The Vaccine Blog

What is an "antivaxxer" anyway? Probably not what you`re thinking

You, Me & Vaccines Post 19: What is an "anti vaxxer" anyway? Probably not what you`re thinking


  • Introduction

“Why, anti vaxxer”, and  “Anti vaxxers twist tragedies to push vaccine lies”, are just some of the titles you`ll see if you Google search “who are anti vaxxers”.  

Not on the third page, mind. Not even the second . The first. 

Well, what does a Google search have to do with anything, I hear you asking. Well, quite a lot, as it happens. It means these polarised views rank high in searches. Meaning that these attitudes are very prevalent towards those who ask questions about vaccines. They wouldn`t be on page 1 of Google if they weren`t. They get hits.

Clearly, trends online can reflect cultural norms. Which is broken down into how people think, act and make decisions in their everyday lives. So people's behaviour influences trends online, and vice versa. And that can really perpetuate stigma. 

That means that the online world has very real consequences in our lives.  Not just that, but for people`s health. Now, I'm completely in favour of vaccination and all public health interventions, and misinformation is an issue. I just don`t think villianising people is the answer. No matter whether you support vaccines or not. And that's why I`m addressing this stigma. Like everything, it's good to start with a definition so everything discussed is clearly defined


  • What is an anti vaxxer?

It's generally easier to begin with something the majority of people are familiar with. Then we can get into the more nuanced ideas. In that vein, let's start with the well-known “anti vaxxer”. 

So, what IS an “anti vaxxer”?  It generally means anyone against vaccination. Now that's in the broadest sense of the word, so it can mean numerous things. 

Is it your aunt who likes to debate after a few drinks?

Or, jokes aside, are those who engage in more serious protests involving rioting, looting, and even burning laws such as those in the protests against the first smallpox vaccine?

Regardless of your stance, I think we can agree on one thing: it generally involves those with a more extremist point of view about vaccines. And, most likely, about other issues too like climate change. The research shows that, particularly in the US, true “anti vaxxers” tend to be conspiratorial in general. 

With everything from vaccines causing autism and other neurological conditions, to cocaine being better for their children than vaccines (a real statement!) - very few things are off limits for true anti vaxxers.

Now, luckily, true “anti vaxxers” are actually in the minority of everyone who asks questions about vaccines. That's why they're called “extremists”. 

It's an “extreme” point of view. 

Meaning it`s outside the norm by quite an extent.


“Anti Vaxxer”. Even the phrase sounds polarised. Why? We associate “anti” with extremist, polarised views in literally any other context. “Anti-immigration”, “anti-gun” laws etc. It's never tame. You never hear anyone say they`re “anti” pineapple on pizza , for instance (Which I am definitely not, for the record!).


Now, that just begs the question; what about everyone else who has worries about vaccines? The fence-sitters, the lurkers, those in the middle. They`re not all brandishing toilet brushes and feeding crack to their children. What about those? “Antivaxxer” just doesn't quite seem to fit. That's why we have the alternative term “vaccine hesitant”. This has quite a different, more nuanced definition from the World Health Organisation. 


  1. What is vaccine hesitancy

I`ve said this before, but for clarity I'll repeat the definition. Vaccine hesitancy is defined by 

the WHO as “a delay in acceptance or refusal of vaccination, despite availability of vaccination services”. It can vary with time, place, and the particular vaccine.


  1. What causes it?

 It is also tightly linked to complacency ( simply, a lack of motivation to vaccinate due to low perceived risk of vaccine preventable disease), convenience (how easy is it to get a vaccine), and confidence (do they trust their doctor, the healthcare institution they are employed by, and the government bodies that make healthcare policies).


  1. Why is it important?


 It was listed by the WHO as one of the top 10 threats to global health in 2019, along with other serious threats like climate change, an influenza pandemic, and antibiotic resistance. So this isn't a joke. It's really threatening lives every day, all over the world. 


So, what's the difference between this and being anti vaccine? Or is there one at all?


It's not necessarily that there's a difference between them in terms of definition. It's more like they're different degrees of reluctance to vaccinate. And anti vaxxers are more strongly opposed to vaccinating than those who are vaccine hesitant. 


The point is; do these really seem like extremists to you? Do these really seem irrational to you? Should we really group these people alongside those who engage in violent protests, storm sports matches , attack police and reporters, some of whom even deny the existence of the SARS-Cov2 virus and thus the pandemic?


If you do, I'd love to hear why. I`m looking at the two tabs I have open beside each other comparing these two stories. I can't help thinking you'd need a very strong justification to think that these two groups of people are closely comparable. 


  1. A re-frame


And yet, I continue to see accusations of people who question vaccines being extremist, ignorant, stupid, scientifically illiterate, and even, shockingly, “terrorists''. And yet in the same breath, we ask, wHy wOn'T tHeY LiSteN tO Us?  We've tried so many things. We've tried scary stories of vaccine-preventable disease. They don't work. We've tried facts. Nope. So what's the common denominator here?I think it's time to look in the mirror. 


You can't really change something until you understand what is wrong with the current culture around it. The media depicts vaccine discussions as “pro vaxxers vs anti vaxxers”. And while like any issue, there are of course extremists, they are very much in the minority, as I`ve described before (shameless plug of my other post).


So I think that might be one place to start. Including people who simply have questions about vaccines might be one way to represent the issue properly. Which would contribute to greater public understanding of how complex the issue is, thus making these people feel more understood. And, in turn, might make them more likely to vaccinate. 


Or, at least, open to new information. If not from you, from their doctor. Or, they may even schedule an appointment. It's not exactly going to make them a hardcore vaccine advocate. But, it might just move the needle in the right direction. Because people operate in networks. They talk to one another. And most important, they LISTEN to each other. If you influence one person, you influence the others. And that's how you create impact. That's how ideas spread.


  1. What else could we do?


When the issue is represented properly, you then have a foundation to build off. So now we understand that not everyone who asks questions about vaccines is an anti vaxxer. As I've Tweeted many, many times, we normalise people asking questions about vaccines without automatically branding them “anti vaxxers.” Great! Step 1 done. Check. 


Now that we have people's attention, what next? People feel really deceived if you capture their attention and then do nothing. So another thing to do is actually establish with people what the difference between a vaccine hesitator and an “anti vaxxer” actually is. Because, in my experience, most people simply hear the word “vaccine hesitator” and laugh. “Oh, those people hahahaha” , followed by an eye roll. Ask almost anyone you know. I can almost guarantee a response along those lines, if they support vaccination. 


It doesn't just demonstrate a lack of understanding of the issue on the responder`s part. It demonstrates how the stereotype has permeated our culture. Discussions. Comedy sketches. So my criticism isn`t of specific people or television shows. It`s of the culture we have around people who ask questions about vaccines. 


 And that's where my next point is going to come in. It's important to establish what an anti vaxxer is and isn't, and also what a vaccine hesitator is and isn`t. Not only this, but in a way that is interesting, accessible and understandable to as wide an audience as possible. Since those informal ways of getting through to people drive the current perception of those who ask questions about vaccines; maybe they could also be used to change it. 

  1. What's the point of this anyway? What's in it for them?


Now, I've been writing on a lot of social media platforms since 2022. The first of these was LinkedIn. I wrote a post making the distinction between an anti vaxxer and someone who is vaccine hesitant. Someone who responded pointed out that this requires people to think critically, which in turn requires work, and thus a motivation. 


So, what's in it for you?


Well, I`m going to echo my response on LinkedIn. Vaccine hesitancy is like any issue. Not everyone is interested. No matter how hard you try to convince people of the importance of it, just not everybody is going to get it. And that's OK. That's absolutely fine. No judgement. Scroll on by.

But I'm referring to those who are interested. And to those for whom this is relevant. Like healthcare workers, psychologists, social scientists, philosophers etc. I know it's important to target your content to a specific audience, but no audience will ever be a monolith. There is variety in any group of people. 

So given these areas of interest, what's in it for them? Why should they care what the blog of a random college graduate has to say?People are busy. They don`t have time or energy to invest in every idea they come across. Especially if they`t physicians, researchers, or just anyone with a relatively busy life in general. Well, getting through to vaccine hesitant patients can be a real pain point for physicians. And understanding them can be an issue for psychologists, philosophers etc. So it's relevant to their area of work.  


The goal is to motivate these people to vaccinate. And to do that, they need to listen. And not just listen in a broad sense, but really engage and actively listen. To do that, people need to feel empathised with. You can't empathise with people unless you`ve at least made an attempt to understand them. And it's these nuances I've talked about that lead to that understanding. It matters. Empathy matters.


Let me tell you a story. When I was 20, I worked 9 hours a week in a call centre in my college, fundraising for various causes. I had a list of people to call on each shift to ask for donations. But the most effective way to have people listen to information? Literally the number one thing that worked? Almost every single time? Empathising with them and their situation. There were people who were jobless, had failed businesses, family members who were seriously sick. It's not until you actually acknowledge what people are going through that they'll even begin to listen to you. And from there, you can build a rapport. And long-term trust. There are no shortcuts to trust. There are no “hacks” to building relationships. 


  1. Conclusion


I`m going to finish short and sweet today. “People don't care how much you know….until they know how much you care” - Theodore Roosvelt. I think this is more important to keep in mind now than ever before. Thanks for reading.


For access to other insightful articles and other benefits; do consider becoming a paying subscriber on substack


  1. References


  1. Autism and Vaccines | Vaccine Safety | CDC
  2. Ten threats to global health in 2019
  3. Vaccine hesitancy: A growing challenge for immunization programmes