A new report looking at vaccine confidence in the EU shows some troubling trends. Belief in the safety and effectiveness of vaccines seems to be very regional. We see this in the US as well as Europe. In this survey they found:

The results of the survey suggest that a number of member states – including France, Greece, Italy, and Slovenia – have become more confident in the safety of vaccines since 2015; while Czech Republic, Finland, Poland, and Sweden have become less confident over the same period.

In some countries anti-vaxxers have a stronger foothold, and are actually decreasing acceptance of vaccines. But there are two other trends that are more disturbing. First, in the countries with decreasing vaccine acceptance there is high levels of vaccine skepticism among general practitioners.

While GPs generally hold higher levels of vaccine confidence than the public, the survey found that 36% of GPs surveyed in Czech Republic and 25% in Slovakia do not agree that the MMR vaccine is safe and 29% and 19% (respectively) do not believe it is important.

Those are shockingly high numbers for physicians. This is one of my greatest fears about the advance of alternative medicine and anti-scientific medical views – that they will affect the medical profession itself. Once unscientific ideas creep into the culture of medicine, the game is all but lost. This is why teaching pseudoscience in medical school is such an alarming problem. In this survey, the countries with higher levels of GP vaccine skepticism, had higher levels of public skepticism and lower levels of vaccine compliance.

Another disturbing trend was the relationship between age and vaccine skepticism:

Those aged 18 to 24 were 28 per cent less likely than those aged 65 and older to agree that vaccines are safe. Those aged 25 to 34 were 39 per cent less likely than seniors to believe in the safety of vaccines.

The younger generation were more likely to hold anti-vaccine ideas. These are the ages when people also have children, and will therefore be making decisions as parents about getting their kids vaccinated. But also this is concerning if it represents a general generational trend.

Millennials are trending away from organized religion, but toward more belief in spirituality, including embracing new age and pseudoscientific beliefs like astrology. It is always complex to tease apart the many possible cultural factors leading to this trend, but it is clear that the younger generation has increasing beliefs in nonsense and woo. This apparently includes vaccine denial.

Social media always comes up as a possible factor, and this is plausible as one of many. Misinformation and fashionable nonsense can spread quickly and easily on social media. It is also easy to spread fear, and fear can be very effective. It is more difficult to reassure the public with complex evidence than to stoke fears through misinformation. This has been the chronic advantage of movements like the anti-vaxxers. They only have to instill doubt and fear, they do not have to make a solid case with science and evidence.

There are other trends that are also likely tied to this one. There is a decreased respect overall for experts and the very concept of expertise. Citing expertise is perceived as elitism. The millennial generation does appear to be more egalitarian, which is a good thing, but those sentiments are misplaced when it comes to science and scholarship. Science is not a democracy, and all opinions are not equal. Facts, evidence, and logic matter.

In general it seems that the challenge we face is properly balancing a sense of fairness, openness, and the free exchange of information with a respect for expertise, facts, and following a proper rigorous methodology. These things do not need to be in conflict. A proper balance does require a thoughtful nuanced approach, and that’s a lot of intellectual work. There are also many forces out there motivated to keep people from doing the hard work of thinking for themselves. It’s a lot easier to accept a pre-packaged narrative, and if that narrative sells you some snake oil -well, that’s actually the point.

The challenge we face now is promoting a culture in which respect for facts and valid methods are paramount. We need a return of respect for expertise and a shared reality based on agreed-upon methods for determining which facts are more likely to be true. The persistence of anti-vaxxers is a good overall measure of how we’re doing, and simultaneously a good reminder of the stakes. Lives are literally at stake, and not just for the anti-vaxxers themselves. Their pseudoscience threatens the community immunity that protects us all.