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Opinion: We Need To Distinguish Between Vaccine Hesitancy and Anti-Vax

2020 has been a rollercoaster of a year, defined by the Black Lives Matter movement, President Donald J. Trump’s failure to seek reelection, and lest we forget, the pandemic.

What started out as any normal year, very quickly moved to a stream of lockdowns worldwide. The year seemed to drag on forever as, every day, we were collectively overwhelmed with the uncertainty of a virus the world did not seem to understand. 2020 was a year full of ups and downs, lockdowns, masking, hand-washing, and social distancing. However, we ended 2020 with a beacon of hope for millions across the globe — the approval of some COVID-19 vaccines — the light at the end of a really long tunnel. However, with vaccine hesitancy and anti-vax sentiments on the rise, scientists believe we still have an uphill battle ahead of us.


If you would’ve asked me if I would take a COVID-19 vaccine in August 2020, my response would have been a yes, but a hesitant yes nonetheless. Ask me now if I would take a COVID-19 vaccine? Unlike before, my response is a strong, confident yes. This is vaccine hesitancy in real life. I was hesitant because the news portrayed these novel technologies without explaining that 10+ years went into developing the mRNA vaccine platform. Similarly, there was a lot of talk of “record” speed initially, which made me wonder if corners were cut (which I know, they weren’t). And of course, there was the question of there being no long-term safety assessment. We still don’t have long-term safety data, but as far as science goes, vaccines are more likely to have short-term safety issues, than long-term issues — a fact that I understand because the body will simply eliminate anything that is “foreign” to it within weeks.


If you would’ve asked me if I would take a COVID-19 vaccine in August 2019, my response would have been a yes, but a hesitant yes nonetheless. Ask me now if I would take a COVID-19 vaccine? Unlike before, my response is a strong, confident yes. This is vaccine hesitancy in real life.

Contrarily, ask an anti-vaxxer if they would take a vaccine, any vaccine, whether old or new, and they’re most likely going to say no. Subscribing to false conspiracy theories, anti-vax folks would turn down a rigorously tested vaccine every time. While there is some overlap between vaccine hesitancy and anti-vax, I am of the opinion that there is a fine line that we are treading. Unfortunately, anti-vaxxers are gaining more ground amid this pandemic, with related social media groups having grown by almost 7.8 million people since 2019. This severely undermines the efforts of scientists, institutions, and governments worldwide that have been vital in curbing the effects of the pandemic.


Anti-vax, not Vaccine Hesitancy, Is the Real Global Health Concern

In 2019, the World Health Organization (WHO) released a list of the top 10 global health concerns. Within that list was vaccine hesitancy, defined as a “delay in acceptance or refusal of vaccines despite the availability of vaccine services”. If I was asked to critically analyze this definition before 2020 (pre-COVID), I would have found myself simply thinking vaccine hesitancy is indeed a pressing problem.


However, I now believe the WHO or the Centers for Disease Control and Prevention (CDC) should drop the term “vaccine hesitancy” and use “anti-vax” instead, or at the very least, distinguish between the terms, especially in light of the pandemic. The issue with the current definition is that true vaccine hesitancy, a state of doubt or uncertainty but not a complete behavior of rejecting the vaccine, is normal human behavior while being anti-vax, or the outright rejection of all vaccines (including the new COVID-19 vaccines developed), is the real global health concern. This somewhat general definition, which includes a state of doubt and a complete behavior of rejection, has some individuals muddling the terms and inaccurately concluding that vaccine hesitancy and anti-vax are synonyms.


The issue with the definition is that true vaccine hesitancy, a state of doubt or uncertainty but not a complete behavior of rejecting the vaccine, is normal human behavior while being anti-vax, or the outright rejection of all vaccines (including the new COVID-19 vaccines developed), is the real global health concern.

Wikipedia, a commonly used public resource that is considered not rigorous enough within the sciences and academia, defines vaccine hesitancy as follows:


“Vaccine hesitancy, also known as anti-vaccination or anti-vax, is a reluctance or refusal to be vaccinated or to have one's children vaccinated against contagious diseases. People who subscribe to this view are commonly known as "anti-vaxxers". The term encompasses outright refusal to vaccinate, delaying vaccines, accepting vaccines but remaining uncertain about their use, or using certain vaccines but not others.”


This (in my opinion) inaccurate definition is one used by the public at large. Consider that recently in New York City, Bonnie Jacobson, a waitress, was fired because she wished to hold off the COVID-19 vaccination. While she was enthusiastic about the vacci