Vaccination Hesitancy Through the Ages: The Past, Present, and Future Implications

Abstract

Vaccines are a scientifically proven method of preventing disease. Immunization has eradicated and continues to protect individuals from life-threatening and fatal diseases. However, as a public health measure, trust in efficacy and safety of vaccines has not been unanimous since their inception. Historically, acceptance of vaccination as a method for disease prevention has been debated since development of the smallpox vaccine. Vaccine hesitancy exists on a spectrum with the advent of each new vaccine but has been amplified in the present day COVID-19 pandemic across the United States. Higher vaccination rates have been associated with lower COVID-19 caseload, a miracle for special populations such as pregnant, pediatric, and older patients at higher risk for COVID-19 complications. This thesis seeks to explore, through a bioethical lens, the factors that contribute to the growth of today’s vaccine hesitancy movement. I highlight previous vaccine hesitancy movements and hesitancy today by examining multiple themes present in literature. I argue that describing a patient as an “Anti-Vaxxer” further ostracizes them from the healthcare institution, politicizes a healthcare issue, and generates inequitable healthcare. I use the example of Philadelphia’s own COVID-19 vaccination response through interviews with involved individuals. In terms of solutions, I propose open and persistent conversation between healthcare institutions and community, public education, and structural reform. The key concern of this thesis is to explore how to navigate a complex healthcare ecosystem regarding vaccination and strategies to ensure patient safety while maintaining the bioethical principles of autonomy and agency.