Yaffa Shir-Raz’s research while affiliated with University of Haifa and other places

T he controversy over vaccines has persisted since their introduction in the eighteenth century. While many studies have addressed the concerns and motivations of the general population regarding hesitation and resistance to vaccination (especially parents, concerning routine childhood immunization), the present study was designed to examine this issue among professionals from a victimological perspective, thus its uniqueness. Study participants were researchers and practitioners involved with vaccines who hold a critical position on vaccines and their ways of dealing with what they perceived as suppression of dissent in the field of vaccination. The motivations identified among the researchers and practitioners in our study referred to ethical aspects of professional obligation to patients, patient rights, freedom of choice, and lack of trust in the medical establishment. The participants also perceived themselves as victims of suppressive tactics due to their critical position, to which they responded in two contrasting ways: continuing to dissent while insisting on their right to have their voices heard or abandoning their public dissent due to the reactions and repercussions they faced. The article discusses the implications of these findings in the context of scientific integrity, violation of democratic and ethical values, freedom of speech, and its impact on the public’s trust in science and medicine.

The emergence of COVID-19 has led to numerous controversies over COVID-related knowledge and policy. To counter the perceived threat from doctors and scientists who challenge the official position of governmental and intergovernmental health authorities, some supporters of this orthodoxy have moved to censor those who promote dissenting views. The aim of the present study is to explore the experiences and responses of highly accomplished doctors and research scientists from different countries who have been targets of suppression and/or censorship following their publications and statements in relation to COVID-19 that challenge official views. Our findings point to the central role played by media organizations, and especially by information technology companies, in attempting to stifle debate over COVID-19 policy and measures. In the effort to silence alternative voices, widespread use was made not only of censorship, but of tactics of suppression that damaged the reputations and careers of dissenting doctors and scientists, regardless of their academic or medical status and regardless of their stature prior to expressing a contrary position. In place of open and fair discussion, censorship and suppression of scientific dissent has deleterious and far-reaching implications for medicine, science, and public health.

The controversy over vaccines has recently intensified in the wake of the global COVID-19 pandemic, with calls from politicians, health professionals, journalists, and citizens to take harsh measures against so-called “anti-vaxxers,” while accusing them of spreading “fake news” and as such, of endangering public health. However, the issue of suppression of vaccine dissenters has rarely been studied from the point of view of those who raise concerns about vaccine safety. The purpose of the present study was to examine the subjective perceptions of professionals (physicians, nurses, researchers) involved with vaccines through practice and/or research and who take a critical view on vaccines, about what they perceive as the suppression of dissent in the field of vaccines, their response to it, and its potential implications on science and medicine. Respondents reported being subjected to a variety of censorship and suppression tactics, including the retraction of papers pointing to vaccine safety problems, negative publicity, difficulty in obtaining research funding, calls for dismissal, summonses to official hearings, suspension of medical licenses, and self-censorship. Respondents also reported on what has been termed a “backfire effect” – a counter-reaction that draws more attention to the opponents’ position. Suppression of dissent impairs scientific discourse and research practice while creating the false impression of scientific consensus.

The controversy over vaccines, which has recently intensified following the COVID-19 pandemic, provokes heated debates, with both advocates and opponents raising allegations of bias and fraud in research. Researchers whose work raises doubts about the safety of certain vaccines claim to be victims of discriminatory treatment aimed at suppressing dissent, including the unjustified retraction of their published research. Such practices have previously been discussed in other controversial fields in science (e.g., AIDS, the environment, and water fluoridation) but not in the field of vaccines. The purpose of this study was to analyze, for the first time, the subjective views of researchers whose papers were retracted. Study participants are active researchers, most with international reputations in their respective fields. They perceived retraction as a means of censoring and silencing critical voices with the aim of preserving the pro-vaccination agenda of interested parties. Participants also reported additional measures aimed at harming them personally and professionally. These findings point to the need for a fair, open, and honest discourse about the safety of vaccines for the benefit of public health and the restoration of trust in science and medicine.

In most Western countries, where direct advertising of prescription drugs (DTCA) is banned, the pharma industry relies primarily on PR activities to promote its products. Despite the pharma industry's ever-increasing share in framing media coverage of health issues, the strategies used in its press materials have not yet been systematically examined. This study uses framing theory to explore the PR strategies and tactics employed by pharmaceutical companies to promote their products in Israel, where DTCA is banned. Using a combination of qualitative and quantitative content analysis, we examined 1548 pharmaceutical press releases. The Israeli example can serve as a case study for understanding how the pharma industry operates in many countries around the world where DTCA is banned. Our findings show that strategies and tactics dubbed as “disease mongering” dominate the pharma industry’s press releases. The four main strategies identified in this study are third party technique, disease branding, drug branding and Astroturfing. Some of the common PR strategies and tactics we found are not only unethical, but also opposed to the regulatory bodies in Israel, and would never receive approval, even in countries where DTCA is allowed.

Studies indicate uncertainty surrounding vaccination safety and efficacy for pregnant women, causing a central problem for health authorities. In this study, approximately 26% of participants do not recommend the tetanus, diphtheria, and acellular pertussis and influenza vaccines to their patients, although being aware of the health ministry recommendations. We found significant statistical discrepancies between the knowledge about the recommendations and their actual implementation, revealing the concerns of health care workers regarding vaccine safety.

Background: Vaccine compliance has long been a cause for concern for health authorities throughout the world. However very little effort has been made to examine parental discourse during the decision-making process. Methods: An online survey was conducted (N = 437) to examine predictors of parents' attitudes regarding childhood vaccination. Results: Hesitant parents were 4 times more likely to conduct intrafamily discussion regarding vaccination compared with provaccination parents (Exp[B] = 4.26). There were no significant differences between hesitant and antivaccination parents with respect to intrafamily discussion. Hesitant parents were also 4 times more likely than provaccination parents to report intrafamily disagreements regarding vaccination (Exp[B] = 4.27). They were also twice as likely as antivaccination parents to express disagreements regarding vaccination within their families (Exp[B] = 2.33). Likewise, Jewish parents were significantly more likely to define themselves as vaccination-hesitant, whereas Muslim parents were significantly more likely to be provaccination. Conclusions: To improve the way health organizations communicate information about vaccines and increase parental trust in immunization programs, we should not only look at the level of understanding, perceptions, and biases of different groups, but also thoroughly examine parents' decision-making processes and the discourse during this process. We must communicate risk to all groups, including the provaccination group, to improve parents' decision making and the process of informed consent.

In a digital world where the public’s voice is growing increasingly strong, how can health experts best exert influence to contain the global spread of infectious diseases? Digital media sites provide an important source of health information, however are also powerful platforms for the public to air personal experiences and concerns. This has led to a growing phenomenon of civil skepticism towards health issues including Emerging Infectious Diseases and epidemics. Following the shift in the role of the public from recipients to a vocal entity, this book explores the different organizational strategies for communicating public health information and identifies common misconceptions that can inhibit effective communication with the public. Drawing on original research and a range of global case studies, this timely volumeoffers an important assessment of the complex dynamics at play in managing risk and informing public health decisions. Providing thought-provoking analysis of the implications for future health communication policy and practice, this book is primarily suitable for academics and graduate students interested in understanding how public health communication has changed. It may also be useful to health care professionals.

Water fluoridation is a controversial issue in public health. Despite the uncertainty regarding its efficacy and safety, health officials continue to communicate it as 'unequivocally' safe and effective. Our focus is on how health officials and policy-makers in Israel frame the issue of water fluoridation in terms of certainty while promoting a mandatory fluoridation policy. According to van Asselt and Vos, the uncertainty paradox describes situations in which uncertainty is acknowledged, but the role of science is framed as providing certainty. Our study is an analysis of documents and media articles emphasizing the paradoxical language used by official representatives on the controversial topic of fluoridation. A central contribution of this study is that we coin the term 'uncertainty bias,' in which policy-makers do exactly what they accuse laypeople of doing, framing uncertainty in biased terms. We found that in order to establish mandatory regulation , health ministry officials expressed information in an unbalanced format, promoting the topic of fluoridation by framing it in exclusively positive terms. This study does not focus on the practice of water fluoridation per se, and is not intended to decide for or against it, but rather, to explore how the debate regarding it is communicated. Understanding this particular case can shed light on how other controversial topics are transformed into health policy that is characterized in equivocal terms.