Heidi Larson did not anticipate such a frenzied year, but as the founder of the Vaccine Confidence Project, a nonprofit that works to monitor and address public trust in vaccines, she has never been busier. Larson, also the author of Stuck: How Vaccine Rumors Start — and Why They Don’t Go Away, spends most of her days now on Zoom and Skype, speaking to health ministries, universities, and government leaders around the world about COVID vaccine hesitancy and how to address it.
Larson, 63, is now a professor of anthropology at the London School of Hygiene & Tropical Medicine. She previously worked for Save the Children in India and Nepal, for UNICEF in New York, and for the UN, where she met her husband, virologist Peter Piot. Here’s how she gets it done.
On her ‘typical’ workday
I always have my espresso. I’m a big oatmeal fan. I jump onto my computer and start to see what dramas the world brings. Pre-COVID, I was traveling globally a lot, but when in London, I’d take a bus to my office, which is at the London School of Hygiene & Tropical Medicine in a historic building behind the British Museum. I would spend my day there with my team.
I vicariously continue to travel. The talk I just gave this morning was at the University of North Carolina, and the day before I was giving a talk in India. The strange part is just sitting at the same desk but jumping through time zones, either in virtual round tables or while talking to research collaborators. I also do a lot of media interviews, some of which are outside because of COVID restrictions, but most are by phone or computer. I do try to take walks as often as I can during the day, because otherwise it’s not the healthiest.
On trust as a public-health necessity:
COVID has amplified the need for some of the things I wrote about in the book regarding vaccines in general, which is that we need to find more time for conversations between the public and the medical and health community. People trust health professionals more than a lot of figures in government and business, but I think there’s still a sense that doctors dismiss their questions and concerns about vaccines. Individuals feel like they’re just a number. We’re living in a time where people want to be more engaged and in charge of their choices, which I think is perfectly reasonable, but it’s been hard to adjust to that from the medical and health side.
In the context of COVID, a lot of what I encourage is more listening as a medical and health community. We need to understand what the public’s concerns and questions are, because if we’re not responsive to what they care about, they’re going to go somewhere else for information. Instead of wagging our fingers at social media or blaming Facebook, the public-health field needs to take some responsibility for what we can do differently, and I think a lot of that just starts with being open.
On cautious optimism:
My favorite part of my job is working with young researchers. They keep me motivated. I have a pretty mixed group — my team includes psychologists, anthropologists, social-media analysts, mathematical modelers, and they all ask different kinds of questions. What we have in common is that we’re all working on the same challenge of trying to understand why people are questioning and refusing vaccines more than they used to. My students give me confidence that the world is going to be okay.
There are still a number of people in the health and public-health community who are very dismissive of some of those questions and concerns about vaccines. They say it’ll go away, so they don’t talk about it. I’ve had that written to me on official stationery from the health authority. Sometimes I find critics in the public-health and media crowds who feel like I shouldn’t be giving so much attention to [vaccine skepticism], but I think it hasn’t been given enough attention. If we don’t give attention to it, it’s just going to get worse.
On her side-gig as a children’s-book author:
I’ve got little grandchildren who live down the block, and they help put me in a whole different space. I was never able to have my own children, but I’m so grateful for my stepchildren and grandchildren. My work has always featured children as a theme. I was at Harvard for my BA, and I chose to do my thesis on a photo ethnography of children with Down syndrome. I went and photographed them for a year, and then I got a research fellowship from Harvard to take that approach to the West Bank and Gaza Strip, and then to Hindu and Muslim communities in India. I was always interested in childhood and how children negotiate differences — how through play and joking they negotiated their differences and overcame stresses in their lives. I started doing children’s books by drawing from my fieldwork. It’s definitely not an income opportunity, but it’s a passion.
On her career path toward vaccines:
I’ve always been interested in health. In 2000, UNICEF asked me to lead the strategy in communications for new vaccines around the world — and to launch GAVI, which is a global alliance on vaccines. There was a growing epidemic of individuals and communities and even some government officials questioning and refusing vaccines. I ended up getting the nickname ‘Director of UNICEF’s Fire Department,’ because it turned out to be a crisis-management position, because people weren’t taking vaccines. I saw what seemed to be a trend: The northern Nigeria boycott of the polio program made it into the international press, but it wasn’t one place, it was everywhere. I didn’t have time in my day job to investigate what was going on there, because there was not a quick fix. That’s when I put together a proposal and got some seed money and founded the Vaccine Confidence Project.
On frequent flying:
My husband and I have been able to travel together a lot. We were both in the UN before, and that was more difficult, but now in academia, because we’re both in global health, we’re able to coordinate better.
There was a spell when I was on autopilot with travel. You have your suitcase always half open. I used to try to work on airplanes or get things done, and then I realized that’s the one time to shut it off and watch movies. I put up with movies I’d never go out and watch otherwise. I don’t have a lot of time to watch them during my normal day. I drink a lot of water and walk up and down the plane a lot, especially on long-haul flights.
On the advice she’d give her younger self:
I’d tell my younger self to speak up a bit more than I did. My voice mattered as much as the next guy’s, and in general it was a guy who was louder. Another really important thing I tell younger people who come to me for career advice is to go for what they want — to not get stuck in a Where am I going to be in five years? mentality. I find that now there are more people in their 20s who are already thinking about their pension. Even 15 years ago, when I left the UN, some of my colleagues were like, “What do you mean you’re leaving? What about your pension?” And I was like, “Oh my god, if I’m living for my pension, I might as well pack it up.” Taking some risks is really important. Whatever you do, you’re going to have tough times and good times. If you don’t really believe in it, it’ll be much harder to deal with the tough times.