Editor’s note: This article is written by a Canadian medical officer of health. The author’s name has been omitted to prevent further acts of harassment and intimidation. We have closed the comments section to protect the author’s identity.
Anti-vax protesters arrived at my home recently. I am not unique in having experienced this; many medical officers of health and civil servants have throughout the pandemic. I started in my current role recently, so although I have explicitly taken a strong position of no-tolerance of harassment against my staff and actively dispelling misinformation circulating from our community, this escalation was disconcerting.
It was suggested that my condemnation of protests obstructing our facility were in part to blame for the actions brought to my home over the weekend. Indeed, one sign affixed to my house read: “You didn’t like our protest at (the public health office) so … here we are!”
The protesters’ tactics are evidently intended to harass and intimidate, and suggesting that protests were brought to my home because of my strong public position amounts to victim-blaming. I also recognize that softening my strong public position in response may put wind in their sails as the groups sense Pyrrhic victory.
Having trained and worked in public health, I have learned our 3 Cs framework for vaccine uptake: complacency, convenience and confidence. Sometimes a fourth C is added, culture, but given my observations perhaps cult is a more appropriate framing for the present issues.
Increasingly, I am noting that the anti-vaxxers we are dealing with visibly in the public and bolstered by continuous media attention, those protesting at our hospitals and at my own home, demonstrate a cult-like phenomenon and are conflating broad antagonism with the system and government with anti-vaccination (and anti-lockdown, anti-mask) rhetoric.
As one individual wrote in social media comments related to the protesters at my house: “They don’t even care about the vaccines … This is just a social club for local assholes.” Some individuals may not deeply believe in what they spew or may be hypocritical in their personal decisions. These cults are also conflating broad disgruntlement with the pandemic and its restrictions on liberty with anti-vaccination. The media attention they garner and the messages they spread impact vaccine confidence for the rest of the population and may cause lasting damage to vaccine programs.
More scholarly study and new strategies are needed from public health and other arms of government to counter these anti-vaccination cults.
Firstly, we need to actively work with media for responsible reporting and avoid giving disproportionate voice to this vocal minority. This means supporting responsible journalism. Public health physicians or other vaccine experts must be as available and responsive to media inquiries as possible. It may mean bolstering pre-pandemic communications capacity given the heightening demands for information placed on our public health organizations.
Secondly, we need to counter vaccine misinformation rhetoric with strong public health messaging because if their loud rhetoric is not countered, it will impact confidence in the broader public. As Peter Hotez, dean of the National School of Tropical Medicine at Baylor College of Medicine and co-director of the Texas Children’s Hospital Center for Vaccine Development, has written: “The bad guys are winning, in part because health agencies either underestimate or deny the reach of anti-science forces and are ill-equipped to counter it.” The common wisdom to “not vocally counter it” because it “adds fuel to the fire” represents a misunderstanding of the scope of the current problem. It also represents a misunderstanding of the principles of forest fire management. Sometimes directly and strongly countering with “a controlled burn” is healthier for the forest as a whole. This is, however, difficult to implement when you are targeted personally.
Thirdly, we need to consider that while much traditional vaccine hesitancy induced by internet misinformation exists, some anti-vaxxer groups now conform to cult-like characteristics. We must therefore learn from sociology’s study of the phenomenon. They form and multiply on social media. Cult characteristics include the seeking of loyalty to their leaders, opposing critical thinking and the same messaging rhetoric to indoctrinate their followers. We therefore need to learn from sociology on the practices for therapy and support for exiting cults that have been effective in other domains.
Fourthly, we need to ensure that public health workers, such as myself, are personally supported in their work and personally protected from these groups through strong and effective implementation of the amendments to the criminal code to counter health-care protests through Bill C-3. Provincial legislation prohibiting protests near health facilities, such as Quebec’s Law 105, is also important.
Anti-vaxxers are becoming a liability to our pandemic exit strategy. They influence broader individuals who are only vaccine hesitant. We need to act urgently before more individuals are recruited, their support base grows and confidence in vaccines and public health more broadly erodes further.