CORRESPONDENCE
VOLUME 397, ISSUE 10280, P1181,
MARCH 27, 2021
Rochelle Burgess and colleagues eloquently described participatory community engagement as essential for successful COVID-19 vaccination, which involves appreciating the heterogeneous public and working with communities and their leaders to enable bottom-up approaches. They suggested that COVID-19 has drawn attention to the structural violence that is embedded within society, with the pandemic furthering the marginalisation of historically oppressed and excluded groups. Burgess and colleagues drew attention to how people who might have suffered disproportionate economic and health consequences from COVID-19 are now being asked “to trust the same structures” that failed to provide adequate resources and social protection during the pandemic. Failure to address these contextual dimensions can worsen mistrust, damaging vaccine uptake. However, Burgess and colleagues make a distinction between “people wholly opposed to vaccinations (anti-vaxxers) and…vaccine hesitancy”, and imply participatory community engagement as a means to engage only people with vaccine hesitancy.
Lessons from studying cults (which are less pejoratively called new religious movements, describing movements that emerged in the late 20th century) can inform approaches to the anti-vax movement. A cult has come to mean a non-conforming ideology, or a religion that is disliked, with beliefs that are unacceptable to mainstream society. Just as cults are grouped together as sinister, bad, or wrong, the discourse surrounding anti-vaxxers in both academic and popular circles can be dismissive and derogatory. The pejorative label and negative attitudes towards cults promote an us-and-them viewpoint, creating martyrs and extending the length of time that members hold the new beliefs, thus encouraging further involvement in the movement and radicalisation.
Learning from these consequences, a more constructive perspective could view the anti-vax movement as a religious phenomenon, involving a whole spectrum of ideas, and focus on the essential need to understand the beliefs that are involved to avoid further marginalisation. Hence, implying that anti-vaxxers are beyond the reach of community engagement activities could result in increased anti-vax activities. We suggest a more inclusive approach, where the same inquisitive dialogue and contextual understanding that was suggested for vaccine hesitancy should be extended to members of the anti-vax movement.
Rochelle Burgess and colleagues eloquently described participatory community engagement as essential for successful COVID-19 vaccination, which involves appreciating the heterogeneous public and working with communities and their leaders to enable bottom-up approaches. They suggested that COVID-19 has drawn attention to the structural violence that is embedded within society, with the pandemic furthering the marginalisation of historically oppressed and excluded groups. Burgess and colleagues drew attention to how people who might have suffered disproportionate economic and health consequences from COVID-19 are now being asked “to trust the same structures” that failed to provide adequate resources and social protection during the pandemic. Failure to address these contextual dimensions can worsen mistrust, damaging vaccine uptake. However, Burgess and colleagues make a distinction between “people wholly opposed to vaccinations (anti-vaxxers) and…vaccine hesitancy”, and imply participatory community engagement as a means to engage only people with vaccine hesitancy.
Lessons from studying cults (which are less pejoratively called new religious movements, describing movements that emerged in the late 20th century) can inform approaches to the anti-vax movement. A cult has come to mean a non-conforming ideology, or a religion that is disliked, with beliefs that are unacceptable to mainstream society. Just as cults are grouped together as sinister, bad, or wrong, the discourse surrounding anti-vaxxers in both academic and popular circles can be dismissive and derogatory. The pejorative label and negative attitudes towards cults promote an us-and-them viewpoint, creating martyrs and extending the length of time that members hold the new beliefs, thus encouraging further involvement in the movement and radicalisation.
Learning from these consequences, a more constructive perspective could view the anti-vax movement as a religious phenomenon, involving a whole spectrum of ideas, and focus on the essential need to understand the beliefs that are involved to avoid further marginalisation. Hence, implying that anti-vaxxers are beyond the reach of community engagement activities could result in increased anti-vax activities. We suggest a more inclusive approach, where the same inquisitive dialogue and contextual understanding that was suggested for vaccine hesitancy should be extended to members of the anti-vax movement.
SM declares funding by the Economic and Social Research Council and the Parkes Foundation towards the cost of her doctoral study. CH declares no competing interests.
*Sophie Mylan, Charlotte Hardman sophie.mylan@lshtm.ac.uk
Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London WC1H 9SH, UK (SM); National Health Service, London, UK (SM); Department of Theology and Religion, Durham University, Durham, UK (CH)
1 Burgess RA, Osborne RH, Yongabi KA, et al. The COVID-19 vaccine rush: participatory community engagement matters more than ever. Lancet 2021; 397: 8–10.
2 van Twist A, van Eck D, Newcombe S. “Trust me, you can’t trust them”: stigmatised knowledge in cults and conspiracies. In: Dyrendal A, Robertson DG, Asprem E, eds. Handbook of conspiracy theory and contemporary religion. Leiden: Brill Academic Publishers, 2018: 152–79.
3 Singler B. Big, bad pharma: the indigo child concept and biomedical conspiracy theories. Nova Relig 2015; 19: 17–29.
4 Barker E. New religious movements: a practical introduction. London: Her Majesty’s Stationery Office, 1989.
https://www.thelancet.com/action/showPdf?pii=S0140-6736%2821%2900443-8
https://www.thelancet.com/action/showPdf?pii=S0140-6736%2821%2900443-8
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