Heidi Larson Knows How to Build Trust in Vaccines
For the founder of the Vaccine Confidence Project, squashing viral rumors means building trust — and avoiding the term “anti-vaxxer.”
By Jenny Anderson
In late September, Heidi Larson, an anthropologist and the founder of the Vaccine Confidence Project in London, sat on a Zoom call with the project team for Verified, a United Nations-led group that is working to combat a rising tide of misinformation about potential vaccines for Covid-19.
Dr. Larson, 63, is arguably the world’s foremost rumor manager. She has spent two decades in war torn, poor and unstable countries around the globe, as well as in rich and developed ones, striving to understand what makes people hesitant to take vaccines. She is obsessed with the origin and evolution of rumors, which she calls “collective problem solving,” and has come to see most anti-vaxxers — a term she considers too oppositional — not as uneducated, science-denying individualists but as people with genuine questions and doubts in search of guidance. “This is a public cry to say, ‘Is anyone listening?’ she writes in her recently released book “Stuck: How Vaccine Rumors Start and Why they Don’t Go Away.”
These are busy days for a rumor manager, as they are for rumormongers. The Vaccine Confidence Project, which began in 2010, comprises more than a dozen staff with backgrounds in political science, psychology, mathematical modeling, epidemiology and more. They monitor news, social-media outlets and community conversations in nearly every country and in 63 languages, to catch wind of rumors that might undermine the acceptance of critical vaccines. Above all, with hard data gathered from the many surveys and questionnaires the team administers, they have shown that what once seemed like the ghost of a problem is something troublingly tangible and real.
In September, the team published a paper in The Lancet that mapped shifts in vaccine confidence in 149 countries from 2015 through 2019, with data from more than 284,000 adults. For instance, in Indonesia during that period, the perception that vaccines are safe fell from 64 percent to 50 percent after Muslim leaders questioned the safety of the measles, mumps and rubella vaccine and issued a fatwa, or religious ruling, that the vaccine contained forbidden ingredients. In Poland, a highly organized anti-vaccine movement has helped drive down vaccine confidence from 64 percent in November 2018 to 53 percent by December 2019.
With a global pandemic now in full stride, and vaccines of varying quality vying for release, the consequences of hesitancy could not be higher. In the United States alone, a study by the Pew Research Center found, the share of adult Americans who say they would “definitely” or “probably” get a Covid-19 vaccine fell from 72 percent in May to 51 percent in September.
This trend is often blamed on the viral spread of misinformation on the internet, and it plays a role. In the Zoom meeting with the Verified team, Alex de Figueiredo, the lead statistician for the Vaccine Confidence Project, presented findings from a study they had conducted testing how negative social media posts might affect a person’s decision to take a Covid-19 vaccine.
Three thousand people in Britain were asked: If a Covid-19 vaccine existed, would you definitely take it? Fifty-four percent of respondents said yes. Then most were shown a series of negative social media posts, including a post from David Icke, an English conspiracy theorist, claiming that a Big Pharma whistle-blower had said that “97 percent of corona vaccine recipients will become infertile.” After exposure, the percentage of the study’s respondents who expressed a willingness to take a vaccine dropped more than 6 percentage points.
For a vaccine to create herd immunity — Dr. Larson prefers the term “community immunity,” to avoid conjuring images of animal herding — in a population, 60 to 70 percent of people need to take it, scientists expect. Even a 6 percentage point decline in acceptance could endanger that goal.
Vaccine confidence “is every bit as important as how effective the vaccine is,” said Daniel Salmon, director of the Institute for Vaccine Safety at Johns Hopkins Bloomberg School of Public Health. “Vaccines don’t save lives. Vaccinations save lives.”
But to focus on the inaccuracy of any given rumor is to miss the point, Dr. Larson has learned. During the call with the Verified team, a young woman with that group asked Dr. Larson how they should respond to the data. Shouldn’t they target social media companies and press them to take down the anti-vaccine posts?
“I don’t think taking it down is going to get rid of the sentiment,” Dr. Larson said. “If you shut down Facebook tomorrow, it’s not going to make this go away. It’ll just move.”
It is a message that Dr. Larson has been pressing on the health ministries, drug companies, nongovernmental organizations and social media companies that have been flocking to her team lately for insights and help. Rumors take root in the soil of doubt, and it’s the soil that wants attention. “We don’t have a misinformation problem,” she says. “We have a trust problem.”
‘A Sort of Soft Diplomacy’
The small offices of the Vaccine Confidence Project occupy a second-floor corner in the stately London School of Hygiene & Tropical Medicine in Bloomsbury. In normal times, staff members would be spread around the world, from Japan and Laos to Brazil and Bosnia and Herzegovina: conducting surveys, gathering data, developing community networks, listening. The travel, at least, stopped in March.
In mid-September, when Dr. Larson stopped in after months away, she managed to lock herself out and had to borrow the security guard’s key. “We’ve forgotten how to do all this,” she said, with what could be mistaken for a nervous laugh but which has the effect of putting others at ease.
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