March 5, 2021

Dr. Noel Brewer

Dr. Noel Brewer

On February 24, The Lancet, one of the world’s foremost publications on health research, announced the formation of the Commission for Vaccine Refusal, Acceptance, and Demand in the USA. Noel Brewer, PhD, professor of health behavior at the UNC Gillings School of Global Public Health, will serve on this commission alongside a group of health experts and global health advocates, including Chelsea Clinton, vice chair of the Clinton Foundation.

“Vaccination is one of the greatest inventions of the 20th century, yet many children and adults’ health is at risk because they are missing vaccines,” said Brewer. “The Commission is a brain trust charged with finding practical solutions to vaccine misinformation, hesitancy and refusal.”

Vaccines play a powerful role in the fight against infectious diseases, but to be successfully effective in a population, they must be widely accepted and received. Vaccine refusal has become a growing problem in the United States and has been linked to outbreaks of many vaccine-preventable diseases, including measles. According to The Lancet, more than 1,200 people contracted measles in 2019, leading to multiple hospitalizations. Refusal of the human papillomavirus (HPV) vaccine can put adolescents and adults at unnecessary risk of six types of cancers, and many Americans die every year from seasonal influenza.

“Anti-vaccine activities are prominent but are only a part of why vaccine refusal has increased,” the announcement noted. Ongoing distrust of the medical community also plays a role, particularly among communities that are socially vulnerable, medically mistreated and historically exploited by scientific misconduct and systemic racism. Poor or inconsistent public communications on the safety of vaccines to prevent emerging pandemic threats has also been of concern, particularly during the ongoing coronavirus pandemic.

Overcoming the barriers to vaccine acceptance will be critical in the attempt to prevent both the spread of COVID-19 and the deaths that could result. The Commission will rely on the Increasing Vaccination Model developed by Brewer and colleagues. The model is also used by the Centers for Disease Control and Prevention (CDC), the World Health Organization (WHO), several public health foundations and vaccine manufacturers.

The Lancet established the Commission for Vaccine Refusal, Acceptance, and Demand in the USA to design a plan for public policy to support high acceptance of safe and effective vaccines in the U.S. The commission will examine the state of vaccine acceptance and its potential link to vaccine hesitancy so that it can identify and predict future trends in vaccine acceptance and impacts on the public health community. The commission will also identify and assess demand-side vaccine uptake interventions and solutions to counter anti-vaccine information.

The Commission had its first meeting in 2020 and aims to produce a first interim report on COVID-19 vaccines in the coming months. It will present a comprehensive report on broader vaccine acceptance and hesitancy in the U.S. by 2022. Updates about the Commission’s ongoing work are available on the Commission website.

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