One of the world's longest-running human health studies has shone light on the roots of vaccination resistance. Among native New Zealanders, those refusing vaccination against COVID-19 are much more likely to have been abused or neglected as children.
While refusal of COVID-19 vaccines elicited widespread frustration, researchers from Duke University decided to investigate the underlying reasons.
In the journal PNAS Nexus, the new study reveals the results of a special survey of participants in the Dunedin Multidisciplinary Health and Development Study. The study started by collecting data on almost every child born in Dunedin, New Zealand, in 1972 and '73, and has followed those who are willing through life, interviewing them every few years and recording their health. This has allowed insights into the health effects of factors such as childhood lead exposure.
In mid-2021, Professor Terrie Moffitt and co-authors sent the Dunedin-born an additional survey, asking whether they would take the COVID-19 vaccines when they became available in New Zealand. An impressive 88 percent responded. The team compared the answers with almost 50 years of data on the almost 1,000 participants.
The 13 percent who said they would not get vaccinated were far more likely to have experienced childhood abuse, neglect, deprivations, or serious threats from adults.
“That suggests to us that they learned from a tender age 'don't trust the grownups,'" Moffitt said in a statement. "If anyone comes on to you with authority, they're just trying to get something, and they don't care about you, they'll take advantage. That's what they learned in childhood, from their experiences growing up at home. And that kind of learning at that age leaves you with a sort of a legacy of mistrust. It's so deep-seated that it automatically brings up extreme emotions."
However, that can't be the whole story – New Zealand has some of the highest COVID-19 adult vaccination rates in the world. Just 4 percent have not been vaccinated there, compared to 24 percent in North Carolina, where Moffitt is based. Whether or not childhood abuse was higher in the USA than New Zealand in the 1970s, the difference was unlikely to be this dramatic.
The work provides insight into those who distrust vaccination. More importantly, it provides a starting point to work out how to reach such people. It's a hard task however: the paper reports Dunedin participants in this group were distrustful of friends, family, and co-workers, plus authority figures such as scientists and politicians.
Finding someone whose word carries weight to bring a pro-vaccine message will not be easy. Nevertheless, the any empathy the findings generate may help.
The authors also identified characteristics at intermediary ages that help link betrayed child to distrustful adult. As teenagers, the vaccine-resistant generally believed their health was out of their control, so there was no point trying to look after it. Unsurprisingly, at 18 they were more alienated, aggressive, and unable to absorb information when stressed.
Abuse also affected reading, verbal capacities, and processing speed as children, and was associated with lower health knowledge as adults, even about uncontested topics. These results remained after the authors controlled for socioeconomic background.
The study was motivated by the author's personal experiences. “We had so many friends and family who initially said that the pandemic was a hoax, and then refused to wear a mask or social-distance,” Moffitt said. “And then when the vaccines came along, they said 'over their dead bodies,' they would certainly not get them.”
The authors suggest; “To prepare for future pandemics, education about viruses and vaccines before or during secondary schooling could reduce citizens‘ level of uncertainty during a pandemic, and provide people with pre-existing knowledge frameworks that prevent extreme emotional distress reactions and enhance receptivity to health messages.”
In the longer term, co-author Professor Stacy Wood of North Carolina State University noted the work demonstrates the importance of addressing these issues early. We may not always be able to stop child abuse, but there is plenty more that could be done about neglect. "The best investments we could make now would be in building children's trust and building stable environments, and ensuring that if the individual caregiver fails them, society will take care of them," Wood said.