Draft:Vaccine myths and misconceptions

Vaccine myths and misconceptions are inaccurate beliefs widely held about the safety and effects of vaccines. Since the vaccine’s first success in 1796. , it has been accused of numerous myths and misconceptions emerging from various controversies. The spread of groundless narratives about vaccinations creates vaccine myths, while misinterpretations of a specific vaccine science fact produce vaccine misconceptions. Both aspects induce public fear of vaccination, resulting in vaccine hesitancy, a perturbation, or rejection to be immunized. Most vaccine myths and misconceptions are related to the instrument itself, but there are some false claims about specific vaccinations owing to their distinct traits. Vaccine hesitancy causes a decline in the vaccination rate, ultimately reaching a damaging impact on public health. Thus, elucidating vaccine myths and misconceptions is crucial to support infection prevention and control.

Evolution of significant achievements of vaccines with the misconceptions and concerns
1796 - Conducted the first successful scientific vaccination against smallpox by Dr. Edward Jenner. However, the lack of understanding of using cowpox to prevent human disease led to fears about the safety and misconceptions of the vaccine mechanism.

1974 - The onset of thimerosal, a toxic substance used in vaccination, raised concerns about its safety. The Food and Drug Administration (FDA) review on the use of children's vaccination peaked the controversy surrounding thimerosal in 1999.

1995 - The use of the Polio vaccine raised a misconception that vaccination causes changes in the internal body system due to dangerous chemicals, including infertility agents, carcinogens, and HIV agents.

1998 - The false claim of Andrew Wakefield's study on Measles, Mumps, and Rubella (MMR) vaccine linkage with autism spectrum remains a significant case where mistrust in the authoritative health organizations expanded.

2006 - The introduction of the Human papillomavirus (HPV) vaccine raised the misconception of being female-specific. This misconception is rooted in a divergent perception of vaccinations between genders to emerge.

2020 - The COVID-19 vaccine extended the misunderstanding about the effectiveness and longevity of vaccine-acquired immunity. This recalled a discussion comparing the efficiency of vaccine-acquired immunity to natural immunity.

Vaccines may contain perilous ingredients
The concept that vaccines may be toxic is a myth that has arisen due to the fear and misunderstandings regarding the presence and significance of vaccine ingredients. While vaccines contain substances that might be distinguished as toxic, such as thimerosal, aluminum, or formaldehyde, the origin of this myth lies in the lack of understanding about the quantity and form of these substances.

Disseminating misinformation about vaccines peaked during the COVID-19 pandemic due to social media platforms and public figures’ statements. The algorithm, which tends to show content that elicits strong emotional reactions, of social media facilitated the spread of medical misinformation and exaggerations of side effects, causing vaccine hesitancy.

However, the presence of these substances in vaccines is carefully regulated and monitored by different health organizations and regulatory bodies to ensure their safety and effectiveness. The measure to ensure safety and efficacy effectiveness is critical in understanding the quantity and form of these substances in vaccines, which pose no significant risk to human health.

COVID-19 vaccination was also involved with doubt of vaccine ingredients, for carrying track-detecting microchips. The myth originated from several factors, including fear of the pandemic and misinformation about the vaccine. In 2019, the Bill & Melinda Gates Foundation made efforts to develop a storage system within a patient’s skin to ease the vaccination records of the public. Although the project did not include any track detection of people, the misinterpretation of technology of inserting microchips has been embedded among the public through this event. Investigation revealed that a microchip was not included in the vaccine. Lack of understanding of vaccine science among the public confused the truth of the vaccine ingredients.

Vaccines may cause Sudden Infant Death Syndrome (SIDS)
To prevent a higher risk of infection against germs and getting a severe illness from an infant’s poor immune system, vaccinations targeting infants were introduced. In addition, the myth of vaccines causing SIDS emerged. This concept began in 1999, when a 1-month-old girl received a second dose of the hepatitis B vaccine and died 16 hours after the injection. With the release of infant-targeted vaccines, the combination of misinterpretation of data and the plausible relationship between vaccines and SIDS emerged, heightening awareness of the safety of vaccines and their potentiality.

The expansion of the fallacious belief that vaccines are associated with SIDS occurred with the increased vaccine coverage in the late 20th century. The temporal assumption of a causal link between vaccines and SIDS was amplified through the dissemination of misinformation via various social media platforms and non-scientific publications.

Multiple studies have consistently indicated the absence of a causal association between vaccine administration and the incidence of SIDS. In fact, vaccinations are primarily administered during the 2-4 month age range, which coincides with the peak occurrence of SIDS cases in infants. Moreover, supplementary research has substantiated comparable rates of SIDS between vaccinated and unvaccinated infants within the same age group.

MMR vaccine may lead to autism
The myth of a potential link between the MMR vaccine and autism arose due to the controversial studies published by Andrew Wakefield in 1998. Publication of the research article that supported the concept of linkage was taken as public fear and skepticism about the MMR vaccine. With the expansion of false information about the MMR vaccine in the media, the vaccination rate declined, and concerns about not only the MMR vaccine but also general vaccinations increased.

The article was retracted in 2020 due to methodological flaws and ethical issues. Following the retraction, different comprehensive studies concluded that there is no credible evidence to support the linkage between the MMR vaccine and autism.

Continuous Vaccination might overload the immune system
This misconception originated from a misinterpretation of vaccination and immune system response among the public. Immune system response is triggered through vaccine injection of antigen, a molecule that potentially instigates antigen presentation, driving activation of the immune cells. This mechanism of immune response stimulation was suspected to have a limited capacity for antigen acceptance, alleged as immune overload. Excessive antigen administration was believed to cause dysfunction of the immune system.

The fallacy about immune overload was amplified due to recent advancements in science, which resulted in an expansion in the vaccination schedule . Particularly for toddlers under 24 months, only two types of vaccinations, the Smallpox vaccine and the Diphtheria, Tetanus, and Pertussis (DTP) vaccine, were generally administered in the 1950s while recommendation by the United States Centers for Disease Control and Prevention (CDC) in 2024, is up to twelve vaccinations. The changes in the scheme resulted in parental concerns, causing a dilemma in their children's immunization.

In fact, the human immune system has the capability of manipulating an immense number of antigens. Besides, the amount of artificial antigens injection is only a fraction of daily natural exposure to microorganisms. Although the increase in vaccination requirements is undeniable, its design was thoroughly examined and supported for its safety and efficacy without relation to the overwhelm of an individual's immune system.

Vaccine might cause the disease it was meant to prevent
The concern of vaccination being a threat rather than protection was an outcome of misunderstanding the nature of vaccines. Vaccine types called live-attenuated vaccines involve a weakened form of the pathogen as the vaccine ingredient to imitate an infection-inducing immune system activation. The idea of injecting a live microorganism into the human body raised a concern that disease might instead be developed.

Vaccination, like other medical treatments, has the potential for side effects, which is an unintended adverse event due to medical interventions. The side effects are mostly mild and transient, such as minor headaches or low-grade fever. Coincidentally, the side effects of vaccination may overlap with the disease's symptoms that it aimed to prevent. For example, side effects of Influenza vaccines include muscle aches and fatigue, which are the main signs of flu, and the infection of interest for respective vaccines. Such a random occurrence participated in the construction of vaccine misbelief.

The truth of such misconception is that infection of a healthy individual by live attenuated vaccines is unexpected except for an infrequent phenomenon where regaining virulence of the weakened virus due to mutation, referred to as viral reversion, occurs. In remaining cases, requisite rigorous testing before approval assures the safety of virus inoculation. Also, an attentive investigation of the side effects is carried out before approval. Side effects are a normal process in the construction of immunity, as vaccination is recognized as an invader, which causes the initiation of a defense mechanism that leads to different adverse events.

HPV vaccination would have been designed only for females
The misapprehension about the HPV vaccination target population, the intended group of individuals to receive the vaccination, has created such misconception. HPV vaccination is purposive for immunization against HPV infection that is primarily caused through sexual intercourse. The two types of HPV vaccinations are Gardasil and Cervarix, developed in 2006 and 2007, respectively. Upon their approval, the emphasis of the vaccination role was kept on protection against cervical cancer, a female-specific disease.

In 2006, the United States Food and Drug Administration (FDA) announced the approval of Gardasil for females between the ages of 9 and 26. After three years, males of the same age range were additionally included in the vaccination target population. The three-year interval between different genders for HPV recommendation has reinforced the misconception.

However, apart from cervical cancer, the HPV vaccine also serves as protection for oropharyngeal, anal, vulvar, vaginal, and penile cancer. Among the potential infections, oropharyngeal and anal cancer can affect both genders, while penile cancer is male-specific. Thus, HPV vaccination is designed for both genders

COVID-19 vaccination might not have been carefully designed
A misunderstanding of the vaccination approval guidelines raised this misconception of the design of COVID-19 vaccination. COVID-19 vaccination protects against the SARS-CoV-2 virus through various types, including mRNA, Viral Vector, subunit, and attenuated vaccines. The distribution of several types of vaccination resulted in a difference in efficacy rates, which led to public doubts.

The spread of COVID-19 resulted in a global pandemic declaration in March 2020 by the World Health Organization (WHO). Subsequently, the Pfizer-BioNTech COVID-19 vaccine was rolled out in the following December, and the rapid development provoked mistrust in the efficacy of the vaccination. Many COVID-19 vaccinations gained permission from Emergency Use Authorizations (EUA), considering the magnitude of the situation. This confirms that the potential benefits outweigh the possible risks under rigorous evaluation. Furthermore, an unprecedented global collaboration and investment from different organizations enabled the preparation of immediate vaccine production directly after approval. Soon after, extensive clinical trials were completed to ensure the safety of every approved vaccination regardless of its variety. Thus, the quick commercialization and variety of the vaccines are recommended to be perceived as an emergency response rather than indicative of careless vaccination design.