Because vaccine hesitancy has been framed as a problem of public misunderstanding of science, vaccine outreach has focused on educating the misguided public. Where efforts to change vaccine attitudes have failed, cynicism has bred the harsher view that the publics are anti-science and anti-expertise. Yet research into science and the public lends strong support to the view that public attitude regarding scientific claims turn crucially on epistemic trust rather than familiarity with science itself. It follows that it is poor trust in the expert sources that engender vaccine hesitancy.
This consideration redraws the lines of responsibility, where vaccine hesitancy signals a problem with scientific governance rather than a problem with the wayward public. In order to improve vaccine communication, we should focus on building that trust rather than educating the misinformed public or puzzling over the moral and epistemic failings of the public. Doing this does not discount that public health agencies have the science on their sides. It does mean recognizing that the best science is not enough to ensure public uptake of health recommendations.