Outrage circulates over new safety warning on RSV vaccines

This week, debates spiked online about maternal and COVID-19 vaccine safety, while regional conversations discussed school and employer vaccine mandates.

This week, online vaccine conversations focused on the safety of RSV, COVID-19, and other maternal vaccines. A new FDA safety label on two RSV vaccines about a possible increased risk of a rare nerve disorder sparked conversation among vaccine opponents. In Florida, a grand jury investigation found no criminal wrongdoing related to COVID-19 vaccine development and approval, leading some social media users to recirculate misleading claims about COVID-19 vaccine safety. Finally, a social media thread launched a contentious discussion about vaccination during pregnancy. 

Regional vaccine conversations were dominated by rising school vaccine exemptions, the fallout of employer COVID-19 vaccine requirements, and a Texas lawsuit claiming that Pfizer lied to the public about its COVID-19 vaccine. 

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What’s trending nationally in vaccine conversation:

On January 7, the FDA announced new safety labeling for the Abrysvo and Arexvy RSV vaccines, warning that there is evidence of a potential increased risk of the rare neurological disorder Guillain-Barré syndrome for 42 days after vaccination. The warning is based on an observational FDA study that found seven to nine excess GBS cases per million doses in adults 65 and older. Yet, the agency noted that “available evidence is insufficient to establish a causal relationship.” Vaccine opponents are misrepresenting the FDA’s alert to suggest that RSV vaccines are unsafe and that GBS is a common side effect. Some social media users expressed outrage that the vaccine will remain in use, while others argued against the need for any vaccines, claiming they’ll “trust” their immune systems. A prominent anti-vaccine physician blamed “excessive vaccination” for a so-called “global explosion” of vaccine-related GBS cases. To support this claim, he cited a study that identified 15,377 unverified reports of cases over 48 years in 170 countries out of the billions of vaccines administered during that period.

A Florida grand jury tasked by the state’s governor in 2022 with investigating “any and all wrongdoing” related to COVID-19 vaccines found no evidence of any criminal activity. However, in a report unsealed on January 7, the grand jury accused federal regulatory agencies of “a pattern of deceptive and obfuscatory behavior” and recommended greater transparency around clinical trials and a ban on advertising of therapeutics. Many responses to the grand jury’s final report repeated baseless claims that the federal government “hid” adverse reactions from the public and claimed that the vaccines should be pulled from the market.

A pregnant social media user asked for guidance in navigating conversations about vaccination with her doctors. The woman stated that she is not anti-vaccine but believes the current vaccination so-called “paradigm” is not safe. Top responses to the post discouraged all vaccination during pregnancy and linked anti-vaccine groups like the National Vaccine Information Center. Some recommended databases of pediatricians that accept unvaccinated patients, while others falsely claimed that doctors receive “kickbacks” to vaccinate patients.

Read the fact checks: 

• Pharmacy Times: Research Shows Guillain-Barré Syndrome Remains Rare Among Older Adults After RSV Vaccination 
•  Infectious Diseases Society of America: Understanding Vaccine Safety 
• ACOG: Vaccine Safety During Pregnancy

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What’s happening in the Northeast:

A former Boston police sergeant who was fired in 2023 after refusing to get vaccinated against COVID-19 due to her religious beliefs is suing the city for wrongful termination. The former officer was terminated after she organized anti-mandate protests outside the mayor’s home, which she claims violated her First Amendment rights. Many social media users expressed support for the lawsuit and opposition to vaccine requirements. The responses repeated false claims about COVID-19 vaccine safety and effectiveness.

What’s happening in the South:

On January 8, the Texas attorney general appealed the recent dismissal of his lawsuit against Pfizer. The 2023 lawsuit accused the pharmaceutical company of misleading the public about the effectiveness of its COVID-19 vaccine. A federal judge ruled on December 30 that Pfizer is protected under the Public Readiness and Emergency Preparedness Act. Some social media users cheered the decision to appeal the court’s ruling and called for criminal accountability, while others criticized the attorney general for wasting taxpayer money on “frivolous lawsuits.”

What’s happening in the Midwest:

A January 6 news article about the rise in non-medical exemptions for school vaccinations in Minnesota generated a pro-vaccine conversation on social media. The article notes that religious and personal belief exemptions have increased significantly since 2020. Several commenters blamed recent pertussis and measles outbreaks in the state on rising exemptions and declining vaccination rates. Other users criticized parents who skip vaccinations, calling them irresponsible and dangerous to their children and community. Some posts also called for a restriction of medical reasons that qualify for vaccine exemption, although data suggests that medical exemptions remained steady over the last decade.

What’s happening in the West:

Some conversations online about the Los Angeles fires claim without evidence that the city is facing firefighter shortages due to its COVID-19 vaccine mandates. The source of the claim appears to be a former LA firefighter who made national headlines in 2021 for refusing to comply with the city’s vaccination requirements. Responses to the claim blamed vaccine mandates for the devastation caused by the fires and called the fires a self-made crisis. Several posts also spread skepticism about climate change and disparaged diversity, equity, and inclusion hiring policies.

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Talking points for health care providers to use in response to trending narratives

Each week the Infodemiology.com team will provide talking points and supporting messages in response to some of the trending narratives outlined above. Health care providers can use this messaging when discussing vaccines online, talking to patients, or engaging with communities.  

RSV vaccines are safe and thoroughly tested—the FDA flags and alerts the public to all potential risks, even those that are extremely rare. 

• A single RSV vaccine dose is between 86 and 94 percent effective against severe illness and provides lasting protection.
• The FDA identified a potential increased risk of a rare neurological disorder following vaccination with the Abrysvo and Arexvy RSV vaccines, resulting in new safety labeling. Importantly, the FDA emphasized that there is no evidence that RSV vaccines caused the disorder, just that it occurred in a small number of vaccine recipients. 
• The risk is low—an additional seven to nine cases per million vaccinations—and is minimal when compared to the benefits of vaccination.
• The early detection and labeling of a rare potential adverse reaction is an example of vaccine monitoring systems working as they should.

How do we know that COVID-19 vaccines are safe?  Multiple clinical trials, large-scale studies, and over four years of independent safety monitoring tell us so. 

• A recent Florida grand jury report is being used to circulate false and misleading claims about COVID-19 vaccine safety. The report did not produce any evidence that COVID-19 vaccines are unsafe or of any wrongdoing related to the development or approval of COVID-19 vaccines. 
• Federal health agencies have carefully monitored and flagged potential safety signals related to COVID-19 vaccines and promptly informed the public throughout the pandemic.
• Federal regulators are required to investigate all potential safety signals to ensure that vaccines are as safe as possible. The detection of extremely rare safety signals is a sign that the monitoring is working as it should.  

Vaccines aren’t just important during pregnancy. They’re lifesaving.

• Pregnant people are frequently targeted by anti-vaccine figures who exploit legitimate concerns to discourage vaccination. 
• For over four years, large-scale studies in the U.S. and worldwide have shown that COVID-19 vaccination during pregnancy is safe.
• Pregnant people and newborns are at high risk from certain vaccine-preventable diseases, like the flu and RSV, making staying up to date on recommended immunizations during pregnancy especially important.

Interested in recommendations tailored to public health professionals? Click here.