Thread by @ProfColinDavis

Here we go again [LONG THREAD].

First we had “behavioural fatigue”. Now JCVI is invoking the notion of “vaccination fatigue” to explain falls in childhood immunisation.

theguardian.com/society/2021/a…

You might recall that “behavioural fatigue” was a previously unheard of phenomenon invoked by government advisers (chiefly Chris Whitty, it seems) to justify their (mistaken) belief that the public would not comply with lockdowns that lasted more than a couple of weeks.

In response, a large group of behavioural scientists signed an open letter asking for the evidence for this alleged phenomenon that they’d never heard of. (They never received an answer).

behavioralscientist.org/why-a-group-of…

So is "vaccine fatigue" a real thing? I'm familiar with the literature in this area-I've recently published research about vaccine hesitancy and I have a good understanding of the factors affecting vaccine behaviour. I've never come across this term.

bpspsychub.onlinelibrary.wiley.com/doi/10.1111/bj…

So I did a literature search for the term “vaccination fatigue”. It came up with a grand total of 4 results.

Two of these four search results are papers written in German that use the term “Impfmüdigkeit”. That can be translated literally as “vaccine fatigue”, but it’s clear from the context of the articles that it’s actually referring to what’s known in English as vaccine hesitancy.

We know quite a lot about vaccine hesitancy. One of its key determinants is vaccine confidence, which can be undermined by exaggeration of risks, as in these comments by (checks notes) members of JCVI. bbc.co.uk/news/uk-581700… telegraph.co.uk/news/2021/06/3…

Incidentally, the research that I published with Ryan McKay and @mattgolding suggests that experience with other vaccines, far from promoting "vaccine fatigue", is something that helps to overcome vaccine hesitancy. theconversation.com/vaccines-for-c…

Another of the four papers that mentions “vaccination fatigue” is about post-vaccination fatigue in those who have had the rubella vaccine. That’s clearly not relevant to what JCVI are claiming.

The only paper I found that used the term “vaccination fatigue” in the sense JCVI is using it was a throwaway comment in a 2016 paper about challenges to eradicating polio. It's suggested that parents in Pakistan may experience VF after their children have had >15 vaccinations.

There's no evidence provided for that claim in the paper, and they also note that another relevant factor may be outright bans on vaccination (e.g., by the Taliban). None of this seems relevant to the situation in the UK.

Just to be comprehensive I also ran a literature search for the term “vaccine fatigue”. This search found a single, solitary result.

That paper (from 2009) reports on focus groups conducted in Monroe County, NY. The participants were health-care providers (doctors and nurses). Some of those in the suburbs mentioned "vaccine fatigue".

Why would this factor be mentioned by those in the suburbs but not those in urban settings? It sounds like, rather than “vaccine fatigue” this phenomenon might reflect how people access vaccination.

We know that maximising vaccine uptake requires going to where people are. In the case of children, this is routinely achieved by holding vaccination clinics in schools.

In the last 18 months that approach has been disrupted due to uncontrolled transmission of Covid, which has led to school closures and self-isolation of hundreds of thousands of children at a time.

Ironically, perhaps, the mass self-isolation of school children we saw in July might have been avoided had JCVI recommended the Covid vaccine for 12-15 year olds once it had been approved by the regulator. That would’ve allowed more immunisation to take place.

Interestingly, that paper which mentioned “vaccine fatigue” also suggested that it might actually refer to attitudes among those *giving* the vaccines rather than those being offered them. I wonder if something similar might apply to JCVI?

In summary, vaccination fatigue isn't really a thing. But then again, maybe the members of JCVI know something that the rest of the world's scientists don't?

https://twitter.com/ProfColinDavis/status/1426238521812135944?s=20

While we're making up new conditions, how about vacillation fatigue: the increasing frustration with public health experts who can't decide whether to give children a vaccine that will protect them against COVID-19?
pressandjournal.co.uk/fp/news/politi…

And there's no need to stop there. The pandemic has given rise to:

- corruption fatigue
- stupidity fatigue
- incompetence fatigue

Or is that just me?

And if I seem a bit intemperate (or perhaps just usually intemperate), this has something to do with it.

https://twitter.com/ProfColinDavis/status/1424026641592950785?s=20

As does the fact that my son has now tested positive. So rather than spreading antivax talking points and then making up excuses for why vaccination isn't happening, I'd really like to see JCVI pull their finger out and get this vaccination program moving. [ENDS].