Lamnbert here: “Vaccine hesitancy” is one of those psychologizing, indeed infantilizing, PMC terms that I really hate. (This article applies it mostly to parents, but its broadly used.) On the one hand, many millions are alive today because of the MMR series of vaccines. On the other, many have good reason to think twice about many of the vaccines developed during our ongoing Covid pandemic. For example, I would prefer killed virus technology, which is proven, over mRNA, which is “innovative.” And I would prefer nasal delivery, were it [family blogging] available, over intramuscular injection. And I would treat any pronouncement by Big Pharma with a hermeneutic of suspicion, and read the studies carefully. I think a lot of people are of like mind. To throw all considerations like these into a “hesitancy” bucket is, I think, underthinking the problem and asking me to place way too much trust in professional classes that have not, to put it mildly, behaved well. All that said, this is a very stupid timeline, and it’s always possible to make things worse, so it is with a degree of happiness that I see some data that shows that anti-vax discourse, though corrosive and highly amplified by our Rolodex-driven famously free press, is so far a surface phenomenon.
By Dan Falk, a science journalist based in Toronto and a senior contributor to Undark. Originally published at Undark.
David M. Higgins, a pediatrician at the University of Colorado and Children’s Hospital Colorado, sees patients and also conducts research — but “not the type of research that’s done in the laboratory with beakers and things like that,” as he puts it. Rather, his focus is on health services research, including the study of vaccine delivery, public access to vaccines, and vaccine hesitancy.
He’s particularly concerned about misconceptions regarding vaccine hesitancy, especially among parents — which he says is not as widespread as many believe. As he wrote recently in an essay in The New England Journal of Medicine, co-authored with Sean T. O’Leary: “We believe vaccine hesitancy shouldn’t be normalized when it is not the norm.”
Our interview was conducted over Zoom and by email, and has been edited for length and clarity.
Undark: Although vaccine hesitancy has a long history, it seemed to spark increased discussion beginning in 2020, when the first vaccines for Covid-19 were developed. In your recent essay, you call for caution in the way we talk about vaccine hesitancy. What are your main concerns?
David Higgins: The dominant narrative, that the data doesn’t support, coming out of mass media, social media, and just the national conversation about childhood vaccine hesitancy, seems to be this idea that parental hesitancy about routine childhood vaccines is now commonplace, and it’s widespread.
This kind of narrative that the sky is falling tends to ignore the actual data, which show that an overwhelming majority of parents in the U.S., across political and ideological divides, continue to see the value of childhood vaccines, and continue to vaccinate their children according to recommendations from the American Academy of Pediatrics and the CDC.
UD: What trends have you noticed in terms of parents’ willingness to have their children receive routine vaccinations like measles, mumps, and rubella?
DH: There are multiple different data points, including research studies, national polls, and data out of the CDC, that really still paint a picture of broad support for the value of vaccines in children. For instance, some of the most recent data from the CDC says that 93 percent of parents of kindergarten students opted to vaccinate their kindergarteners with all of the state-required vaccines, and that vaccine coverage for children, by the time they’re 2 years old, hasn’t significantly changed since the start of the pandemic. And even further, only 1 percent of children born in 2019 or 2020 didn’t receive any vaccines by their second birthday. That’s a tiny percent of children.
We also have seen data from national polls, such as the Pew Research and [KFF], showing still robust confidence in the value of vaccines, such as vaccines for measles, with close to 9 out of 10 parents continuing to see the value and benefit of measles vaccines. We also did a study here in Colorado last fall, looking at changes in parental vaccine hesitancy from before the pandemic, throughout the pandemic, and after the pandemic — and we didn’t find large changes in parental vaccine hesitancy overall.
Now, we did find some changes and in whether parents trust vaccine information, and those types of changes, but we didn’t find big changes overall. And those data collectively really continue to paint a picture of strong, robust confidence in the value of vaccines.
The research and the data that we see really paint a picture that’s different than the dominant narrative — that vaccine hesitancy for routine childhood vaccines is now commonplace and widespread and the norm.
UD: What should doctors keep in mind as they talk with people, and especially parents, about vaccines?
DH: The concern with this false narrative is that this can have negative repercussions on people such as doctors, health care professionals, public health professionals. We know that a strong recommendation for vaccines, when it’s formed in a way that presumes parents want to vaccinate their children, because that is still the norm — we know that can actually increase vaccine acceptance.
So if a doctor or health care professional continually expects significant vaccine resistance — because they misperceive the norm — then their recommendation, if they give one at all, may be less effective. They may lose confidence in their ability to really have any influence on parental vaccine decision-making, if they assume that most parents are hesitant.
UD: In your essay you wrote, “When it comes to parents themselves, normalizing vaccine hesitancy has the potential to be a dangerous self-fulfilling prophecy.” Can you explain that idea in more detail?
DH: I am concerned that when parents see this narrative that they might start to think whether vaccines are a good idea for their children as well, when they didn’t have those concerns in the first place. Normalizing vaccine hesitancy could unnecessarily contribute to parental self-doubt about the value of vaccines — this idea that “it seems that everyone else is hesitant about vaccines; maybe I should be hesitant too.”
UD: A number of outbreaks of measles have been reported recently. Do we know how closely those outbreaks are associated with vaccine hesitancy?
DH: That’s a great question, because we unfortunately have seen an increase in measles cases across the U.S. this year. Measles is an incredibly, incredibly contagious disease, and really requires extremely high vaccination rates to prevent outbreaks and spread.
Now, vaccine hesitancy has a role in under-vaccination, or vaccine delay and refusal. However, the reality is more complicated than simply “vaccine hesitancy is the only cause of measles outbreaks.” It might be easy to blame the 7 percent of children who were under-vaccinated for measles by the time they reach kindergarten on anti-vaccine or science-denier parents — but in reality we still have significant access issues as well. Unfortunately, accessing vaccines is still often far too difficult for families, especially families in marginalized communities.
To illustrate this, many families still can’t find a primary care provider that has reasonable availability. During the unwinding of Medicaid last year, many families lost Medicaid insurance for their children, and they are having a hard time finding free vaccines for measles through great programs like the Vaccines for Children program.
Also, many parents simply haven’t had the chance to ask a trusted health care professional about vaccines, and hear from them about the value of vaccines for diseases like measles. So the problem is, when the dominant narrative is that vaccine hesitancy alone drives under-vaccination for diseases like measles, then efforts to address access barriers to measles vaccines may fall short.
UD: Are you concerned about children in the U.S. not being up to date on their Covid vaccines?
DH: Yes, I am concerned. Let’s simplify things and remove the Covid-19 name and all the polarizing baggage that may come with that name out of the equation. In our communities, we have a common and contagious respiratory disease that is still causing severe illnesses, hospitalizations, and deaths in children. And we have a safe and effective vaccine to prevent this disease. Yet, most children are not receiving it. That concerns me.
The reasons children have fallen behind on Covid-19 vaccines are complex and evolving, including attitudinal and access barriers. However, I am careful not to blame low pediatric Covid-19 vaccination rates squarely on parents or mislabel parents as being “anti-vaccine.”
Most parents I see whose children haven’t received recommended Covid-19 vaccines or parents who have concerns about Covid-19 vaccines aren’t “anti-vax” or “science deniers.” Usually, these parents accept other vaccines for their children. Many of these parents don’t know and haven’t heard about the continued value of Covid-19 vaccines for their children from someone they trust. As health care providers, we must do a better job of sharing this continued value with parents with empathy and clear communication.
UD: Have we learned all the lessons that we ought to have learned from the pandemic, or are there are there lessons that you feel might not have sunk in yet?
DH: I think it’s important to continually be learning lessons about how we have handled vaccine delivery, vaccine hesitancy and confidence, so that we can apply those lessons to the future. Because this is not the last time we will have either a pandemic or a new disease, or the last time that we’re going to have great vaccines that can really improve health and keep children healthy.
Vaccine hesitancy did not start with the Covid-19 pandemic. As pediatricians we have been addressing vaccine hesitancy for a very long time. In fact, vaccine hesitancy goes back as far as the first vaccine created for smallpox, over 200 years ago.
There’s a saying in vaccine delivery research that even the best vaccine is zero percent effective if it only sits in a vial, right? Vaccines don’t save lives — vaccinations save lives. Actually having people take the vaccines saves lives. And so we absolutely can continually improve on how we communicate about the value of vaccines, how we share information with families and parents, so that more and more children can get the benefits of vaccines.
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DH: ” And we have a safe and effective vaccine to prevent this disease.”
I must have missed the memo. When was a vaccine released that prevented the disease from spreading?
Every time I see some ‘expert’ say something like that (and this is far from restricted to pronouncements related to covid) all I can think is: “Why are they lying?”
Or do they even realize they’re lying? No, Russia isn’t losing, no China’s economy isn’t collapsing, no Hamas isn’t making Israel do it, no electric cars won’t solve anything, no self-driving will never work (and also won’t solve anything), etc, etc, etc. Are our ‘elite’ intentionally lying to us about everything, or is there a huge amount of self-deceit also at play?
This wasn’t an honest discussion of the problems with the Covid mRNA vaccines, acknowledging neither their higher than previous vaccine complications, nor the dishonest rollout, nor it’s very short lived efficacy. All discussion of which was actively suppressed. And while a notoriously criminal industry, Big Pharma, made bank. So yes, it is rational to be suspicious
I agree. Not honest at all. I was going right along with the article until the discussion turned to the COVID vaccine, and then my perception of a calm and rational discussion was instantly destroyed.
I received a pretty thorough explanation from “someone I trust” – my family physician – for why he was “hesitant” to recommend COVID boosters to anyone under age 50. And anyone who continues to push COVID vaccines and *regular boosters* on children at this stage without acknowledging the potential cost-benefit tradeoffs or *any* reasons for possible skepticism are not worthy of my “trust.”
I definitely do not want to paint all “science journalists” with a broad stereotyped brush. But most of them seem to be naive gate-keepers who mainly accept and pass on The Science as represented by the status quo Authorities.
There’s vaccines, like MMR and smallpox, and then there’s “vaccines,” like mRNA shots.
“ Most parents I see whose children haven’t received recommended Covid-19 vaccines or parents who have concerns about Covid-19 vaccines aren’t “anti-vax” or “science deniers.” Usually, these parents accept other vaccines for their children. Many of these parents don’t know and haven’t heard about the continued value of Covid-19 vaccines for their children from someone they trust. As health care providers, we must do a better job of sharing this continued value with parents with empathy and clear communication.”
Yup, all that’s needed is better messaging, right? From “someone they trust.” The product must flow!
One of my very best friends was injured by a shot that she was mandated to take. Happened back in 2021.
Suffice it to say, she hasn’t been treated to empathy and clear communication. Quite the opposite. My friend has been left untreated while her health continues to decline.
If you’re thinking she’s now among the “anti” people, you’re right.
I, too, have several friends who were/are badly injured. Some were healthy young 30-somethings. Probably a coincidence.
The binary, “W”-esque “You’re either with this new mRNA or your an anti-vxer ” is just bullying tactics, imo.
I’ll leave this Feb. 2021 Pfizer paper (pdf) again. See the table on page 8. Note the Y-axis is marked in increments of 10-thousands.
https://phmpt.org/wp-content/uploads/2021/11/5.3.6-postmarketing-experience.pdf
In the past, a new vx with only a fraction of these serious side effects was pulled off the market within the year. See the mid-1970s swine flu vx and others. If pharma has abandoned duty of care, imo, I canna trust ’em.
Adding, the reason I trusted vx, until now, was because harmful vx were soon pulled off the market. Mistakes were corrected. That hasn’t happened here. This taints my view of all new vx. Good job, FDA and CDC and Pharma. You’ve proved yourselves untrustworthy to the wider public.
Back in the 1970s, one of my mother’s teaching colleagues took the swine flu shot and got Guillain-Barre Syndrome from it. According to my mother, the colleague became quite ill and had a very lengthy recovery.
> Good job, FDA and CDC and Pharma. You’ve proved yourselves untrustworthy to the wider public.
Yes, this is a big, big problem, and they don’t even recognize it. They think sending Mandy on tour smiling at people is a solution. And better PR, of course.
If, heaven forfend, H5N1 mutates and human-to-human transmission goes exponential (not the case with every mutation, I hasten to add), the vaccine stockpiles won’t make much difference. (And in my copious free time, I would like very much to dig into the efficacy and safety of Audenz.)
Women seem to be especially vulnerable to vaccine injury. I’m not aware of any male equivalent to ‘reactivates periods when you should have aged past them’.
As is so often the case, the girl boss feminist woke world screws women on more fundamental issues.
More fun with the latest “word Magik” (widdershins; inside out and upside-down). The neo-pig-latin, used as secret coded communication, between TPTB.
“Hesitancy” is like/the same as, “Denial”…… an innovative, pejorative/slur (like “deplorable”) deployed as information warfare, against the teeming masses (us!).
“Hesitant” really means……..”terrified”. (inside out, upside down)
Used in a sentence;
“The very old and wise dog, was “veterinarian hesitant.”
When did shots for dogs go beyond rabies? What is the whole list now?
Before WWII. But most of the dog vaccines of today are from the 50s. For Parvo, which wasn’t known until more recently, it was developed shortly after dogs started dying from it.
There is a vaccine for Lyme that is recent. Not a standard vaccine and may not be considered useful.
Are they pushing the older vaccines onto the new “improved” mRNA platform?
Interestingly vets seems to be the only medical professionals for whom overvaccination is a concern.
Same. Quite a few years ago my vet brought it up, said he’d noticed an increase in allergies in dogs tracked with the big increase in vaccinations. At the time I was surprised to hear it coming from a vet. Now I always wonder about it.
I asked my dog’s vet this, and she said there’s not really a standard battery of vaccines for dogs, but there’s ones that most kennels require and/or that it seems prudent to give, so that’s what the dogs get.
Mr. Higgins is lost. He says “Let’s simplify things and remove the Covid-19 name and all the polarizing baggage that may come with that name out of the equation.” Yea, right. We’re just supposed to forget the last 4 years of a sheit show and “trust the experts”. That’s as bad as suggesting that someone should forget how sharp the knife is and just lick the peanut butter off. His attitude is why people are hesitant to take “new, improved” medications that are labeled as “safe and effective”.
Shorter: Please make my knee jerk! Come on.
Sorry to be so blunt.
The pharma industrial complex can shove their mRna vaccines where the sun doesn’t shine.
I did not take the mRNA shot, and I will never take another vaccine. I can’t say that I’ve lost all trust in the pharma/healthcare industry since I never had any since I read about Tuskegee when I was in high school in the 1970s, but it is true that my lack of trust now has a greater effect on my actions.
Count me as another one of those who didn’t take mRNA shot or the J&J variety. (BTW, the friend I mentioned earlier was injured by a J&J shot.)
I would like to thank Naked Capitalism for arming me with the knowledge that kept that [family blog] out of my arm. I owe my health to you, NC!
Lambert’s intro is about all that needs saying. Am I correct thinking vaccine “hesitancy” used to be more about acknowledged side effects documented over time. Now it seems to be more driven by a basic mistrust in institutional public health. That ain’t coming back and here we are. See morongobill’s comment above for a well distilled reason why.
We got a puppy from a pound back in 1992. She had all the usual vaccinations. She had terrible inflammatory bowel disease from the start. We brought her to the best vets and her life was still worth living, but it was a challenge.
We cloned her after she died at age 15. Her clone had all the usual vaccinations, and had the same IBD. Because vet science and specialty foods had improved, her life was very well worth living, but it was a challenge.
When she died at age 14, we had her cloned again (from the cells of the original dog). We have two nine month old dogs now. We brought them to an alternative vet. She has given them the most minimal vaccinations, calibrated to their weights, without the usual substrates, and separated out in time. They do not have IBD so far (knock on wood).
Take this anecdote for what it is worth to you. Obviously the mitochondrial DNA was not held constant.
I didnt realise it got worse than wealthy scumbags with their status symbol pedigree dogs. Stupid, tennis ball swallowing breeds bred to look weird as a conversation starter for their personality free owners. Inappropriate breeds, devoid of purpose, sitting in cages all day so the owner can fantasize that they are loved, or get off on being the all powerful master.
But apparently it does. Now narcissistic monied types can perpetuate the miserable existence of their best friend for only the price of a small house or ten years wages for a deplorable.
Oh, we’re not rich. We scrimped and saved for this for decades (literally). If we had instead spent the relevant amount of money on a larger condo than our tiny one would you be as enraged? Or if we’d owned two cars instead of our one subcompact? Also, it costs 50k for as many as are born. That is not ten years wages for a badly paid person. So – what about the vaccine data points?
I also wonder – if we’d spent the money (actually it would have been more) sending a kid to college who truly wasn’t suited to college, would you be as upset? Loads of people do that.
Or, would you be upset if the data that I just provided, had come from a university study of dogs who were genetically identical? In an attempt to find out the result of different approaches to vaccination? Well, there is no money for such a study; there is very little money for veterinary research to benefit companion animals. Advances in (pet) veterinary medicine mostly come from the spending of people who are doing their best for their pet, and pushing the limits. The only other money comes from the pet pharma industry, so that they can flog vaccines and flea and tick meds that are often toxic.
We will be sharing our data about the reaction of genetically identical dogs to different vaccine regimes with a renowned canine IBD expert. Unfortunately, he gets his research funding from pet food companies, who want to sell a lot of costly dog food to people whose dogs have IBD. Also unfortunately, if these dogs have IBD due to the usual vaccines, this researcher will not be able to tell people that since it would get him in trouble with the vet pharma world and that would be terrible for his teaching hospital. So I have to post this info places like here, and accept being ranted at. But that is okay if the word gets out that this is a possible cause of so many dogs having IBD these days.
Fascinating. I would like to hear more. Does your dog have the same personality in each iteration. What is it like emotionally, the loss/rebirth cycle. Losing a pet is like losing a family member for me. Does it still hurt the same? Damn these are crazy times. Immortality for pets.
Same personality, but with IBD under better control, feistier.
Same pain in loss.
It’s not immortality this way, just a way of staving things off.
And who knows for how long; covid is a major factor with dogs.
I like the part where an animal has to serve a practical work function for humans in order to justify its existence.
Former KP employee here. Back in 2021, when the president of the northern California Permanente medical group got on a region-wide video call and informed the lot of us that the vaccines that were out were indeed “safe and effective,” the nervousness he showed made alarm bells go off and little red flags waved around in my head. Yet those around me were getting the mRNA shots. “No big deal!” claimed a friend who was a director at Google at the time.
Then stuff started to happen. A friend’s mom with no underlying symptoms or conditions passed a few days after the second shot. Another friend’s 19yo son got myocarditis. Both with Pfizer. Reading NC’s excellent and very detailed coverage made me extremely wary. I ended up taking the single dose Janssen way after everyone had had a 1st and 2nd dose Nov 2021.
I understand hesitancy and even the small percentage of staunch anti vaxers. Good friend’s son has autism. He’s got a PhD in microbiology and still believes in the technology behind vaccines. He is suspicious of big Rx and how vaccines are created/combined and administered to infants. Nephew has immune thrombocytopenia. My sister is hardcore antivax and believes covid is a hoax. Ain’t nothing convincing her otherwise.
I try to stay informed. Doc said to give my son the 2 dose hpv vaccine. I trusted him so I did. Now it’s my daughter’s turn and I’m not sure it does any good after some research. The whole medical industry has made us suspicious. I think what they call hesitancy is not such a bad thing.
Most folks have come to where if it’s taking your chances against some alleged ‘bug’ vs shutting down stores, schools, businesses etc. plus being forced to take dubious medicaments you can bet on the favourability. Any move to implement a regime will meet with very strong resistance.The unenforceable line will be reached. The economic consequences will rouse fury. Social cohesion will be jeopardy.
While Russia rolls along and China advances. Regimes with strong, well-tested leaderships and strong social support. Why not? Both are winning and gaining advantageous momentum.
Besides, look at the range of impending elections. The EU, France, Germany, Canada, UK, US. Gues which way the results will lean? Sailing into the wind, the old regimes will splinter along factional lines.
Doesn’t look like a propitious environment for the food/med biz.
> he economic consequences will rouse fury. Social cohesion will be jeopardy.
That’s why people should be paid to stay home when there’s a quarantine. Dude, this isn’t hard.
Is it your view that Covid is an “alleged bug”? H5N1?
Paid to stay home lol. I’d refuse any payment by the government to curtail my rights to circulate in public space. You stay home if you want to. Totalitarian wet dreams.
And your thoughts on Mary Mallon?
https://en.wikipedia.org/wiki/Mary_Mallon
Also exercising her rights to circulate in public space.
>That’s why people should be paid to stay home when there’s a quarantine. Dude, this isn’t hard.
I”ve always been fascinated by this premise. I understand it and it makes perfect sense to have everyone stay home to snuff out transmission, but the working mechanics of this in the background and for how long?
It seems there are so many parts of our “just in time” society that needs people on duty to keep things running even if everyone else stays home. How are power plants operated and maintained? Or supplied. The sewer treatment plants, the slaughterhouses for food, how do they keep running? Hospitals staffed for people with emergencies because some weekend warriors decided to try to build a new deck and cut off a few fingers? Dozens more jobs in the background that few likely know about yet those jobs are the most basic to keep a modern society (or as we like to think of it) functioning. How do we deal with the homeless? The addicted that need weekly meetings to stay on their path to sobriety? Just really curious how this would be handled. How do you get a “buy in” from all when it became pretty apparent in the beginning of the wave of Covid all the states had various exceptions to the shut downs? Quite apparent that the list of exceptions in some States was pretty much written by who had the best lobbyists.
I think it would be great to be able to pull this off to stop a pandemic in its tracks. Just trying to understand how.
It did happen. Taiwan, New Zealand, Australia, Korea, etc. had zero covid policies, with test and trace. They were able to have businesses, including restaurants open up without surges in hospitalizations and deaths. They had negative excess deaths.
Then they had vax and relax, because foreign travel.
That’s fine but I am curious to the inner workings of it.
How is food delivered to residents packed in cities? How are sewage treatment plants and power plants mantained? Food processing plants. And how long would true shutdown need to be in effect.? I know with human behavior there is going to be some “leakage” from folks not doing their part. Plus’s the USA is vastly larger in both land areas and population than the countries you’ve listed. And there are always a few that are gonna to say, “But the constitution, bill of rights…”
what went wrong in those countries?
What would be done differently the next time around?
“Vaccine hesitant” is a slander against anyone questioning statement substantiated by appeals to authority or similar ad hominem as vaxx hesitant.
Or what level of exposure to S protein is safe, much safety of mRNA invading human cells.
They haven’t learned a family bloggin thing. They are still talking to the public like they are in grade school and making broad stroke assumptions about what everyone should think, while presenting no real data or facts. What they should have learned is that people see a con and changing the definition of vaccines in the middle of a pandemic, and changing all of the liability and research disclosures differently and reinventing the definition of a vaccine to make them more widely acceptable would have moral hazard. And now they are facing it. Gee, it may hurt the credibility of the medical profession. Gee, ya think?
Previously vaccines had to undergo at least a few years of testing before being brought to market. In particular regulators tested that the vaccine didn’t make things worse when exposed to descendants of the original virus. It might occur to the thinking person that, if vaccines are indeed innately safe and effective why do they need these years of testing, perhaps the safety and effectiveness isn’t intrinsic to the technology but instead that these products under went a thorough testing regime and passed.
For cv-19 vaccines we got warpspeed. Under this testing regime we get 1 rct trial which was arguably flawed (for pfizer, those in the treatment group were significantly more likely to be kicked from the trial than the placebo, at least one whistleblowef). Follow on testing of these products involves observational studies. To highlight the reason why observational studies are bad, https://www.medsafe.govt.nz/COVID-19/safety-report-44.asp from the link, in NZ for the 3 weeks after receiving a shot a vacinated person was half as likely to die (any cause) as a random person from the population. We know this is not an effect of the shot, it can only be an effect of the vaccinated population being healthier than the general population before shots were administered. This means that even if the shots were placebos observational studies would show significantly improved health outcomes for vaccinated vs unvaccinated. This would be an Issue even if cv19 vaccines were predominantly standard vaccine tech. The fact that we as a society decided to agree with Donald J Trump to gut drug testing standards especially for the first ever mRNA vaccine products, produced by companies which have never even brought a drug to market before just shows how dumb our societies are.
Interesting that the protagonist of this story (its all narrative, I would say antagonist) was unable to articulate or unwilling to state the other sides’ (vaccine hesitant) arguments, and then make coherent rebuttals, but simple made assertions. It would be interesting to see whether the “unchanged” stats (its not a problem, but it is a problem of the story) are geographically uniform.
After being red pilled about the massive financial conflict of interest of our health regulatory agencies, and the number of safe and effective drugs and medical devices pulled each year as not safe and not effective, its hard to take such assertions as more than marketing drivel. The sad part is we pay for this.