The internet has long been a place for the free exchange of ideas, regardless of the ideological beliefs of the posters. Indeed, the idea of internet censorship is anathema to Americans, whose free speech is protected by the First Amendment.
But what can be done about the growing amount of harmful misinformation intended to influence thousands of people to make decisions that put not only their lives, but the lives of their and others’ children, at risk?
{mosads}Such is the situation for the anti-vaccination, or “anti-vax,” community, thousands of whose members flock to social media pages where they promptly remove “pro-vax trolls,” and post fear-mongering memes and exaggerated personal anecdotes.
They also direct like-minded individuals to websites like vaccineimpact.com, which promotes error-filled articles topped by misleading headlines such as “WARNING: Dangerous flu shots being given to children without parental consent” and “FDA decision to approve Gardasil vaccine for adults will likely increase cervical cancer rates.”
If it were only a matter of putting oneself at risk by refusing vaccination, we would not necessarily be called to action. After all, a personal choice is just that, regardless of how silly it may seem to outsiders. But people who refuse vaccines for themselves and their families are putting the most vulnerable members of their community at risk of severe illness or death.
Case in point: In 2018, measles rates in the United States continued to skyrocket, with over 1,700 cases reported since 2010 even though just two decades ago, it was largely eliminated from the country. The situation is even worse in Europe. In the first six months of 2018, more than 41,000 Europeans were infected with measles and 37 died. The recent uptick in preventable infectious disease-related morbidity and mortality has been directly linked to the increasing rate of parents who opt out of vaccinating their children.
Many of those in the anti-vax community are energized by Andrew Wakefield’s 1998 Lancet article, which linked the MMR vaccine to autism. Though the article was retracted in 2010 and Wakefield lost his medical practice license, it circulated very widely and became an integral component of anti-vax communities around the world.
Unfortunately, misinformation tends to spread faster and more profusely than the truth. According to a study from 2018, the top 1 percent of false news cascades propagated on Twitter from 2006 to 2017 diffused to between 1,000 and 100,000 people, while the truth rarely diffused to more than 1,000 people.
Such was the case in October 2014, when another article linking autism and the MMR vaccine went viral, despite its retraction just a month after its original publication due to unstated conflicts of interest and questionable methods and statistical analysis. Not only did it circulate through anti-vaccination websites for weeks, but it also became mainstream once it was published on a CNN-affiliated website, which subsequently garnered more than 786,000 views and 256,000 shares on social media.
Measles is not the only preventable disease on the rise because of vaccine rejection, nor are Western nations the only countries with vaccine skeptics. Northern Nigeria poses a threat to the worldwide eradication of polio because of rumors, misconceptions and anti-polio vaccine propaganda circulating the region. Much of the distrust in the polio vaccine stems from claims made by local Muslim clerics that the vaccines were contaminated with anti-fertility agents, HIV and cancerous agents. Further complicating the issue is a general distrust of aggressive, mass immunization programs in a country where basic healthcare is not easily available.
Given the vast scale of misinformation, it is important that there be a very active counter-movement to dispel myths, especially those that counter the well-being of citizens and scientifically sound public health principles.
There are many strategies that could be developed and expanded in a robust effort to refute misinformation using commonly available communications tools. For instance, billboards, posters, signs and online media could more effectively promote how vaccinations are safe, easy and appropriate.
Active use of Twitter, Facebook and Instagram can rapidly correct misinformation, rumors or false information. Likewise, creative campaign partnerships with known, respected organizations, like FEMA, Red Cross or the American Academy of Pediatrics can be effective. Faith leaders, survivors and medical professionals also add credibility to messaging.
In places where the internet is not as widely available, mass public awareness campaigns can be created about why vaccines are so important using radio, television, print media, local music and theater.
{mossecondads}And we would not be above calling out “conspiracy sites” and statements based on ignorance. Finally, we should start early, making sure that young people, at least by middle school and continuing through higher education, understand science and how to distinguish between credible and non-credible information.
While there is no single infallible strategy capable of overcoming all the intricacies of correcting people’s misinformed beliefs, the most successful corrective strategies aim to tailor different, simultaneous and frequent interventions in order to increase the likelihood of people making sound decisions about their own health and the health of their communities.
Rachel Alter is a graduate research assistant at the National Center for Disaster Preparedness at Columbia University. Follow her on Twitter @rachelalter007.
Irwin Redlener, M.D., is president emeritus and co-founder of the Children’s Health Fund and has more than three decades of experience providing healthcare to medically underserved children. Redlener is also the director of the National Center for Disaster Preparedness at Columbia University’s Earth Institute, and professor of Health Policy and Management at the Mailman School of Public Health at Columbia University. Follow him on Twitter @IrwinRedlenerMD.