The majority of Texans support vaccines, but a vocal minority are actively working on weakening or dismantling vaccine requirements, according to a journal article published in Vaccine: X from Rice University's Baker Institute for Public Policy and The Immunization Partnership.
Vaccine hesitancy is considered one of the top health challenges of this decade. Texas is the second-largest state by population, geography, economy and birth rate - one out of every 10 Americans are born in Texas. It also has a significant rural-urban divide, and all state leadership positions for the past decade have been held by Republicans, the authors explain.
Texas is an ideal case study for understanding how politics impact vaccine bills, the report authors argue. By identifying the major themes of vaccine opposition, vaccine advocates and policymakers can address these concerns more effectively.
The research team reviewed witness statements from hearings during the 2021 Texas Legislative session related to vaccine requirements and information transparency to understand vaccine detractor arguments used to influence policymakers. The authors found five major themes surrounding opposition to vaccines, vaccine requirements or COVID-19 vaccines. Medical freedom as well as vaccine safety and effectiveness were the top concerns of the testimonies, followed by discrimination, informed consent and mistrust of science and scientists.
The data shows that there are myths or misinterpretations of data being perpetuated related to vaccines. For instance, one witness believed that mRNA vaccines were manipulating "the instruction sets that determine how my cells operate."
To combat this, the authors argue that vaccine advocates and policymakers should work to address the concerns of the vaccine hesitant.
"For example, numerous witnesses were concerned that COVID-19 vaccine mandates did not permit medical exemptions," the authors wrote. "Other witnesses confused the EUA process with full FDA-approved vaccines, believing that only minimal data were provided. These concerns highlight the need for a public engagement campaign prior to and during the release of a new vaccine to the public. Bolstering public health outreach initiatives to address individuals' greatest concerns will be vital in the future to improve immunization rates and prepare for future outbreaks."
Physicians and health care professionals who support vaccines should consider attending public hearings to refute false claims and misinformation in real time. One of the goals of the anti-vaccine movement is to marginalize discussions about the benefits of vaccinations, explained Kirstin Matthews, fellow in science and technology policy at the Baker Institute. Even when anti-vaccine legislation is presented but does not pass, the rhetoric used influences public distrust, she said.
"While this approach may not fully address all the misinformation out there, correcting as many points of misinformation during a public hearing goes on the public record and can prevent these claims from being further disseminated," said Rekha Lakshmanan, nonresident scholar at the Baker Institute's Center for Health and Biosciences and chief strategy officer at The Immunization Partnership.
Public health figures should also identify new ways to appeal to values that can counter medical freedom and individual rights claims such as working with religious and community leaders to promote vaccines as altruism and kindness, the authors argue.
"A major takeaway from these hearings is that policymakers must address the critical necessity of initiatives to make accurate scientific information more accessible to the public and create programs to enhance the public's scientific literacy. Both issues would best be approached by avoiding a confrontational attitude, despite aggressive behavior by some individuals and organizations opposed to vaccines," according to the article.
