinformation campaign. And now, of course, it's spilling over to childhood immunizations. Where right now, where I am in Texas, we're enduring a horrific measles epidemic with 40 kids in the hospital and one pediatric death. And so this is an important cause of illness and serious illness, hospitalization, even death in America right now. So it's important to study. Unfortunately, it's part of a larger erosion and trying to dissolve any sort of pandemic preparedness.
F. Perry Wilson, MD, MSCE, Yale School of Medicine, Yale School of Public Health
One of the things that stood out to me in this poll, so this is a poll of 2000 Americans, all walks of life, asking what they think of vaccines, what makes them more likely to want to get vaccinated, what makes them less likely to want to get vaccinated. And really the strongest thing out there in terms of motivating people to get vaccines was personal experience with the disease.
Peter Jay Hotez, MD, PhD, Dean of the National School of Tropical Medicine, Professor of Pediatrics and Molecular Virology and Microbiology, Baylor College of Medicine
I don't doubt that's what the poll showed, but whether people are being genuine in their response. I mean, look what happened with Covid, right? 200,000 Americans died because they refused the Covid vaccine. And yet, you know, in in areas, more conservative areas, more rural areas of the country where people refuse Covid vaccines, they're still doubling down. They're still not getting boosters and that sort of thing. So I'm not even convinced that even that is what turns people around. And of course, you don't want to wait for an epidemic to convince people of this. And even here in West Texas, where we're seeing a large measles epidemic, there is some of a catch-up campaign, and now people are starting to get it and getting vaccinated, but a lot of people aren't. So, I don't know that we want to rely on that as our long-term approach.
F. Perry Wilson, MD, MSCE, Yale School of Medicine, Yale School of Public Health
You mentioned social media as an accelerant for vaccine hesitancy. The Harris Poll shows actually that only one in three people said that influence from online communities influenced their choice of whether to vaccinate or not. Is that one of the statistics that you believe or do you think that people are underestimating the effect of social media on their personal choices?
Peter Jay Hotez, MD, PhD, Dean of the National School of Tropical Medicine, Professor of Pediatrics and Molecular Virology and Microbiology, Baylor College of Medicine
I think, you know, social media was a component, particularly as Twitter morphed to X and started inviting back all the anti-vaccine activists. That's a component. think the cable news channels, Fox News was a big driver of vaccine hesitancy during the Delta wave, the podcasters, the conservative. I mean, I use the word conservative, not really conservative, sort of MAGA podcasters who railed against vaccines, you know, were also, you know, a component of it. So, in that sense, yes, I mean, I think the online stuff, or least social media is just part of a larger communications ecosystem that's out there.
F. Perry Wilson, MD, MSCE, Yale School of Medicine, Yale School of Public Health
There's a positive signal in the polling data that I wanted to mention. 90 % of those surveys said they went to their healthcare providers for vaccine information and over 70 % said their healthcare provider has an influence on their decision.
Peter Jay Hotez, MD, PhD, Dean of the National School of Tropical Medicine, Professor of Pediatrics and Molecular Virology and Microbiology, Baylor College of Medicine
I'm trained in pediatrics where we get to do a pretty deep education into vaccines, how vaccines work. And so certainly pediatricians and pediatric nurse practitioners should be trusted messengers for that. And so that's appropriate and a positive finding.
And of course, now we have all these new adult vaccines, right, for RSV and of course flu and Shingrix and Prevnar. And so now the internists presumably are getting a pretty deep dive into vaccines and the OB-GYNs as well. So yeah, that would be good news, of course, if people could rely more on their healthcare provider because I think that…that's probably one of our best hopes is a trusted messenger. It may not be sufficient, but it's certainly the right direction.
F. Perry Wilson, MD, MSCE, Yale School of Medicine, Yale School of Public Health
Any final thoughts before I let you go, Dr. Hotez?
Peter Jay Hotez, MD, PhD, Dean of the National School of Tropical Medicine, Professor of Pediatrics and Molecular Virology and Microbiology, Baylor College of Medicine
Well, I just again, I think, you know, I'm very concerned about the rise in deaths from vaccine refusal during COVID. I'm worried about spilling over to childhood immunizations in the U.S. I'm worried about globalizing to other countries as well, that U.S. style anti-vaccine activism.
And the other problem with it, of course, is the anti-vaccine movement attempts to demonize healthcare professionals and scientists who disagree with their views and portraying us as cartoon villains or public enemies.
That's a very dangerous route as well and very demoralizing. So, it's going to be really important to see how we can walk this back. I don't see the current events putting us in the right direction, maybe down the road.
For the full version of our interview on vaccine hesitancy, please visit our Substack: https://healthday.substack.com/
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