Heidi J. Larson at Nature: “A hundred years ago this month, the death rate from the 1918 influenza was at its peak. An estimated 500 million people were infected over the course of the pandemic; between 50 million and 100 million died, around 3% of the global population at the time.
A century on, advances in vaccines have made massive outbreaks of flu — and measles, rubella, diphtheria and polio — rare. But people still discount their risks of disease. Few realize that flu and its complications caused an estimated 80,000 deaths in the United States alone this past winter, mainly in the elderly and infirm. Of the 183 children whose deaths were confirmed as flu-related, 80% had not been vaccinated that season, according to the US Centers for Disease Control and Prevention.
I predict that the next major outbreak — whether of a highly fatal strain of influenza or something else — will not be due to a lack of preventive technologies. Instead, emotional contagion, digitally enabled, could erode trust in vaccines so much as to render them moot. The deluge of conflicting information, misinformation and manipulated information on social media should be recognized as a global public-health threat.
So, what is to be done? The Vaccine Confidence Project, which I direct, works to detect early signals of rumours and scares about vaccines, and so to address them before they snowball. The international team comprises experts in anthropology, epidemiology, statistics, political science and more. We monitor news and social media, and we survey attitudes. We have also developed a Vaccine Confidence Index, similar to a consumer-confidence index, to track attitudes.
Emotions around vaccines are volatile, making vigilance and monitoring crucial for effective public outreach. In 2016, our project identified Europe as the region with the highest scepticism around vaccine safety (H. J. Larson et al. EBioMedicine 12, 295–301; 2016). The European Union commissioned us to re-run the survey this summer; results will be released this month. In the Philippines, confidence in vaccine safety dropped from 82% in 2015 to 21% in 2018 (H. J. Larson et al. Hum. Vaccines Immunother. https://doi.org/10.1080/21645515.2018.1522468; 2018), after legitimate concerns arose about new dengue vaccines. Immunization rates for established vaccines for tetanus, polio, tetanus and more also plummeted.
We have found that it is useful to categorize misinformation into several levels….(More).