Do not overestimate opposition to vaccines
I appreciate this article [ https://doi.org/10.1136/bmj.r2338 ], which downplays the importance of “misinformation.” The vast majority of people support vaccination. One should not miss the forest for the trees. For example, the increase in measles cases is often cited as an example of the consequences of a significant decline in vaccine confidence. However, the necessary vaccine coverage to achieve herd immunity against measles is estimated at 95%, as it is a highly contagious disease. Therefore, even a slight decrease in vaccine coverage is sufficient to allow outbreaks, and there have always been outbreaks of measles in certain communities that oppose vaccination. The increase in measles cases in the last ten years in the U.S. is associated with a decline in average vaccine coverage from 95.2% to 92.5%. In Texas, the epicenter of the outbreak, only 6.2% of children are unvaccinated against measles. This represents a very small fraction of the population.
Overestimating vaccine resistance fosters the perception that such opposition is becoming a social norm and may encourage hesitant individuals to align with those opposing vaccination. Conversely, as stated by England’s Chief Medical Officer in the article, we should emphasize that the vast majority of children are vaccinated. The very small minority of parents who oppose vaccination are exposing their own children, as well as others, to a disease that affected 1,681 children in the United States in 2025, 203 of whom were hospitalized and 3 of whom died (as of November 2025).
Readings:
B. Seytre, "Should we be Afraid of an Infodemic?," https://doi.org/10.4148/2572-1836.1353
S. Altay, M. Berriche, and A. Acerbi. “Misinformation on Misinformation: Conceptual and Methodological Challenges.” https://doi.org/10.1177/20563051221150412
Bernard Seytre
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HIFA profile: Bernard Seytre is a Consultant at BNSCommunication in France. Professional interests: Health communication and education. seytre AT bnscom.fr