Hurdles to Herd Immunity: Distrust of Government and Vaccine Refusal

More children have been granted nonmedical exemptions from required vaccinations in recent years in the United States. While the majority of the population quietly benefits from high vaccination rates, there exists a small (but growing) raucous minority of opponents who refuse vaccination and are incredibly vocal in society. Underlying this minority antivaccine ethos is a sense of distrust of the government and in healthcare providers. This distrust influences where parents obtain their vaccine information and further serves as a filter that colors immunization resources from healthcare providers or government agencies with a layer of skepticism and suspicion. Parents who distrust the government or their healthcare providers are less likely to vaccinate their children fully and more likely to seek out complementary/alternative medicine (CAM) practitioners or antivaccine websites for vaccine information. These antivaccinators do not change their decisions about vaccination when confronted with scientific information on vaccine safety and the dangers of vaccine-preventable diseases. New modalities for delivering pro-vaccine messages need to be researched. Innovative techniques to reach this distrustful population could include vaccine negotiation training for healthcare providers, specifically emphasizing the importance of gaining trust. Local initiatives to create parental peer advocate programs for vaccines through school Parent-Teacher Associations, professional groups, or religious groups could better access the antivaccine population. Increased collaboration between public health officials and CAM practitioners may also improve vaccination rates.