Bertalan Meskó, MD, PhD
Anti-vaccination (anti-vax) movements lure increasingly more people into skipping potentially life-saving immunisation against infectious diseases, such as measles, mumps, or rubella; highly impairing herd immunity for entire communities. You might have encountered such sentiments on social media, but people living a century before also experienced similar resistance to vaccines during the smallpox vaccination effort. Such objection in 1920 prompted Seattle’s commissioner of public health to call the city “a hotbed for anti-vaccination, Christian Science, and various anti-medical cults, and it is difficult to enforce vaccination.”
Even in times of a pandemic, anti-vaxxers’ activism does not falter. According to a December survey by Kaiser Family Foundation (KFF), 27% of Americans say they probably or definitely would not get a COVID-19 vaccine; even if it were free and deemed safe by scientists. This trend can prove devastating if we consider the impact of similar resistance in recent years. For example, measles led to some 140,000 worldwide deaths in 2018, while Q1 2019 saw a 300% rise in measles cases compared to the same period a year before. Among the reasons, the WHO cites vaccine hesitancy.
And that was about a disease that we’ve had an effective vaccine for about 60 years. For a virus as new as the novel coronavirus, skepticism is heightened. Some blame an apparent lack of data, while others fall for conspiracy theories rampant on social media. Indeed, as we race to slow COVID-19’s spread and vaccinate as many people as possible, misinformation is spreading faster than those efforts.
For their part, social media platforms could restrict the reach of anti-vax messages, groups, and activities, with algorithms recommending tailor-made content and health apps providing information about vaccinations. Here’s our collection of the most recent steps and digital tools supporting the fight against anti-vaccination and its believers.
Skepticism is as infectious as a disease
Although lack of access to vaccination and religious reasons add to the causes of vaccination hesitancy, the biggest problem has been lately the global spread of the anti-vaccination movement fuelled by various celebrities, politicians and social media platforms profiting from such viral content. Facebook has been trying to tackle its anti-vaxxer problem for years, but just as we publish this article, the social media giant announced that it plans to remove posts with false vaccination claims globally. However, as of today, one can still browse Instagram freely for such damaging content.
While the phenomenon of skepticism towards vaccination or medicine in general is not new, it’s recurring with a newly found resilience. It seems that the toll of infectious diseases on human life, such as that of measles, mumps, and rubella, has already been largely erased from the collective memory of humankind.
In parallel, the rise of fake news and conspiracy theories about the greediness of vaccine manufacturing companies and the fear of the potential harm that vaccines allegedly cause have taken over significant space in the public discourse. Some are linking coincidental medical conditions, where the patient’s age or declining health are the real cause, to the COVID vaccine. “They will sensationalise anything that happens after someone gets a vaccine and attribute it to the vaccine,” said Dr. Peter Hotez, an infectious diseases specialist.
Others even take a more physical approach to express their distrust in vaccines. For example, in January, 50 anti-vaccine protesters in Los Angeles forced one of the U. S.’s largest vaccination sites to close for one hour. While a certain level of skepticism is understandable when it comes to matters relating to one’s health, it becomes dangerous to err in the path of the anti-vaxxer; especially when independent regulatory authorities and peer-reviewed studies deemed the vaccines in question to be safe. But fuelling the skepticism to extreme levels in the digital age are social media platforms. These act as the breeding ground for anti-vaccination movements.
Access to the right information empowers – access to the wrong one can be lethal
Largely responsible for the rise in anti-vaccination movements is the fast and easy spread of misinformation on new media platforms. Viral posts work just like political propaganda. The key is in the repetition of such messages. If you listen to a negative message several times over a longer period, it sticks with you and may influence your attitude; no matter what you rationally think.
A recent example is that of an edited video making rounds online that showed a nurse “dropping dead” after getting her COVID-19 vaccine. In fact, the nurse simply fainted, but social media users further fuelled the conspiracy by posting a fake death certificate and obituary. Such posts are normalising and fuelling skepticism about vaccination. For instance, the Royal Society for Public Health found that 2 in 5 parents are exposed to negative messages about vaccines on social media, while over a quarter incorrectly believe that “you can have too many vaccinations.”
Despite such worrying trends, social media platforms still lag behind when it comes to taking timely action. A recent investigation by the London-based Bureau of Investigative Journalism found 430 Facebook pages, followed by 45 million users, that spread false information about COVID-19 or vaccinations while using Facebook’s tools such as virtual “shops” and fan subscriptions. Mark Zuckerberg’s company occasionally takes a cut when fans tip their content creators. Facebook also monetises the spread of such disinformation from the ads revenue generated as users engage on the platform and use its services.
In an age when the problem is not the access to health information anymore but rather that most people have to face a data overflow, finding the right piece of knowledge will be the biggest challenge. The ‘right’ information will make you empowered, but fake information might get you into serious health trouble.
Social media to the rescue?
In the wake of rising disinformation, the American Medical Association recently warned that these “could derail this Herculean effort” to immunise the population. This warning was specifically addressed to the CEOs of leading social media platforms. That’s why the appropriate assessment of online information and the role of social media giants in restricting space for the spread of such messages are becoming crucial in clamping down anti-vaxxers. The former necessitates the education of internet users about how to evaluate online medical information; we even have a guide about it. As for the second part, it requires a systemic response from such companies as Facebook, YouTube or Amazon.
Social media companies like Facebook, Twitter and YouTube did tighten their policies against coronavirus misinformation on their platforms; with millions of posts taken down and even more tagged with fact-checking labels. But they don’t always find and remove them all. You could try a search for yourself to see it.
Still, we believe that YouTube, Facebook, or Google should not only make anti-vax messages disappear. They should also push for even better visibility of ‘vaccination advocates’ or influencers at the expense of accounts spreading misinformation. As the WHO says, health workers, especially those embedded in communities, remain the most trusted advisors and influencers of vaccination decisions. As such, they must be supported to provide trusted, credible information on vaccines. The American Medical Association also echoed a similar message. They called for social media companies to “share timely, transparent and accurate information about COVID-19 vaccines from public health institutions like the FDA and CDC that are rooted in science and evidence.”
This could only happen with knowledge bases like Google, Facebook, or YouTube pushing back online anti-vaccination propaganda with efficient measures. Thus, we expect them to step up their game even more in the coming months.
Algorithms, VR and innovation against anti-vaxxers
How can digital health tools outside the realm of communication and social media platforms help? Well, there are quite a few ways to bring health technology into the fight against anti-vaxxers; but we have a couple of ideas for the developers too.
Sophisticated algorithms could play a role in addressing vaccine hesitancy. Just as Amazon and Netflix are adept at suggesting products and movies that ‘people like you’ might enjoy, health systems could build individually tailored messages most likely to resonate with individuals.
Artificial intelligence could also bring a helping hand in determining vaccine side effects from those who have already received their jab. This is what A.I. company Genpact is doing in the U.K. Their machine learning algorithm screens patient reports for patterns that could show signs of a possible issue. This can subsequently allow healthcare authorities to further investigate the case. This could help clear any false claims while also raising awareness of the actual side effects that one could experience.
Alternatively, innovative solutions could provide new opportunities to inform those at risk that they should be vaccinated. This could be, for example, via SMS alerts and reminders of dedicated health apps. Others are crowdsourcing data to build reliable online resources to help those eligible find a vaccination centre.
Other innovations might mitigate the discomfort that children feel when getting vaccinated. In a pilot study involving 244 children, about half were given virtual reality headsets to view calming scenes while getting their flu shot. Children in the VR group were reported to have felt less pain and fear than those without such a headset. Similarly, another study had 17 children use VR goggles as a means of distraction while getting a vaccine. All but one child reported of less fear and pain from the shot than they had anticipated. The Hermes Pardini Laboratories’ VR Vaccine campaign even put such an approach in practice:
No matter whether it’s VR, artificial intelligence, health apps, or measures of social media platforms, the most important objective is to show everyone that the benefits of vaccination are a matter of fact. NOT an opinion.
Dr. Bertalan Mesko, PhD is The Medical Futurist and Director of The Medical Futurist Institute analyzing how science fiction technologies can become reality in medicine and healthcare. As a geek physician with a PhD in genomics, he is a keynote speaker and an Amazon Top 100 author.
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