ACOG’s maternal vaccine schedule sparks online debate

Plus, a viral video resurfaced myths about tetanus vaccines, and the health secretary was criticized for demanding an explanation for a  “flawed” vaccine study’s removal.

False and misleading claims about routine vaccines circulated online over the past two weeks. The American College of Obstetricians and Gynecologists’ maternal vaccination schedule drew both praise and criticism for diverging from the CDC on recommendations for COVID-19 and flu vaccines during pregnancy. Meanwhile, scientists and others online criticized the U.S. health secretary for demanding that a journal explain why it retracted a vaccine study due to methodological flaws and potential research errors. Finally, a video promoting false claims about tetanus vaccines was removed from social media, fueling speculation that information about vaccines is being suppressed.

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What’s trending in vaccine conversations

For the first time, the American College of Obstetricians and Gynecologists has released a maternal immunization schedule. The schedule recommends flu, COVID-19, RSV, and tetanus, diphtheria, and pertussis (Tdap) vaccines for all pregnant people, diverging from the CDC, which no longer recommends COVID-19 or flu vaccines containing thimerosal during pregnancy. Some online commenters applauded ACOG for promoting evidence-based guidance endorsed by other major medical organizations. Others falsely claimed that vaccination during pregnancy is dangerous and increases the risk of complications, despite decades of research showing that maternal vaccines are safe and effective.

A 2021 study claiming that childhood vaccines may be linked to sudden infant death syndrome (SIDS) was retracted because of “serious methodological flaws” and “potential research errors,” according to the publishing journal. On June 11, U.S. Health Secretary Robert F. Kennedy Jr. sent a letter demanding an explanation for the study’s retraction. Some scientists and public health experts noted that the journal had already published an explanation at the time of the retraction and accused Kennedy of attempting to influence the scientific editorial process. Several posts speculated that information about vaccine safety is being suppressed because multiple flawed vaccine papers have been retracted, removed, or flagged for concern in recent months. The online debate also resurfaced the debunked myth that SIDS was “nonexistent” during the first year of the COVID-19 pandemic because children missed routine vaccinations.

A video promoting false claims about tetanus and tetanus vaccines had garnered more than 1.3 million views as of June 15 after being removed from a social media platform. The video, posted by a “natural medicine” website, claims that tetanus vaccination is unnecessary because tetanus deaths are rare. It also promotes vitamin C as an alternative to vaccination and falsely claims that tetanus vaccines contain toxic ingredients and are produced using “decaying beef organs.” Commenters echoed the video’s claims, with many suggesting that tetanus immune globulin is superior to tetanus vaccines. Others described the diphtheria, tetanus, and pertussis (DTaP) vaccine as the “most dangerous vaccine” and expressed opposition to its use during pregnancy.

Read the fact checks: 

• American College of Obstetricians and Gynecologists: Vaccines During Pregnancy
• American Academy of Pediatrics: Fact Checked: There Is No Link Between Vaccines and Sudden Infant Death 
• AFP: Doctors say tetanus still merits vaccination, despite posts downplaying risks

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Recommendations for public health professionals

The Infodemiology.com team will provide messaging recommendations in response to some of the trending narratives outlined above. Use these helpful tips when creating content, updating web pages and FAQs, and developing strategy for messaging about vaccines.

Concerns about the safety of maternal vaccines may contribute to hesitancy, particularly when federal health recommendations conflict with established scientific evidence. Health communicators may emphasize that ACOG’s maternal vaccine schedule is evidence-based and endorsed by 13 major medical and health organizations, including the American Academy of Pediatrics, the American Academy of Family Physicians, and the Society for Maternal-Fetal Medicine. Messaging may explain that maternal vaccines are rigorously tested and monitored for safety during pregnancy and that maternal vaccination is recommended because pregnant people are more susceptible to severe illness from infections such as the flu and COVID-19.

The false claim that vaccines cause SIDS continues to fuel hesitancy and may influence parents’ decisions about childhood vaccination. Debunking messaging may explain that decades of research have found no evidence linking any vaccine to SIDS, and that SIDS rates increased in 2020 as childhood vaccinations declined. Emphasizing that childhood vaccines help protect children from serious and potentially life-threatening diseases is recommended, as is explaining that vaccines work with a child’s developing immune system to safely build immunity. Communicators may also explain that the recently retracted paper relied on unverified VAERS reports and that the study’s author is a prominent anti-vaccine figure with no apparent expertise in the field.

Claims that vaccines are unnecessary because the diseases they prevent are rare may influence people to skip or delay vaccination. Health communicators may emphasize that tetanus deaths are rare largely because tetanus vaccines protect people before they are exposed to tetanus toxin. Messaging may explain that tetanus vaccination provides protection for up to ten years, that children should complete the initial tetanus vaccine series by age 12, and that adults should get a booster every 10 years to maintain strong protection. Debunking messaging may note that tetanus immune globulin consists of essentially borrowed antibodies from people who have immunity to tetanus, but provides temporary protection through antibodies from people with immunity to tetanus but does not generate lasting immune protection. Explaining that tetanus can be life-threatening and that vaccination is highly effective is recommended, as is emphasizing that tetanus vaccines have a strong safety record and contain no harmful ingredients.