Vaccine confidence, public understanding and probity: time for a shift in focus?

Abstract

Lack of vaccine confidence can contribute to drops in vaccination coverage and subsequent outbreaks of diseases like measles and polio. Low trust in vaccines is attributed to a combination of factors, including lack of understanding, vaccine scares, flawed policies, social media and mistrust of vaccine manufacturers, scientists and decision-makers. The COVID-19 crisis has laid bare societies’ vulnerability to new pathogens and the critical role of vaccines (and their acceptability) in containing this and future pandemics. It has also put science at the forefront of the response, with several governments relying on academics to help shape policy and communicate with the public. Against this backdrop, protecting public trust in scientists and scientific output is arguably more important than ever. Yet, conflicts of interest (CoI) in biomedical research remain ubiquitous and harmful, and measures to curb them have had limited success. There is also evidence of bias in industry-sponsored vaccine studies and academics are voicing concerns about the risks of working in a CoI prevalent research area. Here, we set out to challenge established thinking with regard to vaccine confidence, by shifting the gaze from a deficit in public understanding towards probity in research relationships and suggesting an alternative and perhaps complementary strategy for addressing vaccine mistrust. We argue that a concerted effort needs to be made to revisit the norms that undergird contemporary vaccine research, coupled with a willingness of all stakeholders to reimagine those relationships with an emphasis on demonstrating trustworthiness and probity.

Parental Perspectives on Immunizations: Impact of the COVID-19 Pandemic on Childhood Vaccine Hesitancy

“…Our data shows that during the pandemic, there was increased doubt about benefit of vaccines offered by the government and trustworthiness of healthcare provider recommendations. This may reflect growing public concern regarding the extent of government involvement in the COVID-19 vaccine development process [14] and global distrust for scientific research [15], both noted during the pandemic. Previous publications have found an "anti-vaccination infodemic on social media" [16], with increase in anti-vaccine searches during the pandemic [17].…”

Meta-summaries effective for improving awareness and understanding of COVID-19 vaccine safety research

“…The COVID-19 pandemic has highlighted how low public trust and understanding of vaccine research has led to vaccine hesitancy 1 . In turn, hesitancy has contributed to suboptimal vaccination rates, which in turn contributes to an excess of preventable infections, hospitalizations, and deaths 2 .…”

Attitudes Toward HPV Vaccination in Sweden: A Survey Study

“…Such worries about profit being a motive in drug development and research are noted by Hausman ( 36 ) as she refers to vaccine hesitancy reflecting concerns that are not uncommon in the US population. Accordingly, Wheeloch and Ives ( 84 ) argue that efforts to increase vaccine confidence should include medical research and practice demonstrating trustworthiness through renewed measures to curb financial conflicts of interests in biomedical, including vaccine, research. Similar arguments about the relevance of increasing the transparency ( 37 ) and maintaining the trustworthiness of healthcare practice and research are made by Heneghan and McCartney ( 85 ) and Warren et al ( 86 ) as well as Goldenberg ( 25 , 32 ).…”