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Vaccine Hesitancy

Vaccine Hesitancy

Public Trust, Expertise, and the War on Science

By Maya J. Goldenberg
University of Pittsburgh Press, 2021

Vaccine Hesitancy explores vaccine hesitancy and refusal among parents in the industrialized North. Although biomedical, public health, and popular science literature has focused on a scientifically ignorant public, the real problem, Maya J. Goldenberg argues, lies not in misunderstanding, but in mistrust. Public confidence in scientific institutions and government bodies has been shaken by fraud, research scandals, and misconduct. Her book reveals how vaccine studies sponsored by the pharmaceutical industry, compelling rhetorics from the anti-vaccine movement, and the spread of populist knowledge on social media have all contributed to a public mistrust of the scientific consensus. Importantly, it also emphasizes how historical and current discrimination in health care against marginalized communities continues to shape public perception of institutional trustworthiness. Goldenberg ultimately reframes vaccine hesitancy as a crisis of public trust rather than a war on science, arguing that having good scientific support of vaccine efficacy and safety is not enough. In a fraught communications landscape, Vaccine Hesitancy advocates for trust-building measures that focus on relationships, transparency, and justice.

More Praise

Vaccine Hesitancy is a refreshing reconsideration of how we frame and might reframe public debate about vaccines and vaccination. Maya Goldenberg’s argument—that at the foundation of today’s vaccine controversies is a public mistrust of science, not a public misunderstanding of science—offers an important point of view in the larger contemporary debate about vaccine hesitancy. Her book is original and compelling, providing a unique perspective on a topic in urgent need of more critical scholarly attention.

— Elena Conis, author of Vaccine Nation: America’s Changing Relationship with Immunization

In 2019, The World Health Organization declared vaccine hesitancy one of the top ten global health threats. How should the phenomenon be understood? Vaccine Hesitancy is a timely response to this pressing issue. Lucidly written, rigorously argued, and comprehensive in scope, Maya Goldenberg’s book demonstrates the value of philosophical analysis to contemporary debates. It deserves a wide audience and is essential reading for anyone engaged in public health and medicine. In light of COVID-19, this would include all of us.

— Ross Upshur, University of Toronto

Centering much of her discussion on the vital issue of trust—indeed, on a ‘crisis of trust’ in current social structures and medical practices, and on the fragile status of expertise, even of ‘facts’—Maya Goldenberg argues convincingly for a ‘dialogical’ understanding of trust. This is a concept and a practice for which cooperation becomes a fundamental epistemic value, and epistemic responsibility is a guiding principle.

— Lorraine Code, York University

Goldenberg presents a fascinating discussion of the complexity of and interrelationships among the myriad factors that result in vaccine hesitancy and refusal. She effectively refutes the idea that such behaviors stem from an inability to understand the science behind vaccines. Rather, she posits that science and public health practitioners should understand that what she terms a ‘crisis of trust’ is the axis around which public skepticism revolves. . . . Highly recommended.

— Choice Reviews

Maya Goldenberg’s timely and well-argued book. . . . provides tools for understanding why rational people might reject policy informed by science. Addressing values directly rather than through the proxy of science means tackling the polarization that creates an environment dangerous for democracy. Goldenberg offers some practical first steps for addressing childhood vaccine hesitancy and in this way also suggests what further work needs to be done if we are to have successful public policy informed by science.

— Philosophy of Science