Vaccine hesitancy has been around for hundreds of years. So, what’s new in the Covid era? PhD candidate James Olliver, and Senior Lecturer Susan Wardell, from the University of Otago, discuss
We are continually seeing stories of the real-life implications, and quandaries, that vaccine hesitancy creates.
The “Baby W” court case is one of the most striking and recent of these.
But from safety concerns to religious concerns, to political disagreement, there is a longer history to vaccine hesitancy and protest that may help us understand the present day, too.
For God and for liberty: the early history of vaccine protest
Almost as long as vaccines have been around, history has recorded resistance to them.
In 1720, an English physician, Zabdiel Boylston, in Boston, Massachusetts, in the United States, was one of the first people to champion public vaccination.
During this time, colonial port cities were losing up to a quarter of their population, upon the arrival of smallpox.
Far from the highly developed modern vaccine, Boylston’s method (learned from a legal clergyman, who learned it from a slave) involved rubbing material from a smallpox sore into a small wound – a procedure called ‘variolation’.
His initial efforts to inoculate 180-250 locals this way were met with immediate resistance.
Some other doctors felt it a threat to health, while still others held fears about it being unnatural, and an affront to God.
At one point, someone threw a hand-grenade into Boylston’s home, in protest.
At another point, he was arrested, and released when he promised to only vaccinate with government permission.
People also protested the erosion of personal liberties, when compulsory variolation was introduced for military recruits, during the American Revolutionary War.
By the early 1800s some US States had introduced immunisation requirements for the general population too.
This also became widespread in the United Kingdom.
In 1853, the UK passed a Vaccination Act to make vaccination mandatory for infants – and later, for children up to 14 years - with penalties for refusal.
In 1885, an anti-vaccination march in Leicester, England, was attended by 80,000-100,000 people.
These movements soon started to formalise.
An ‘Anti-Vaccination Society’ had already started in the US in 1879, with more quickly following.
In the UK, the ‘Anti-Vaccination League’ formed in 1896.
Their protests caused such a stir that England added a conscientious objection clause to the law.
Despite this, smallpox was eradicated in Britain by 1934, and was considered to be eradicated worldwide by 1980.
But other communicable diseases remained rampant.
Vaccination industries: losing and gaining public trust
Over this 20th century era, vaccine hesitancy largely revolved around safety concerns.
Unfortunately, these were not wholly unfounded.
In 1955, amidst the global polio epidemic – which was killing an estimated half a million people per year – a Californian lab released 120,000 incorrectly produced polio vaccines.
These ineffective vaccines were administered to children across five states, resulting in an estimated 40,000 cases of polio.
This understandably created distrust in the pharmaceutical industry.
The diphtheria, tetanus and polio vaccine (DTP) also fuelled concerns when, in the 1970s, across both the United States and the United Kingdom, some children who received this vaccine developed neurological conditions.
A new vaccine, that did not cause this side effect, was quickly produced. But the damage to public trust was already done, and the new vaccine had a much lower uptake.
Probably the largest influence on modern vaccine hesitancy is the infamous Wakefield article, published in 1998 in prestigious medical journal The Lancet.
In the article, British physician Andrew Wakefield claimed to have found a connection between the measles, mumps and rubella (MMR) vaccine and developmental regression often associated with autism.
The article itself did not claim a direct link to autism, but Wakefield publicly called for a withdrawal of the vaccine.
Further studies have shown no causal connection between the MMR vaccine and autism, and highlighted severe ethical issues with Wakefield’s research.
Wakefield’s medical licence was revoked.
Ten co-authors removed their names, and The Lancet formally retracted the article.
Despite this, it remains commonly referred to within many vaccine-hesitant communities, who draw their information widely and often contest authoritative scientific stances.
Covid and the politicisation era
The 21st century has seen a new edge to movements against vaccines.
Throughout the Covid-19 pandemic, vaccine hesitancy has become entangled with political identities.
This is especially evident in the partisan system of US politics, where opposing vaccines emerged as part of common political strategy of simply opposing whatever your adversary promoted.
Donald Trump’s approach to Covid-19 highlights this the best.
The entanglements of politics and religion also became obvious, with Trump’s rhetoric aligning with the beliefs of many conservative Christian circles – opposing vaccines in favour of relying on ‘natural’ (God-given) immunities, and prayer.
These perspectives prevail despite the overwhelming evidence of the benefits of the vaccine during the global pandemic.
At the same time, and sometimes with a surprising presence within the mainstream, we saw the rise of conspiracy theories.
In fact, conspiracy theories have always had a place in opposition to vaccines: for example, an 1805 pamphlet stated that the smallpox variolation would cause someone to grow hoofs and horns.
The key difference in the current era is the scope of these theories.
Instead of focusing solely on the vaccines themselves, the theories entangle broader worries about society, on a national or global scale, such as the theories about 5G and tyrannical governmental control.
It’s important to note that New Zealand does not follow all of the same trends as the US.
Here, we have indeed had strong voices from some anti-vax and vaccine-hesitant communities – including as part of the Parliament protests.
But these have remained largely disconnected from any particular political party – or rather, have brought together strands of people from a number of different political groups, religious alignments, and social demographics.
As recently as August, some have opted to form their own political party – ‘Freedoms NZ’, led by Destiny Church’s Brian Tamaki.
Even with this increase in visible vaccine hesitancy, New Zealanders still largely chose to get vaccinated for Covid-19, with 90.2 percent of those 12 or older receiving their primary course.
Why does it matter?
In some ways, concerns about vaccines today are the same as they always have been: are vaccines safe? Do they work? What role should the government have in promoting or mandating them?
Most people never expected to have to make up their minds about this, amidst the pressure-cooker of a global pandemic.
And while medical knowledge aims to grow support in responding to this, other voices play upon fears, and upon other emotions to do with group affiliation and identity.
They offer people new questions, like ‘do vaccinations align with my political positioning?’, and ‘what groups does getting vaccinated (or not) identify me with?’ and ‘who do I trust to tell me what to do?’.
As such, social, political, and religious movements have come to shape our collective fate, as much as biology.
Which is not so new either but is perhaps higher stakes now, than ever before.
