Raina MacIntyre's book Vaccine Nation celebrates the public health gains of vaccines. It's also a warning

Australia Broadcast Center

26-04-2025

Professor Raina MacIntyre was waiting quietly in the emergency department of a busy hospital last year when she overheard a conversation she'll never forget.
The patient in the cubicle next to hers had been scratched and bitten by his cat but was flatly refusing the tetanus booster his doctor was recommending. Couldn't he just have some antibiotics and be on his way? The doctor told him that wasn't necessary and asked why he didn't want a tetanus shot. "I know 30 people who dropped dead. I don't want it. I'm
not
having it," he said. "Thirty people I know died after getting COVID vaccines."
Instead of correcting him — instead of explaining that there had been 14 deaths from COVID vaccines in Australia, all before 2022, and 13 of them after the AstraZeneca shot which had since been withdrawn — the doctor gave the man the antibiotics he was demanding, likely only reaffirming his beliefs.
"Privately, many doctors and health leaders bemoan falling vaccination rates and stay silent while anti-vaxxers claim the stage, free to make whatever outlandish … claims they wish," MacIntyre writes in her new book, Vaccine Nation: Science, reason and the threat to 200 years of progress. "At the same time, many fail to provide the role modelling needed for change, stricken by the same fear as politicians" who avoid speaking about COVID because it is "triggering" for so many people.
Photo shows
Gloved hands holding COVID-19 vaccine, needle in glass container.
Three local councils in South Australia have been passing motions questioning vaccines, but health experts say they are based on misinformation and heighten community risk.
That emergency department exchange epitomises the public health challenge the world is now facing, and which MacIntyre, who researches infectious diseases, bioterrorism and vaccines as
But Vaccine Nation is also a warning about the acceleration of the anti-vaccination movement during the pandemic and worrying declines in vaccination rates around the world, which MacIntyre links to a broader backlash against science and medicine, including from within the medical profession itself. It is a precarious situation given the looming threat of a bird flu pandemic — one experts fear could be deadlier than SARS-CoV-2 — though it's already a
A catalyst for this backlash, MacIntyre says, were COVID lockdowns, which in Australia were enforced before vaccines were available to prevent the crises unfolding overseas — collapsing health systems, refrigerator trucks full of bodies, mass graves. But lockdowns have become conflated with any kind of public health measure — including face masks and vaccines — as "state-sponsored tools for control" and an attack on personal freedoms. As a result, MacIntyre writes, public health messaging has become "timid and apologetic", myths and misinformation have flourished unchecked, and "we now risk losing the gains of the last two centuries in a post-truth era embraced by the community and medical experts alike".
Vaccines are easily taken for granted
Together with improved sanitation, better nutrition, and antibiotics, vaccines have led to significant public health advances that are easily taken for granted. A
Until then, infectious diseases were a leading cause of death, particularly among children. The
Raina MacIntyre's Vaccine Nation is available from May 1st, 2025.
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Supplied: NewSouth Books
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But these gains are now under threat. Australia's childhood immunisation rates remain relatively high by global standards but fell in 2023 for the third consecutive year, the
More research is needed to understand exactly what's driving these shifts: it's not all about COVID, nor is it all about
MacIntyre also points the finger at doctors, including experts on vaccine advisory committees, some of whom she says have downplayed COVID's seriousness and fuelled vaccine misinformation. She is scathing, for instance, of
"It's a
'I don't want mRNA in my body!'
In a chapter called "I don't want mRNA in my body!" — a tongue-in-cheek nod to the fact that
Crucially, COVID vaccines saved an estimated
COVID vaccines saved an estimated 14.4 million lives globally just in the first year after they were rolled out.
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Supplied: WA Health
)
Still, while the safety of COVID vaccines is well-established, they're not completely risk free — no vaccine or drug is. A study of
.
It may be of little comfort to
That's not to say vaccine programs always go smoothly. In a chapter on vaccine safety MacIntyre explains the strict development process new vaccines undergo and the sophisticated monitoring systems large countries use to track adverse events — this surveillance is used to pick up rare side effects that aren't identified in clinical trials.
But rollouts have occasionally revealed serious failures. One of the most infamous examples is the
Tackling the politicisation of public health
Seventy years later, despite the resounding success of COVID vaccines, we're now grappling with a confidence crisis on a bigger scale, driven by a tangle of factors: the
Perhaps one of the most insidious examples of the challenge science now faces is the backlash MacIntyre has copped personally. Earlier in the pandemic, whenever she'd do media interviews, angry, abusive emails from complete strangers would come pouring into her inbox. They blamed her for lockdowns and, in one bizarre example, accused her of promoting masks and vaccines and causing mass deaths as a result. "F--- you, Raina. You are just so f---ing useless, like 95 per cent of females with 'careers'," one emailer spat.
MacIntyre argues that "risk perception" ultimately drives human behaviour and tolerance for public health measures, vaccines included.
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ABC News: Brendan Esposito
)
"I'm not sensitive at all because I know what I'm doing," MacIntyre insists. "I know what I say is based on evidence, on science … and I'm just not bothered by what anyone thinks or says about me. I also don't want negativity in my life … so if doing interviews is going to bring negativity, I don't need it, I don't want the attention." These days, she says, she'll do an interview if it's about a subject she thinks no one else understands the way she does: "If there's something I can contribute, I would like to. But there's also the question of, when people are over it, what's the point in being a talking head out there?"
Still, things can be turned around, she says — especially in Australia, where as far as public health goes, "we're in a much stronger position than the US or UK". "I think some public messaging to consolidate the gains we already have is important, so we don't lose it in the sea of misinformation that will be coming in the near future," MacIntyre says. "I think the politicisation of public health" — reflected in political leaders' reluctance to mention COVID, for instance — is something we need to tackle."
Photo shows
A stock photo of a boy infected with measles.
Australia is in the middle of a surge in measles cases amid a global spike and declining childhood vaccination rates. So what precautions should be taken to avoid widespread transmission?
She also supports
Other experts have suggested public confidence in vaccines could be bolstered by improving the governance and accessibility of vaccine injury compensation programs (many people who say they were injured by COVID shots
Perversely, though, it may take people dying from resurgent, vaccine-preventable diseases like measles — or the onset of a bird flu pandemic — to really shift the dial. As MacIntyre writes, "risk perception" ultimately drives human behaviour and tolerance for public health measures, vaccines included. "When people see friends, family and neighbours dying or becoming seriously ill with pandemic influenza," she writes, "most will avail themselves of any available protective measures".