Why vaccine misinformation is winning the information war

We aren’t “following the science.”

As I wrote about this weekend, measles is making a comeback in the U.S., and although vaccine attitudes and behaviors are influenced by a variety of factors, one major factor in recent years has been the surge of misinformation coinciding with the growth of the anti-vaccine movement. Research shows, for example, that increases in non-medical vaccine exemptions and declining vaccination rates are linked to misinformation about the safety and efficacy of vaccination. 

Currently, though, our approaches to dealing with misinformation tend to be limited in their effectiveness and, in some cases, may even be contributing to the problem.

According to a recent study published in BMJ, vaccine misinformation on social media is proliferating much faster than efforts to counter it. The study found that the high volume of misinformation online can override more reliable sources of information, limiting the effectiveness of high-quality information campaigns. Furthermore, simply banning misinformation on social media can backfire and actually drive people to seek out even less moderated sources of information — something that I have repeatedly emphasized as more and more people started calling on social media companies to ban anyone who questioned vaccines. Similarly, efforts to debunk vaccine misinformation have mixed results — they can counter misinformation, but can also deepen false beliefs. 

That’s not surprising, given that belief in misinformation is not usually driven by a lack of information or an inability to understand it. Rather, it’s driven by underlying factors like politics/ideology, distrust of government and institutions, poor science communication, and lack of support from trusted health care professionals. In many cases, these concerns are rooted in firsthand experiences and very real legacies of mistreatment by the medical system and scientific or government institutions. 

Although we know very well what causes people to lose trust in vaccination, we aren’t addressing the complexities of vaccine attitude formation in our efforts to counter misinformation and associated negative sentiment towards vaccination. Furthermore, despite having decades of social science to guide us towards what works — and just as importantly, to guide us away from what doesn’t work — we continue to struggle to incorporate this science into the design of counter-misinformation efforts.

Besides banning content and attempting to “debunk” deeply-held beliefs with nothing more than facts, we’ve also seen recommendations for things like deploying thousands of government-funded librarians to “clean up” social media — a real proposal from a leading misinformation scholar at Harvard — that would almost certainly do far more harm than good, as it would simply push the tens of millions of Americans who don’t trust the government off mainstream platforms and onto fringe sites where the most extreme content flourishes without moderation or mitigation. The psychological theory of reactance, which has been around for nearly 60 years, explains why such efforts are so likely to backfire. According to this theory, when an individual feels that their freedom or control is being threatened by advice or guidance, they are motivated to protect their autonomy, often by doing the exact opposite of what they’re told to do. This is the type of foundational knowledge that should be part of any serious counter-misinformation effort, yet more often than not, the most widely-adopted approaches to dealing with misinformation seem to be grounded in politics instead.

Ultimately, undoing the negative effects of the anti-vaccine movement will clearly involve much more than just correcting falsehoods and sharing accurate information. In other words, it will take more than “countering misinformation.” If people don’t trust the agencies and scientists that are producing the information, then the facts will continue to fall on deaf ears. Rebuilding confidence in vaccines means first understanding why people fall for anti-vaccine misinformation in the first place — why it’s appealing, why it draws people in, and what it does for them. It also means acknowledging that some pro-vaccine voices — including some of our nation’s leading public health agencies — have not always been reliable or credible messengers, and it’s not “anti-science” to ask questions about things like how an agency as prestigious and well-resourced as the CDC could be so out-of-touch and get their messaging so wrong for so much of the pandemic. 

It’s also important to recognize that many people who are labeled as “anti-vaccine” actually fall somewhere along the continuum of vaccine hesitancy, meaning that they might be comfortable with certain vaccinations and not others, or they might not believe the current schedule of childhood vaccinations is safe (it is) but may still be willing to vaccinate their children after speaking with their family doctor about scheduling. Furthermore, confidence in vaccination and willingness to get vaccinated can vary over time, going back and forth in conjunction with exposure to new information — or misinformation. That means many people with negative vaccine attitudes can still be persuaded if they are presented with the right information at the right time, and if that information is conveyed by a credible messenger and comes from a source they trust. This also means those people are unlikely to change their minds if the only credible information they’re being given is coming from people who constantly belittle them and refuse to listen to their experiences or consider why they might have lost confidence in vaccination in the first place. 

That’s why contributing to the polarization around this topic is only going to make things worse. In fact, Russia engaged in that very strategy — promoting polarization by amplifying the loudest anti-vaccine and pro-vaccine voices — in an effort to poison discourse around vaccination and weaken our national security in the face of major public health threats. A good rule of thumb is that if you find yourself engaging in tactics that are nearly indistinguishable from those in Russia’s information warfare arsenal, it might be time to ask yourself what you’re doing.

It’s easy to understand why so many people are so frustrated with those who refuse to get vaccinated and/or who spread vaccine misinformation online, but the reality is that most of those people are victims of anti-vaccine misinformation and should not treated as enemies or malicious actors. The people who are getting rich and advancing their political careers by spreading anti-vaccine misinformation are the ones to blame, not those who fall victim to their tactics.

If we are serious about turning this trend around and protecting the health of millions of children, then it’s time to start listening to the social science on this issue, which tells us that vaccine attitudes are complex, fluid, multidimensional, and often influenced by personal experiences. Much of it comes down to who is perceived to be more trustworthy, and we’re not going to win that battle with labels and name-calling. Again, there’s science to back this up. If we’re going to ask others to “follow the science” when it comes to vaccines, then the least we can do is to do the same when it comes to vaccine communication. Some people might not like hearing this and may push back by suggesting that we should do things like ban those who are unsure about vaccination from participating in public discourse, but by ignoring the social science surrounding vaccine communication, those people are no better than the anti-science crowd they claim to oppose.