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Empathy, not facts, key to combating anti-vaxxer mentality

Charli Shield
May 24, 2019

As the world grapples with measles outbreaks, public health advocates are desperately seeking to improve vaccine attitudes. But the facts don't seem to be getting through. A new study says empathy is key.

Pakistan Polio Impfung in Lahore
Image: picture-alliance/AP Photo/K.M. Chaudary

It’s a fact that immunization currently prevents between 2 and 3 million deaths every year — from diseases like measles, influenza and polio. And it could prevent a further 1.5 million if more people were vaccinated.

But another hard fact is that, despite this, vaccination hesitancy is still rife. Which begs the question — why aren’t pro-vaccination messages more effective?

Read more: Why measles is so deadly and vaccination so important

'Victims of their own success'

Vaccines are, in a way, victims of their own success, says Brian Poole, lead author of a new study about overcoming vaccine hesitancy.

They’re "so effective," he says, "that most people have no experience with vaccine-preventable diseases," and no idea just how dangerous and scary they are.

Global vaccination rates are declining, and previously eradicated diseases, like measles, are experiencing a surge around the world. In the first three months of 2019, there’s been a 300% increase in measles cases, compared to the same time last year.

Given the clear role unvaccinated people have played in these resurgences, the outbreaks are being attributed to so-called "anti-vax" mentalities.

Read more: Measles: German minister proposes steep fines for anti-vaxxers

Man getting cholera vaccination
Global vaccination rates have been steadily declining since the 1990sImage: picture-alliance/Photoshot/M. Mohammed

Combating misinformation

But rather than just trying to combat anti-vaccine information, Poole says people need to be able to empathize with those that suffer as a result of their decision not to vaccinate.

As part of a new study Poole was involved in, which comes out of Brigham Young University in Utah, the US — a city which ranks sixth nationally for undervaccinated kindergartners — students opposed to vaccination were asked to interview people with vaccine-preventable diseases, like polio.

Researchers studied 574 students, 491 of which were pro-vaccine and 83 who were vaccine hesitant, according to a pre-study survey. By the end, nearly 70% of the students who interviewed someone with a vaccine-preventable disease moved from vaccine hesitant to pro-vaccine.

Half of the students talked to someone suffering from a vaccine-preventable disease, and the other half, the control group, interviewed someone with an autoimmune disease.  

One student said the experience of interviewing someone with tuberculosis — a deadly disease one can be immunized against — made the prospect of "getting a disease if I don’t get vaccinated seem more real."

Boy getting measles vaccination in Ukraine
The study found that confronting anti-vaxxers with the consequences of not vaccinating caused two thirds of people to change their mindsImage: Getty Images/Y. Dyachyshyn

If we want to change negative attitudes towards vaccines, Poole says, exposing people to the consequences of not vaccinating "works much better than trying to combat anti-vaccine information."

"It shows people that these diseases really are serious diseases, with painful costs, and people need to take them seriously."

Vilification often unhelpful

As others point out, it’s also important to remember where these anti-vax sentiments stem from.

According to Jennifer Reich, professor of sociology at the University of Colorado Denver, asking "What’s wrong with anti-vaxxers?" isn’t the right question.

In her research on how parents come to decide to reject vaccination, she’s found most of these people make decisions not out of spite, but because they best align with their belief system.

An anti-vaxxer stance "doesn’t necessarily mean that parents don’t believe in science," she says, but rather that "they often trust their own instincts about their children more than they trust experts who may have data but do not know their family."

The public health implications of not vaccinating are severe and wide-reaching. Parents who reject vaccines introduce risk to many, including their own children and others. This is something Reich thinks "doesn’t come up enough in discussion."

But understanding what motivates people who reject vaccinations, she says, is key to thinking of how we can better connect with them and find ways "for them to feel invested in increasing community health for everyone’s children, not just their own."