‘It’s not a vaccine, it’s a shot’: uncovering a new trend in vaccine scepticism

It has long been recognised that attitudes towards vaccines may be vaccine-specific, so that people may take up some, but not others.

On July 26 2021, the following statement was posted on Twitter (later renamed X) about the COVID-19 vaccine:

It’s not even a real vaccine. You can catch Covid and also spread it if you are vaccinated. You don’t catch polio or MMR after you are vaccinated.

My colleagues and I came across this comment and many like it while analysing a nine-million-word dataset consisting of tweets about the COVID and MMR vaccines posted between 2008 and 2022, to learn more about vaccine scepticism. We discovered that the author of this tweet is not alone in questioning the status of the COVID-19 vaccines as vaccines, and comparing it to others.

Vaccines (but not as you know them)

Our study also investigated how, in the years of the pandemic, people compared the COVID-19 vaccines unfavourably with the MMR vaccine. Many described a perception that the COVID vaccines were not very effective at preventing infection:

Yes because the covid vaccine is just like the MMR vaccine. NOT. MMR vaccine provides 99.8% protection from catching measles, mumps or rubella. Covid vaccine does NOT stop you from catching covid. Vaccinate away but it’s not going to stop covid.

Some people go one step further and state that, therefore, the COVID-19 vaccines are not vaccines:

How about we start with the fact that it’s not a vaccine, it’s a therapeutic. True vaccines immunize you from the virus. The COVID “vaccine” still allows you to catch COVID just with lesser symptoms. Not the same with polio, MMR, etc.

In some tweets, posters use the term “shot” in contrast with “vaccine”, to suggest an inferior intervention, despite the fact they mean the same thing:

Stop calling it a vaccine. It’s a shot.

Over 20 years ago a discredited but still influential claim that the MMR vaccine may cause autism caused a wave of vaccine scepticism. But this is a new type of vaccine-specific scepticism.

In our data, there is almost no evidence before 2020 of people claiming that some vaccines are not in fact vaccines. In the period 2020-2022, this form of scepticism increased rapidly in relation to the COVID-19 vaccines, and also applied to the flu vaccine:

Can you tell me more about this “vaccine” for the flu that allows tens of thousands of deaths? That’s not a vaccine, it’s a flu shot. Much different than say a polio vaccine or MMR vaccine. I would argue that we do NOT have a flu vaccine.

How can we explain this?

Experts were already aware that some diseases, such as measles, are vaccine-preventable: if you are vaccinated, you are extremely unlikely to be infected. In contrast, other diseases, including influenza and COVID-19, are vaccine-modifiable: if you are vaccinated, you may still be infected, but you are much less likely to become seriously ill or die.

This is not to do with the quality of the vaccines, never mind their status as vaccines, but with differences between, for example, more stable viruses and viruses that mutate over time, and between different rates at which immunity wanes.

Nonetheless, definitions of vaccination by, for example, the World Health Organization and the UK’s National Health Service, tend to focus on the prevention of disease.

Up until the pandemic, these definitions were mostly consistent with people’s experiences of vaccination. Even with flu, there was no easy access to tests that could show that you had been infected with the strain you had been vaccinated against.

The COVID-19 pandemic changed all that. It became a common experience to test positive for COVID-19 even after receiving one or more vaccine doses. Our research found that for some people, this did not undermine confidence in the status of the COVID-19 vaccines as vaccines. For others it did.

This probably explains the new type of scepticism my colleagues and I discovered. It is a scepticism that may be shared by people who normally take up vaccines, for themselves and for their children. The use of informal alternatives to the term “vaccine”, such as “shot”, in public health messaging may unintentionally contribute to this confusion about what counts as a vaccine.

If left unaddressed, this new scepticism may affect the take up of seasonal flu and COVID-19 vaccines, as well as confidence in vaccines in future pandemics.

Elena Semino receives funding from the Economic and Social Research Council, part of UK Research and Innovation (grant number: ES/V000926/1).