It`s not always about vaccines –what isn`t being said about the modern antivaccine movement

Vaccines affect the lives of each of the 8 billion people on the planet. Millions hesitate about or reject them. Reasons for refusing them can vary to differing extents between people. You`ll never get the exact same explanation from any two people. This makes it a complicated issue. Why? In short, there are countless circumstances that can lead to vaccine hesitancy or outright refusal. These include both long and short term circumstances. They include growing up in a high religious environment to the sudden death of a loved one after a vaccine. Even if the events are unrelated. Family members also watch each other more closely after a vaccine. Or after any medical procedure. Particularly, parents watch children. Therefore, to help as many people as possible, we can build a framework for understanding how hesitant people think. That can then be adapted to people as necessary. The most efficient way to do this is breaking it down into several psychological tendencies of hesitators and refusers.

What are the key psychological mechanisms involved in hesitancy?

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Confirmation bias is perhaps the best known. It describes when people look for information confirming their pre-existing beliefs, and disregard evidence opposing their beliefs. We all do it, whether consciously or subconsciously. It’s also difficult to change once stuck. Which makes vaccine discussions very polarised.

Generally, vaccine hesitancy is complex. It isn`t a binary debate i.e. “provax” vs “antivax”. However, for simplicity, I will refer to two sides to get my point across.

One side believes that everyone is against them and that they are being controlled (this is actually a common theme among historical anti vaccination movements. The other side believes that they are incompetent, scientifically illiterate and stubborn. The problem with this is that both sides misrepresent each other. It’s not about any kind of facts about vaccines or science. This is important to understand. It means we can all think more objectively about our own stance. From this, we can challenge our own stance. Not do away with completely. That takes an incredible amount of introspection and self-awareness. However most don’t have the time, energy or capacity to do this. Which makes this issue so difficult to tackle? If we do, it can lead to more open discussion around difficult topics.

The psychology behind the movement

Image courtesy of Milad Fakurian. Image sourced from unsplash.com. I do not own this image.

Motivated reasoning is among the most common ways information is distorted. It involves rationalisation of decisions. This is done based not on the evidence presented, but on how comfortable they are. Some also ignore or put less weight on arguments contradicting what they want to believe. For instance, evidence around climate change would force people to make significant changes to their lifestyle. That takes hard work. Further, people also use it to maintain their identity. Most people go their whole lives searching for a sense of social identity. Therefore, this is highly valuable to them, and people go to great lengths to preserve it. For instance, in fact, the extremity of the movement prompted the World Health Organisation to list vaccine hesitancy as one of the “Ten threats to global health in 2019”.

It is also done to avoid cognitive dissonance. This is psychological distress arising when two inconsistent beliefs or values are held together. However, it becomes serious when people talk themselves out of taking health precautions. For instance, someone who otherwise takes their health very seriously might not vaccinate because “I didn’t get it, nobody I knew got COVID so it won’t happen to me”/ “I haven’t seen it so it must not be that bad”.

Generally, conspiracy theories are harmless to health; i.e the earth is flat, 5G is harmful to health. However, when theories become relevant to vaccines, one feature of them makes them dangerous. They. Spread. Quickly. Nowhere is this free and unrestricted raging of conspiracy theories so clear than on social media. The online world is volatile. Particularly against the backdrop of a pandemic. This means that unchecked information can spread very quickly. Exponentially more people exposed to misinformation. More people not vaccinating themselves and/or their children. A breakdown in herd immunity. Return of diseases from the past. Why is this so important? Social media is one of the most prevalent ways we talk today.

Especially in the context of a pandemic. People relied on technology for important updates. We were emotional. In a high stress state. This created the perfect climate for dis/misinformation to show up and frighten people who then shared it. So, we need to target the misinformation at its source. What is that? The social media platforms allowing it to spread. To their credit, many major sites have acted against misinformation. YouTube no longer monetizes anti vaccine channels. On Twitter and Facebook, the first result returned on searching “antivaccine”, or posting about vaccines, is a link to the World Health Organisation, NHS, HSE, or another reputable website. Pinterest has taken a more hard-line approach and banned vaccine misinformation outright.

The first thing to do is define “conspiracy theory”. It’s defined as a secret plot carried out by an elite group of people. Usually they are primarily concerned with how to benefit themselves. What makes these so enticing to people? Well first, humans are inherently tribalistic. It would be naive to blindly trust everyone, some of whom could and would harm you. So, a healthy degree of scepticism is always good. Indeed, studies show that conspiracy theorism actually has an evolutionary basis. Ancient human tribes warred, and hostile coalitions formed. In other words, conspiracy theories that were true. These coalitions caused significant distress and most importantly, reproductive loss. Those who did not believe the conspiracy theories were likely to be preyed on by the coalitions. They had their genetic line wiped out. Those who believed the conspiracy and avoided these coalitions were more likely to survive and pass their genes on. Therefore, we`ve ended up with a population with a significant number of people believing conspiracy theories.

According to Dr. Karen Douglas, social psychologist, there are three key motivates for believing conspiracy theories. First; epistemic motives. These satisfy our desire for knowledge. People want explanations for things they don’t understand[E1] . And understandably so. In my last post I spoke about the fraudulent Wakefield report and how many parents believed that the MMR vaccine causes autism. Why? They wanted an explanation for their child’s suffering. The fact that their child’s life is going to be different from what they wanted is difficult to accept. Further, anyone with autism will tell you what an isolating experience it is. This has a negative impact on many if not all aspects of an autistic`s life. Parents might not want to accept the suffering of their child. However, there is little they can do about it. Strategies, interventions etc. can absolutely be applied. However, this does not remove the inherent suffering experienced by these people. As an autistic woman myself, I truly understand.

The second reason is existential motives. Put simply, people want to feel safe and secure. In control. I’ve said it many times before. I’ll say it again. Fear of the unknown and lack of control are two of our biggest fears as a species. So, it’s natural that we would want control over our lives. Particularly when something significant happens. We desperately want to maintain a sense of control. If a significant personal event occurs, job loss, relationship breakdown, illness etc., people can be left feeling powerless and out of control. This can lead to extreme beliefs and actions. Research shows that those who feel helpless or disappointed tend to develop a conspiratorial mindset. This is unsurprising. It’s difficult to accept the lack of control we have over many aspects of life.

The third set of motives are social. People like to feel good about themselves, and feel good about the groups they are part of. Maybe someone feels that they lack fulfilment in one or more aspects of their life. Maybe they have felt this way for a long time. Feeling superior to others is one way to re-invigorate self-esteem for them. Having information others don’t is one way to do this. So, is it really surprising that this happens? Not for me

In an interview, Dr. Karen Douglas, professor of social psychology, says these needs are likely to be frustrated during times of unrest. Indeed, she says, almost as soon as information as COVID19 surfaced, so did conspiracy theories[E2] . Why? I think a key reason was that there was no certainty around the pandemic. That’s one people particularly struggled with. We didn`t know when the lockdown would end. Advice kept changing. Wear masks, don`t wear masks etc. We didn`t know when a vaccine would be available. We still don’t know how long the virus is going to persist in the population. So, there’s still uncertainty around it. Due to this, conspiracy theories are still here. People don`t like uncertainty. Conspiracy theories provide simple explanations for complex events. They give people relief from the uncertainty surrounding harsh events, such as a pandemic. These trends are likely to continue with monkeypox.

We`re all vulnerable to them. So, conspiracy theories are a widespread phenomenon. According to numerous studies, large numbers of the human population actually believe in conspiracy theories, to the scale of millions. For instance, in 2004, 49% of Americans believed that the US government co-operated in the 911 terrorist attacks. In 2013, it was found that 61% of Americans believe that Lee Harvey Oswald was not the sole player in JFKs death.

Despite this, we`re all vulnerable to believing conspiracies. Most of us think we would never believe ridiculous notions like the earth being flat, chips being inserted into vaccines, etc. However, put anyone in the right circumstances, at a particularly stressful time in their life, and they will gravitate towards conspiracies. In fact, research has shown that people even believe made-up conspiracies! Therefore, it is not a massive leap to think that you could fall prey to them too. And while it’s certainly important to be aware of this, we can`t get rid of our predispositions towards them.

So, what can we do, if anything, to stop conspiracy theories like this spreading?

A key way to stop the spread of false facts, actually doesn’t relate to facts at all. It’s how you interact with them. Be curious about them. Everyone loves to talk about themselves! Leverage this and ask them how they got to their conclusions. What was their process? What sources did they use? Which information did they find most convincing, and why? Least convincing? The goal of this is not to interrogate people. It is to gently nudge people towards questioning their own conclusions. When people feel that they came up with a different conclusion themselves, they are more likely to believe it.

Ultimately, this isn’t a scientific issue. It’s a people issue. It’s an empathy issue. This is key principle to keep in mind when engaging with people hesitant about vaccines. I genuinely appreciate you taking the time to read this article

If you`re interested in more discussion around this important issue; check out my blog https://youmeandvaccines.ie/blog-you-me-and-vaccines-ireland-communication-on-vaccinations.html

References

https://www.who.int/news-room/spotlight/ten-threats-to-global-health-in-2019

Confidence drives a neural confirmation bias — PMC

Believing is seeing — The Journal of the American Dental Association

Conspiracy Theories: Evolved Functions and Psychological Mechanisms — PMC

The Psychology of Conspiracy Theories — PMC

Speaking of Psychology: Why people believe in conspiracy theories, with Karen Douglas, PhD — permission to cite, need to cite APA and Speaking of Psychology

Explainer: Why do people believe in conspiracy theories? — News Centre — University of Kent

Majority in U.S. Still Believe JFK Killed in a Conspiracy

ttp://nrs.harvard.edu/urn-3:HUL.InstRepos:10880581

[E1]Source: speaking of psychology and the American Psychological Association

[E2]Source: APA and Speaking of Psychology