Recent headlines tell the story. “Measles rates triple in 2013 due to unvaccinated
“Health officials urge vaccination in response to multiple chickenpox outbreaks.”2 Over the
past half-decade, there have been scores of outbreaks of vaccine-preventable diseases
caused by deliberately unvaccinated children.
After virtually eliminating many serious and sometimes deadly infectious diseases,
the U.S. public health system has seen a recent increase in vaccine-preventable
diseases. Growing numbers of parents are either delaying or selectively administering
these vital immunizations—and a few are choosing not to vaccinate their children
at all.3 These
trends reflect diminished public trust in the system that protects all of us against
the timeless threat of communicable diseases—and the result is dangerous and
costly outbreaks that are poised to grow worse in the future.
There is evidence that for some parents simply providing accurate information about
vaccines is not enough. How can physicians, nurses, and other health professionals
engage the growing ranks of “vaccine-hesitant” parents? And what is at stake if
our public health and scientific leadership do not respond to this worrisome turn
These questions get to the crux of the reshaped communication landscape we all face.
It is no longer enough for scientists and federal institutions to issue recommendations;
they also need to develop evidence-based communication strategies and implement
them in consultation with those whom they are committed to protect. The expectation
that experts will engage in a dialogue with citizens was addressed in a 2010 report
of the American Academy of Arts and Sciences, Do Scientists Understand the Public?,
which concluded that just as the public must be educated on scientific topics, so
too must the scientific community be educated on public attitudes and opinions.4
Taking the 2010 report as its inspiration, the American Academy convened a workshop
of leading researchers, practitioners, and policy-makers across a range of disciplines,
from anthropology and communications to pediatric medicine and public health. The
goal was to delineate the types of research that would yield insights to inform
evidence-based strategies for effective communication about childhood vaccination.
The workshop, “Public Trust in Vaccines: Defining a Research Agenda,” was held on
September 26–27, 2013.
As the cochairs of the workshop, we are indebted to the
workshop participants and to the Academy staff who assisted with the organization
of the workshop and the preparation of this report, notably John Randell, Dorothy
Koveal, Nathan Yozwiak, Kimberly Durniak, Catherine McPherson, Hilary Dobel, and
Phyllis Bendell. Madeline Drexler (Brandeis University and Harvard School of Public
Health) served as rapporteur and provided an initial write-up of the workshop. We
would also like to thank Duke University School of Medicine Dean Nancy Andrews and
Institute of Medicine President Harvey Fineberg for their support and encouragement.
The Academy gratefully acknowledges support for the Public Trust in Vaccines project
from the Burroughs Wellcome Fund, CVS Caremark, the American Academy of Pediatrics,
Vax Northwest, and the Hellman Foundation.
Barry R. Bloom
Harvard School of Public Health
Edgar K. Marcuse
University of Washington
Massachusetts Institute of Technology
for Disease Control and Prevention, “Measles—United States, January 1-August
24, 2013,” Morbidity and Mortality Weekly Report (MMWR) 62 (36) (September
13, 2013): 741–743, http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6236a2.htm?s_cid=mm6236a2_w.
Chickenpox Outbreak in the U.S. Hits Vigo County in Indiana,” Huffpost Healthy Living,
November 27, 2011, http://www.huffingtonpost.com/2012/11/27/chickenpox-outbreak-largest-vigo-county-indiana_n_2199231.html.
J. Opel et al., “Social Marketing as a Strategy to Increase Immunization Rates,”
Archives of Pediatrics and Adolescent Medicine 163 (5) (May 2009): 432–437;
4 Chris Mooney,
Do Scientists Understand the Public? (Cambridge, Mass.: American Academy
of Arts and Sciences, 2010), https://www.amacad.org/multimedia/pdfs/publications/researchpapersmonographs/scientistsUnderstand.pdf.