Skip to content

Looking at vaccine hesitancy from a historical perspective

In this Following Up we talk to University of Guelph professor Maya Goldenberg about her new book Vaccine Hesitancy: Public Trust, Expertise and the War on Science

The COVID-19 vaccination programs now underway in the US, Canada and other countries are bringing hope to people around the world after a year of pandemic protocols, lockdowns and general uncertainty.

“Maybe this is the silver bullet, public health intervention that we needed to end this pandemic and that is amazing, but it’s only as good as getting it into everybody,” said University of Guelph philosophy professor Maya Goldenberg. “We know it is going a little slow in Ontario, but I think, if we wait it out, things could look very different by the summer. I am hopeful about that.”  

She is hopeful but aware that not everyone is eager to roll up their sleeves and take one, or in some cases two, for the team.

“I fully expected there would be resistance to a COVID vaccine,” said Goldenberg. “That much I was sure about because there has never been a case where everyone has embraced vaccines. This idea that, ‘if only they had the right information, everyone would line up for vaccines,’ is an inaccurate way of thinking about it.”

Goldenberg has been researching the issue for more than 10 years and it is the subject of her new book Vaccine Hesitancy: Public Trust, Expertise and the War on Science published last week.

“I am a philosopher of medicine,” said Goldenberg. “Specifically, I work on epistemology, which is the study of knowledge claims. How do we know or hold claims to be true or justified?”

She applied that criteria to her research with the assumption that people were resistant to vaccines because they were not properly informed about their benefits.

“I soon discovered that the question was more complicated than I originally thought,” she said. “There is not a missing piece of information that keeps people from trusting the system around vaccines, but a much broader trust issue around our systems of governance and the infrastructure that develops, manufactures, regulates and mandates vaccines for consumption.”

It is a crisis of trust that has existed since 1796 when Dr. Edward Jenner administered the first vaccine by applying fluid from a cowpox blister into a scrape on the skin of an eight-year-old boy. Jenner later inoculated the boy with smallpox and discovered he had developed an immunity. It was a medical breakthrough with far-reaching medical applications and unforeseen social implications.  

Despite medical and scientific evidence that confirms immunizations have significantly reduced potentially fatal conditions such as measles, whooping cough, and polio, outbreaks of vaccine-preventable diseases are on the rise.

Goldenberg discovered that resistance to vaccines and other measures such as quarantines and lockdowns have been common during health emergencies and more often than not the resistance was fuelled by conspiracy theories.

“There are theories about how conspiracy theories spread from the 1930s,” said Goldenberg. “That was back when people wrote letters. It didn’t move as quickly but it still moved nonetheless.”

Many of those same conspiracy theories are fuelling mistrust about the vaccines and other health measures introduced to stop the spread of COVID-19.

“I did not anticipate the anti-mask sentiment,” said Goldenberg. “At least at face value, a mask is cheap and it’s not highly restrictive. In fact, that should have been an easy one, but it wasn’t, because it came to symbolize so many other things. There is a general mistrust of government intervention and the fear that if you allow for one emergency response from the government that you are opening the doors to too much government overreach.”

Historical evidence of government overreach, racism, cover-ups, incompetence and corruption have helped erode public trust in government and its relationship with the pharmaceutical industry. Anti-vax groups exploit these examples and use "selective science" and their own experts to cast doubt and in some cases, propagate false claims about the safety and efficacy of vaccines. 

“There is a lot of information out there, good and bad,” said Goldenberg. “Social media, I don’t think is the cause of distrust and the problems we have today, but it certainly is a way to amplify it and to spread it a lot faster than it used to.” 

Ironically, the conditions of the lockdown have contributed to an explosion in misinformation about the origins, spread and even existence of COVID-19 as well as raising doubt about the truth and accuracy of government and mainstream media reports.

“People have a lot of time at home and a lot of anxiety, which is perfect breeding ground for conspiracy theories to really catch on,” said Goldenberg. “Imagine the person that retweets everything they see on social media versus a journalist who checks their sources. Those skills aren’t always appreciated.”

There is a lot of work ahead to restore people’s trust in the system and that will only happen when they are confident they are being told the truth and that decisions about their health are being made by honest, qualified experts based on established facts. Withholding facts, even with the best of intentions can do more harm than good.

"People can deal with uncertainty," said Goldenberg. "We deal with it every day in our lives. But there is this tendency among leadership to worry if you admit to anything then it is just going to cause panic."

Many would argue the most effective way to respond to the conspiracy theorists and restore trust in vaccines is to end the pandemic by encouraging everyone to get vaccinated.

“I don’t know that it will be all smooth but, if people want to get back to normal, this is the best way to do it right now,” said Goldenberg. “The evidence is very compelling, and the CDC said that small groups of people that are all vaccinated can feel okay to get together indoors and not wear masks. How good does that sound? I want that.”