Medical Examiner

This Dramatic Graph Shows How the Pro-Vaccine Movement Can Win

The anti-vaxxers have relied on their passion to push bad policy. We can beat them—we just have to find ours.

Renee DiResta*

The remarkable graph above tells an even more remarkable story: Evidence-based public health laws, fueled by grassroots activism, can save lives.

What you’re looking at is how many incoming kindergartners in California received exemptions from being vaccinated over the past 30-plus years. The orange line shows personal belief exemptions, while the purple line shows permanent medical exemptions. The turning point on the orange line shows the dramatic decline in personal belief exemptions following a new law, SB-277. The data, which came out on Wednesday, shows that in the one year since SB-277 has been in effect, the proportion of California’s 563,000 kindergartners entering school with their vaccines increased by 2.8 percent. Statewide immunization rates for this new class of students are now at 95.6 percent, the highest they’ve been since 2001, and that number is expected to continue to climb.

There are other visible trends in this graph. You can see how, following Andrew Wakefield’s fraudulent and repeatedly debunked study linking vaccines to autism, “personal belief” exemptions in California began to climb. Despite repeated and constant refutation, the false narrative persisted, and California kindergartens began to see their immunization levels dip below the thresholds required for immunity. That’s scary for children and parents.

And that’s what led to Vaccinate California. The group was started by moms. We connected on the internet. We got to know one another in one of the few pro-vaccination parent groups on Facebook, which each of us had joined out of a feeling of frustration with the low vaccination rates that made our schools unsafe for our children. We shared concerns about the growing Disneyland measles outbreak, about our babies (they were babies then, too young to be vaccinated for MMR) being impacted by the increasingly common measles exposures on public transit. We connected with dozens of other pro-vaccination parents, doctors, scientists, and activists in the group, many of whom had a wealth of experience and perspective earned through  pro-science activism. We grew a network and set up a Facebook page, a petition, and a website. And we sponsored legislation: SB-277, the law that eliminated philosophical opt-outs for school vaccination requirements. We did it because we knew it was critically important that there be a parent voice and a parent face for grassroots, evidence-based activism supporting vaccination. Legislators needed to hear from moms like us.

Legislators have been hearing from moms for the other side—the anti-vaccine side—for quite a while. The anti-vaxx movement is well-organized, it’s well-funded, and it’s media-savvy. One of the largest anti-vaxx organizations maintains a large and engaged action alert network. It tracks all legislation related to vaccines, even truly innocuous administrative tweaks, and sends out action alerts asking members to call, email, and tweet at legislators ahead of committee votes. It gives them talking points. The group asks its entire membership to contact legislators in any one specific state; there is no respect for constituency, and as we saw in California during the battle over our law, the anti-vaxx activists are not above misinforming the legislative aides on the phones about where they live. The result is that legislators who introduce pro-vaccine legislation are deluged with angry phone calls. Many mistakenly interpret that activity as being indicative of widespread, negative sentiment against pro-immunization legislation. It’s not—in fact the opposite is true: Most people (82 percent) believe that immunizations should be required for school.

Perhaps more importantly, anti-vaxx groups are social media savvy. This is important because while legislators care more about phone calls and faxes, social media is incredibly effective for growing numbers and audience for the anti-vaxx movement itself. There is an asymmetry of passion on social networks. Conspiracy theories about vaccines are far more prevalent on Facebook, Twitter, and Pinterest than accurate information; conspiracist content is shared more widely. There are more anti-vaxx groups, and groups devoted to anti-vaccine advocacy have greater numbers than pro-vaccine groups. They are more inclined to participate in mass collective action and, unfortunately, to resort to harassing legislators and others on social networks (especially, lately, using live video apps such as Periscope).

But just because the anti-vaxxers know how to speak louder doesn’t mean that there are actually more of them. In fact, it’s not even close; more than 90 percent of the population vaccinates their children. If you’re reading this, you’re likely to have vaccinated your children and then not given it a second thought. But your clear-headed take probably also means you aren’t motivated to join Facebook groups about it, to tweet about it, or to call your legislators about it. And that’s the problem. Legislators are only hearing from the passionate minority that doesn’t agree with evidence-based public health laws and that chooses to ignore the reality of the science.

We’ve seen the impact that social networks can have on political and policy outcomes; if the 2016 election didn’t make the power of social networks apparent, nothing will. And our success is another clear victory—Vaccinate California played a major part in passing SB-277 and helping California succeed where other states have failed. We won because we provided the counter-voice. We were the suddenly active voice of the silent majority, and it mattered. Legislators inclined to support the legislation—and the science—had a group of supporters to point to. We galvanized 22,000 people in our state who wanted this law to pass. And they called, faxed, showed up, and made themselves heard. None of us had done this before, but we wanted it, we fought for it, and it worked.

Vaccinate California has continued to work with the extensive network that we helped to shape, with the goals of supporting pro-immunization outreach to parents and communities and serving as an example to other states that are interested in improving their own immunization rates and fighting back against the foothold that the anti-vaxx movement has gained.

Anyone can do this. The anti-vaxx movement has known for years that parents have very powerful voices. It’s time for the silent majority to fight back against the asymmetry of passion, to take a stand for science, and to support evidence-based policies that improve public health. So “like” the page of your state’s immunization coalition and find a pro-vaccine parenting group to join. If you can’t find a local one, make one yourself. Do it for the health of our communities and the health of our children.

Update, April 17, 2017: The graph at the top of this post has been updated to clarify the y-axis measurement.