Doubt about vaccines has existed for as long as vaccines themselves.
In England during the 19th century, some people protested against compulsory smallpox vaccinations, arguing it infringed on their civil liberties and human dignity. In the U.S., groups opposing vaccination have been around since the Anti-Compulsory Vaccination League of Brooklyn was founded in 1894.
Today, researchers refer to those who resist standard vaccine advice—by refusing or delaying— as vaccine hesitant. This term is notably linked to the Make America Healthy Again movement, with Health and Human Services Secretary Robert F. Kennedy Jr. at its forefront.
Public health experts and communicators have attempted to counter these beliefs with accurate, factual information. However, as a researcher in medical humanities studying how vaccine-hesitant groups communicate their beliefs, I’ve noticed that combatting vaccine hesitancy is particularly challenging. These groups often use storytelling in persuasive ways.
Unlike pro-vaccine messaging, which must adhere to the nuanced and sometimes uneventful realities of science, the narratives from vaccine skeptics often make bold claims.
Why facts aren’t enough
People often think that those who doubt vaccines are simply misinformed, so providing better science-related information would resolve their concerns. This is referred to as the information deficit approach.
In response to this view, public health advocates have been developing easy-to-understand educational material about vaccines to enhance scientific understanding.
Yet, this effort has seen limited success. It’s evident, for instance, that the number of people expressing vaccine-hesitant beliefs is on the rise.
This phenomenon relates to a misconception about vaccine hesitancy: it’s not necessarily a lack of understanding or access to credible medical information. Vaccine hesitancy is considered a “wicked problem,” complicated by misinformation, a quest for belonging, and deeply held beliefs.
The truth is, not everyone who is hesitant about vaccines fits a stereotypical profile. Individuals with advanced degrees and high health literacy can also be vaccine skeptical.
People may hold these views for various reasons, such as distrust of the medical system, criticism of government actions, efforts to protect their children, or being drawn to compelling personal freedom narratives.
Vaccine symbols
In health communication, both science and storytelling play roles. A patient’s medical history organizes their health data into a coherent story.
However, groups that are vaccine hesitant excel in using narrative to create stories filled with emotion—like doctors dismissing patient worries and children suffering health issues post-vaccination.
The power of these narratives lies in the fact that they often transcend the topic of vaccines themselves. When vaccines are positioned metaphorically, they represent broader anxieties rather than just medical concerns. These narratives tap into deeper societal fears related to personal autonomy and control.
For instance, some online communities portray vaccine refusal as a form of civil disobedience, even though vaccines do not threaten individual freedom directly. Similarly, rejecting the COVID-19 vaccine has been framed as a display of psychological resilience.
A new normal
Under Kennedy, the CDC has begun crafting messages that align with the narratives of vaccine-hesitant groups.
For example, when announcing alterations to the childhood vaccination schedule, the CDC suggested a shift toward “individual-based decision-making.” The chair of the Advisory Committee on Immunization Practices framed vaccination debates around autonomy versus public health.
This portrayal presents vaccination as a challenge to personal individuality, suggesting a philosophical threat rather than a real medical one. The narrative implies that vaccines endanger individual freedom, which isn’t true in a medical context but resonates on a personal level.
Becoming better readers
Given the ongoing challenge of vaccine hesitancy to public health, it’s clear that merely enhancing health and scientific literacy won’t resolve the concerns rooted in narratives about untrustworthy institutions.
However, dismissing those who express doubts about vaccines may lead to missed chances for a deeper understanding of the complex motivations behind such hesitancy. Many of these motivations are shaped by personal experiences with healthcare systems. For instance, marginalized communities, like many Black Americans, have valid reasons to be cautious of health recommendations due to historical exploitation.
Some researchers are now adopting approaches that integrate literary techniques, such as symbolism, to tackle vaccine hesitancy. This involves recognizing the storytelling methods at play to make them less convincing, along with acknowledging the perspectives of hesitant individuals to foster respect.
By understanding the narratives and the legitimate critiques surrounding vaccine hesitancy, a more nuanced approach can lead to better healthcare experiences overall.
