Policy Views and Negative Beliefs About Vaccines in the United States, 2019

Dominik A. Stecula, PhD; Ozan Kuru, PhD; Dolores Albarracin, PhD; Kathleen Hall Jamieson, PhD


Am J Public Health. 2020;110(10):1561-1563. 

In This Article

Abstract and Introduction


Objectives: To determine whether holding vaccine misconceptions, in the form of negative beliefs about vaccines, correlates with opposing governmental action at all levels designed to increase vaccination (e.g., removing personal belief and religious vaccine exemptions).

Methods: Drawing on data from a nationally representative survey of 1938 US adults, we assessed the relation between negative beliefs about vaccines and provaccination policies.

Results: Beyond sociodemographic and policy-relevant variables, such as gender and partisan affiliation, questionable negative beliefs about vaccines are the strongest predictor of opposition to policies designed to increase vaccination.

Conclusions: Negative beliefs about vaccines in the general population may thwart the passage or implementation of policies designed to increase vaccination. Implementing strategies that reduce these negative beliefs should be a priority of educators and public health officials.


In 2019, the United States experienced one of the worst measles outbreaks in a quarter century.[1] Four years before, in response to the Disneyland outbreak, the state of California increased vaccination coverage by removing nonmedical (personal belief and religious) vaccine exemptions.[2] Since then, several states have attempted to tighten their own vaccine laws, but in some cases, most recently New Jersey, a vocal antivaccine lobby successfully opposed the state's efforts.[3] At a time when the world is fighting the COVID-19 pandemic while awaiting a vaccine, understanding the implications of vaccine misconceptions is critically important to public health.

Vaccine misconceptions, in the form of questionable negative beliefs about vaccines, is a potential determinant of the mixed level of public support for provaccine policies. During the 2019 US measles outbreak, between 15% and 20% of US adults accepted at least 1 widely circulated antivaccination claim.[4] Although embrace of such claims is known to correlate with a reduced likelihood of vaccination,[5,6] scholars have not answered this question: do negative beliefs about vaccines also affect the level of public support for provaccination policy, and if so, to what extent?