Beating the anti-vaxxers: how star power can help squash vaccine myths

President-elect Joe Biden’s statement that he would be happy to be vaccinated publicly against coronavirus to encourage people to follow suit – following similar pledges from Barack Obama, George W Bush and Bill Clinton – highlights a fundamental concern in global health circles.

Vaccine hesitancy – as well as anti-vaccination activism, sometimes promoted by celebrities – is growing. Countries that were once measles-free are seeing new cases due to suspicion over vaccination. Vaccine hesitancy was listed a year ago as one of the World Health Organization’s10 global health threats to watch, alongside ebola and the threat of a global influenza pandemic. Coronavirus came instead.

The future and former presidents’ approach is similar to the one that saw Elvis Presley vaccinated with the Salk polio vaccine on the Ed Sullivan show in 1956.

The idea of harnessing star power has also occurred to the NHS, which is considering recruiting “very sensible celebrities” – not polititicians – to be publicly vaccinated. Members of the royal family have been mentioned as potential endorsees, as has the footballer and school meals campaigner Marcus Rashford.

The recruitment of Presley – as the historian Stephen Mawdsley told the Observer on the 50th anniversary of the televised inoculation – was designed to solve a specific problem. “The Salk vaccine against polio had just been produced and young children were being vaccinated in their millions. However, teenagers, who were also vulnerable to polio, were not taking up the vaccine,” Mawdsley said.

“Elvis was approached to provide publicity aimed at teenagers and agreed to help to put things right.”

The present-day problem is more fundamental because social media has amplified bizarre anti-vaccine conspiracy theories and celebrity culture has elevated the objections of figures such as the actor Jessica Biel.

The situation has prompted Facebook to say this week that it will take down false claims about Covid-19 vaccines, in a reversal from previous statements made by the company’s CEO, Mark Zuckerberg.

The issues with vaccine hesitancy, however, go beyond the claims of the anti-vax movement. Countering false narratives about vaccines that are already in circulation, as some experts have pointed out, can simply reinforce the original falsehood.

A lack of trust in politicians and public health messaging, especially in the US, may also prove to be an issue.

As Seth Berkley, the head of the global vaccines coalition Gavi– which has been involved in making sure the developing world gets an equitable share of new Covid-19 vaccines – wrote before the pandemic, vaccination efforts for different diseases were already slowing.

“As things stand, global immunisation efforts are already stagnating, in part because of population growth,” Berkley wrote in 2019. “By its very nature, this makes such efforts Sisyphean — a perpetual and increasingly uphill struggle. Vaccinating enough children just to keep infectious disease at bay, let alone in decline, requires us to reach a few million more children each year … But even if we reach them and increase vaccination coverage so that it’s high enough to prevent outbreaks, there is a different kind of threat looming.

“It’s not anti-vaxxers that we need to only worry about the most,” he added. “An even bigger challenge comes from those who kind of recognize the value of vaccines but have come to take them for granted, making them vulnerable to the misinformation being so efficiently circulated.”

The WHO has identified a similar trend. “The reasons why people choose not to vaccinate are complex; a vaccines advisory group to WHO identified complacency, inconvenience in accessing vaccines, and lack of confidence are key reasons underlying hesitancy. Health workers, especially those in communities, remain the most trusted advisor and influencer of vaccination decisions, and they must be supported to provide trusted, credible information on vaccines.”