VIEWPOINT| VOLUME 401, ISSUE 10380, P967-970, MARCH 18, 2023

Published: March 02, 2023

DOI: https://doi.org/10.1016/S0140-6736(23)00136-8

Prof Richard M Carpiano, PhD, Prof Timothy Callaghan, PhD, Renee DiResta, BS, Prof Noel T Brewer, PhD, Chelsea Clinton, DPhil, Prof Alison P Galvani, PhD et al.

Introduction

Over the past two decades, anti-vaccine activism in the USA has evolved from a fringe subculture into an increasingly well organised, networked movement with important repercussions for public health. The COVID-19 pandemic has exacerbated this evolution and magni ed the reach of vaccine misinformation. Anti-vaccine activists, who for many years spoke primarily to niche communities hesitant about childhood vaccinations, have used traditional and social media to amplify vaccine- related mistruths about COVID-19 vaccines while also targeting historically marginalised racial and ethnic communities. These e orts contributed to COVID-19 vaccine hesitancy and expanded the movement, with early indications suggesting that this hesitancy could now also be increasing hesitancy that existed pre- pandemic towards other vaccines. It is important to understand the implications of this recent evolution of anti-vaccine activism on vaccination uptake and the promotion of sound public health strategies. In this Viewpoint, we summarise the latest developments in US- based anti-vaccine activism and propose strategies for confronting them.

The evolution of anti-vaccine activism

In the years preceding the COVID-19 pandemic, anti- vaccine activism became more visible in the USA. Three patterns are noteworthy, and are outlined below. ...

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