Vaccine misinformation

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Misinformation related to immunization and the use of vaccines circulates in mass media and social media [1] [2] [3] in spite of the fact that there is no serious hesitancy or debate within mainstream medical and scientific circles about the benefits of vaccination. [4] Unsubstantiated safety concerns related to vaccines are often presented on the internet as being scientific information. [5] A high proportion of internet sources on the topic are "inaccurate on the whole" which can lead people searching for information to form "significant misconceptions about vaccines". [6]

Contents

Although opposition to vaccination has existed for centuries, the internet and social media have recently facilitated the spread of vaccine-related misinformation. [7] Intentional spreading of false information and conspiracy theories have been propagated by the general public and celebrities. [8] Active disinformation campaigns by foreign actors are related to increases in negative discussions online and decreases in vaccination use over time. [9]

Misinformation related to vaccination leads to vaccine hesitancy which fuels disease outbreaks. [9] As of 2019, prior to the COVID-19 pandemic, vaccine hesitancy was considered one of the top ten threats to global health by the World Health Organization. [1] [10]

Extent

A survey by the Royal Society for Public Health found that 50% of the parents of children under the age of five regularly encountered misinformation related to vaccination on social media. [11] On Twitter, bots, masked as legitimate users were found creating false pretenses that there are nearly equal number of individuals on both sides of the debate, thus spreading misleading information related to vaccination and vaccine safety. [12] The accounts created by bots use additional compelling stories related to anti-vaccination as clickbait to drive up their revenue and expose users to malware. [12]

A study revealed that Michael Manoel Chaves, an ex-paramedic who was sacked by the NHS for Gross Misconduct after stealing from two patients he was treating, is involved with the anti-vaccine community. These are the type of individuals who were previously interested in alternative medicine or conspiracy theories. [13] Another study showed that a predisposition to believe in conspiracy theories was negatively correlated to the intention of individuals to get vaccinated. [14]

Spreading vaccine misinformation can lead to financial rewards by posting on social media and asking for donations or fundraising for anti-vaccination causes. [13]

The World Health Organization has classified vaccine related misinformation into five topic areas. These are: threat of disease (vaccine preventable diseases are harmless), trust (questioning the trustworthiness of healthcare authorities who administer vaccines), alternative methods (such as alternative medicine to replace vaccination), effectiveness (vaccines do not work) and safety (vaccines have more risks than benefits). [7]

Vaccination causes idiopathic conditions

Alternative remedies to vaccination

Responding to misinformation, some may resort to complementary or alternative medicine as an alternative to vaccination. Those who believe in this narrative view vaccines as 'toxic and adulterating' while seeing alternative 'natural' methods as safe and effective. [30] Some of the misinformation circulating around alternate remedies for vaccination include:

Vaccination as genocide

Misinformation that forced vaccination could be used to "depopulate" the earth circulated in 2011 by misquoting Bill Gates. [34] There is misinformation implying that vaccines (particularly the mRNA vaccine) could alter DNA in the nucleus. [35] mRNA in the cytosol is very rapidly degraded before it would have time to gain entry into the cell nucleus. (mRNA vaccines must be stored at very low temperature to prevent mRNA degradation.) Retrovirus can be single-stranded RNA (just as SARS-CoV-2 vaccine is single-stranded RNA) which enters the cell nucleus and uses reverse transcriptase to make DNA from the RNA in the cell nucleus. A retrovirus has mechanisms to be imported into the nucleus, but other mRNA lack these mechanisms. Once inside the nucleus, creation of DNA from RNA cannot occur without a primer, which accompanies a retrovirus, but which would not exist for other mRNA if placed in the nucleus. [36] [37] Thus, mRNA vaccines cannot alter DNA because they cannot enter the nucleus, and because they have no primer to activate reverse transcriptase.

Vaccine components contain forbidden additives

Anti-vaxxers emphasize that the components in vaccines such as thiomersal and aluminum are capable for causing health hazards. [38] Thiomersal is a harmless component in vaccines which is used to maintain its sterility, and there are no known adverse effects due to it. [39] Aluminium is included in the vaccine as an adjuvant, and it has low toxicity even in large amounts. [38] Formaldehyde included in some vaccines is in negligibly low quantities and it is harmless. [38] Narratives that COVID-19 vaccines contain haram products were circulated in Muslim communities. [40] [41] [42]

Vaccines are part of a governmental/pharmaceutical conspiracy

The Big Pharma conspiracy theory, that pharmaceutical companies operate for sinister purposes and against the public good, has been used in the context of vaccination. [43] [44]

Vaccine preventable diseases are harmless

There is a common misconception that vaccine-preventable diseases such as measles are harmless. However, measles remains a serious disease, and can cause severe complications or even death. Vaccination is the only way to protect against measles. [31]

Personal anecdotes about harmed individuals

Personal anecdotes and sometimes false stories are circulated about vaccination. [45] Misinformation has spread claiming that people died due to COVID-19 vaccination. There are individuals that perpetuate the harmful mistruths about vaccinations and the falsified links vaccinations have with autism. Through the spread of false media, civilians are blindly being led to believe that vaccinations are the leading cause of autism, when in fact, this is far from the truth. For one, autism occurs during fetal development, not after the mother has given birth (Rodier, P. M. 2000). However, there are contributing factors that can influence where a child may be placed on the spectrum. These factors include the mother consuming medication while pregnant that should not be consumed during pregnancy, genetics playing a part, the environment as well as metabolic disorders and epigenetic mechanisms (Manzi, B. et al. 2008). Though individuals tend to believe that autism is a harmful and negative disorder—and therefore refusing to be vaccinated—they are actually causing more harm to themselves and others by potentially putting themselves at risk of being exposed to diseases and infections that can be harmful to their body. Moreover, when infected, they can then transfer the disease to a person who is immunocompromised. This not only harms themselves but can contribute to the spread of viral infections with harmful long-term effects that can potentially result in death. All in all, through the many experiments performed on the links between vaccinations and autism, no experiment has conclusively proven the link between autism and vaccinations. [46]

Vaccine-preventable diseases have been eradicated

Vaccination has enabled the reduction of most vaccine-preventable diseases (e.g. Polio has been eradicated in every country except Afghanistan and Pakistan). However, some are still prevalent and even cause epidemics in some parts of the world. If the affected population is not protected by vaccination, the disease can quickly spread from country to country. [24] Vaccines do not only protect the individual, but also lead to herd immunity if a sufficient number of people in the population have taken the vaccine. [47] Eradication is the permanent elimination of an infectious disease worldwide through deliberate efforts, rendering further intervention measures unnecessary. To date, the only disease that has been successfully eradicated is smallpox. Poliomyelitis is currently being targeted for eradication by the year 2000, and significant progress has been made towards this goal, with the Western Hemisphere being declared polio-free and over a year having passed without any reported cases in the Western Pacific Region of the World Health Organization. An examination of the technical feasibility of eradicating other diseases preventable by vaccines currently available in the United States suggests that measles, hepatitis B, mumps, rubella, and possibly Haemophilus influenzae type b are potential candidates for eradication. From a practical standpoint, measles appears to be the most likely candidate for the next eradication effort. However, it is important to note that global capacity for undertaking eradication is limited, and caution must be taken to ensure that a potential measles eradication effort does not impede the ongoing effort to eradicate poliomyelitis. Despite the challenges, eradication represents the ultimate achievement in sustainability and social justice, and even if eradication is not possible, significant improvements in control can still be made with existing vaccines and new and improved vaccines may offer further possibilities in the future. [48] It is important to note that the information provided in the previous response regarding the "eradication" of certain diseases and the potential for future eradication of others through the use of currently licensed vaccines is not accurate and is a form of popular vaccine misinformation. The eradication of smallpox was a monumental achievement in public health, but it was accomplished through a globally coordinated effort using a specific smallpox vaccine, and not through the use of vaccines for other diseases. Additionally, the current status of polio eradication efforts, as well as the potential for eradication of other diseases through vaccines, should always be verified through credible sources such as the World Health Organization (WHO) or Centers for Disease Control and Prevention (CDC). It's important to always consult credible sources and be skeptical of misinformation. [48]

Other conspiracy theories

Other conspiracy theories circulated on social media have included the false notion such as;

Impact

Fueled by misinformation, anti-vaccination activism is on the rise on social media and in many countries. [62] Research has shown that viewing a website containing vaccine misinformation for 5–10 minutes decreases a person's intention to vaccinate. [63] [64] A 2020 study found that "large proportions of the content about vaccines on popular social media sites are anti-vaccination messages." It further found that there is a significant relationship between joining vaccine hesitant groups on social media and openly casting doubts in public about vaccine safety, as well as a substantial relationship between foreign disinformation campaigns and declining vaccination coverage. [65]

In 2003, rumors about polio vaccines intensified vaccine hesitancy in Nigeria and led to a five-fold increase in the number of polio cases in the country over three years. [66] [67] A 2021 study found that misinformation about COVID-19 vaccines on social media "induced a decline in intent [to vaccinate] of 6.2 percentage points in the [United Kingdom] and 6.4 percentage points in the [United States] among those who said they would definitely accept a vaccine". [5]

Social media is again the leading platform for the rapid spreading of vaccine misinformation during a pandemic. For example, A study in 2020 of public opinions about the developing Chinese domestic COVID-19 vaccines found around one-fifth of the post on weibo related to the vaccine claimed that the COVID-19 vaccines are generally overpriced, even though they are later being administered totally free. Many people in China also hold the belief that inactive vaccines are safer than the newly developed mRNA vaccine of SARS-Covid-2. The cause of this might be a combination of national pride and a lack of understanding of vaccine literacy. [68]  

In general, misinformation related to the COVID-19 vaccine reduced public confidence. Public acceptance of Chinese domestic COVID-19 vaccines dropped significantly due to concerns about the possible high cost. An online survey showed only 28.7% of the participants expressed definite interest in getting the vaccine. Most people (54.6%) hold some hesitancy toward the vaccine. [69]  

Measures against misinformation

Several governmental agencies, such as the Centers for Disease Control (CDC) in the United States and National Health Service (NHS) in the United Kingdom have dedicated webpages for addressing vaccine-related misinformation. [70] [71] Pinterest was one of the first social media platforms to surface only trustworthy information from reliable sources on their vaccine related searches back in 2019. [72] In 2020, Facebook announced that it would no longer allow anti-vaccination advertisements on its platform. [73] Facebook also said it would elevate posts from the World Health Organization and UNICEF in order to increase immunization rates through public health campaigns. [73] Twitter announced that it would put a warning label on tweets containing disputed or unsubstantiated rumors about vaccination and require users to remove tweets that spread false information about vaccines. [74] TikTok announced that it would start directing people to official health sources when they search for vaccine related information. [74] By December 2020, YouTube had removed more than 700,000 videos containing misinformation related to COVID-19. [74]

Research shows that science communicators should directly counter misinformation because of its negative influence on silent audience who are observing the vaccine debate, but not engaging in it. [75] The refutations to vaccine-related misinformation should be straightforward in order to avoid emphasizing misinformation. [75] It is useful to pair scientific evidence with stories that connect to the belief and value system of the audience. [75]

While social media companies have taken recent steps to reduce the presence of vaccine misinformation on their platforms, misinformed users and their social groups remain. After repeated exposure, these individuals now hold misinformed mental models of the function, risk, and purpose of vaccines. The longer an individual holds misinformation, the more staunchly rooted it becomes in their mental model, making its correction and retraction all the more difficult. [76] Over time, these models may become integral to a vaccine hesitant individual's worldview. People are likely to filter any new information they receive to fit their preexisting worldview [77]  –corrective vaccine facts are no exception to this motivated reasoning. Thus, by the time vaccine hesitant individuals arrive at the doctor's office, healthcare workers face an uphill battle. If they seek to change minds and maintain herd immunity against preventable diseases, they must do more than simply present facts about vaccines. Providers need communication strategies that effectively change minds and behavior.

Given the complexity of this problem, effective evidence-based strategies have yet to be identified. Interventions for parents/caregivers who make health decisions for their children are vital. In the United States, the CDC recommends at least 15 vaccinations during the first 18 years of life, given parental consent. [78] This set includes the measles, mumps, and rubella (MMR) vaccine –the central immunization of concern for misinformed parents. Debunked research and celebrity anecdotes that falsely linked the MMR vaccine to autism still have a strong hold on parental behaviors [79] In 15 states, MMR vaccination rates are below 90%. [80] The necessity to counteract misinformation among parents is clear, but the pathway forward is not –researchers are still looking for answers.

Although many wish to provide families with as much corrective information as possible, this often has unintended consequences. One study in 2013 tested four separate interventions to correct MMR vaccine misinformation and promote parental behavioral change: (1) Provide information explaining lack of evidence that MMR causes autism. (2) Present textual information about the dangers of measles, mumps, and rubella. (3) Show images of children with measles, mumps and rubella. (4) Provide a dramatic written narrative about an infant who became deathly ill from measles. [81] Before and after each intervention, researchers measured parents' belief in the vaccine/autism misperception, their intent to vaccinate future children, and their general risk perception of the vaccine. They found that none of the interventions increased parental intent to vaccinate. [81]

Instead, the first intervention (1) reduced misperceptions about autism, but still decreased parents' intent to vaccinate future children. Notably, this effect was significant among parents who were already the most vaccine-hesitant. [81] Nyhan et al. conclude that corrective information may backfire. Motivated reasoning could be the mechanism behind this finding –no matter how many facts are provided, parents still sift through them to selectively find those that support their worldview. While the corrective information did have an effect on a specific belief, ultimately vaccine-hesitant parents used this additional information to strengthen their original behavioral intent. Interventions three and four increased the vaccine/autism misperception and increased belief in serious vaccine side effects, respectively. [81] The authors attribute this result to a potential danger priming effect –when pushed into a fearful state, parents misattribute this fear to the vaccine itself, rather than the diseases it prevents. [81] In all cases, the facts included had little, if not counterproductive effect on future behaviors.

This work has important implications for future research. First, the study's findings revealed a disparity between beliefs and intentions –even as specific misperceptions are corrected, behavior may not change. Since reaching herd immunity for preventable diseases requires promoting a behavior –vaccination –it is important for future research to measure behavioral intent, rather than just beliefs. [81] Second, it is imperative for all health messaging to be tested before its widespread use. [81] Society does not necessarily know the behavioral impacts of communication interventions –they may have unintended consequences on different groups. In the case of correcting vaccine misinformation and changing vaccination behaviors, much more research is still needed to identify effective communication strategies.

In a systematic review of communication strategies to counter vaccine misinformation, communicating the scientific consensus that vaccines are safe and effective, using humour to dispel vaccine myths, and providing vaccine misinformation warnings all improved intention to vaccinate. Debunking vaccine misinformation and providing vaccine education materials had mixed results. Scare tactics, and failing to acknowledge uncertainty proved unhelpful and sometimes backfired worsening intention to vaccinate. [82] [83]

See also

Related Research Articles

<span class="mw-page-title-main">Vaccination</span> Administration of a vaccine to protect against disease

Vaccination is the administration of a vaccine to help the immune system develop immunity from a disease. Vaccines contain a microorganism or virus in a weakened, live or killed state, or proteins or toxins from the organism. In stimulating the body's adaptive immunity, they help prevent sickness from an infectious disease. When a sufficiently large percentage of a population has been vaccinated, herd immunity results. Herd immunity protects those who may be immunocompromised and cannot get a vaccine because even a weakened version would harm them. The effectiveness of vaccination has been widely studied and verified. Vaccination is the most effective method of preventing infectious diseases; widespread immunity due to vaccination is largely responsible for the worldwide eradication of smallpox and the elimination of diseases such as polio and tetanus from much of the world. However, some diseases, such as measles outbreaks in America, have seen rising cases due to relatively low vaccination rates in the 2010s – attributed, in part, to vaccine hesitancy. According to the World Health Organization, vaccination prevents 3.5–5 million deaths per year.

<span class="mw-page-title-main">Vaccine</span> Pathogen-derived preparation that provides acquired immunity to an infectious disease

A vaccine is a biological preparation that provides active acquired immunity to a particular infectious or malignant disease. The safety and effectiveness of vaccines has been widely studied and verified. A vaccine typically contains an agent that resembles a disease-causing microorganism and is often made from weakened or killed forms of the microbe, its toxins, or one of its surface proteins. The agent stimulates the body's immune system to recognize the agent as a threat, destroy it, and recognize further and destroy any of the microorganisms associated with that agent that it may encounter in the future.

<span class="mw-page-title-main">MMR vaccine</span> Any of several combined vaccines against measles, mumps, and rubella

The MMR vaccine is a vaccine against measles, mumps, and rubella, abbreviated as MMR. The first dose is generally given to children around 9 months to 15 months of age, with a second dose at 15 months to 6 years of age, with at least four weeks between the doses. After two doses, 97% of people are protected against measles, 88% against mumps, and at least 97% against rubella. The vaccine is also recommended for those who do not have evidence of immunity, those with well-controlled HIV/AIDS, and within 72 hours of exposure to measles among those who are incompletely immunized. It is given by injection.

<span class="mw-page-title-main">Vaccine hesitancy</span> Reluctance or refusal to be vaccinated or have ones children vaccinated

Vaccine hesitancy is a delay in acceptance, or refusal, of vaccines despite the availability of vaccine services and supporting evidence. The term covers refusals to vaccinate, delaying vaccines, accepting vaccines but remaining uncertain about their use, or using certain vaccines but not others. The scientific consensus that vaccines are generally safe and effective is overwhelming. Vaccine hesitancy often results in disease outbreaks and deaths from vaccine-preventable diseases. Therefore, the World Health Organization characterizes vaccine hesitancy as one of the top ten global health threats.

The National Vaccine Information Center (NVIC), founded under the name Dissatisfied Parents Together (DPT) in 1982, is an American 501(c)(3) organization that has been widely criticized as a leading source of fearmongering and misinformation about vaccines. While NVIC describes itself as the "oldest and largest consumer-led organization advocating for the institution of vaccine safety and informed consent protections", it promotes false and misleading information including the discredited claim that vaccines cause autism, and its campaigns portray vaccination as risky, encouraging people to consider "alternatives." In April 2020, the organization was identified as one of the greatest disseminators of COVID-19 misinformation on Facebook.

Vaccination and religion have interrelations of varying kinds. No major religion prohibits vaccinations, and some consider it an obligation because of the potential to save lives. However, some people cite religious adherence as a basis for opting to forego vaccinating themselves or their children. Many such objections are pretextual: in Australia, anti-vaccinationists founded the Church of Conscious Living, a "fake church", leading to religious exemptions being removed in that country, and one US pastor was reported to offer vaccine exemptions in exchange for online membership of his church.

A vaccine adverse event (VAE), sometimes referred to as a vaccine injury, is an adverse event believed to have been caused by vaccination. The World Health Organization (WHO) knows VAEs as Adverse Events Following Immunization (AEFI).

The MMRV vaccine combines the attenuated virus MMR vaccine with the addition of the varicella (chickenpox) vaccine. The MMRV vaccine is typically given to children between one and two years of age.

Claims of a link between the MMR vaccine and autism have been extensively investigated and found to be false. The link was first suggested in the early 1990s and came to public notice largely as a result of the 1998 Lancet MMR autism fraud, characterised as "perhaps the most damaging medical hoax of the last 100 years". The fraudulent research paper, authored by discredited former doctor Andrew Wakefield and published in The Lancet, falsely claimed the vaccine was linked to colitis and autism spectrum disorders. The paper was retracted in 2010 but is still cited by anti-vaccine activists.

A vaccination policy is a health policy adopted in order to prevent the spread of infectious disease. These policies are generally put into place by state or local governments, but may also be set by private facilities, such as workplaces or schools. Many policies have been developed and implemented since vaccines were first made widely available.

Mass vaccination is a public policy effort to vaccinate a large number of people, possibly the entire population of the world or of a country or region, within a short period of time. This policy may be directed during a pandemic, when there is a localized outbreak or scare of a disease for which a vaccine exists, or when a new vaccine is invented.

<span class="mw-page-title-main">Measles vaccine</span> Vaccine used to prevent measles

Measles vaccine protects against becoming infected with measles. Nearly all of those who do not develop immunity after a single dose develop it after a second dose. When the rate of vaccination within a population is greater than 92%, outbreaks of measles typically no longer occur; however, they may occur again if the rate of vaccination decreases. The vaccine's effectiveness lasts many years. It is unclear if it becomes less effective over time. The vaccine may also protect against measles if given within a couple of days after exposure to measles.

Pakistan is one of the two remaining countries in the world where poliomyelitis (polio) is still categorized as an endemic viral infection, the other one being Afghanistan. While it has yet to fully eradicate Polio, there has been a downwards trend in the number of reported cases per year; the total count of wild poliovirus cases in Pakistan in 2019 was 147, compared to 84 in 2020, 1 in 2021, 20 in 2022, 6 in 2023 and 2 to date in 2024.

Robert William Sears, known as Dr. Bob, is an American pediatrician from Capistrano Beach, California, noted for his unorthodox and dangerous views on childhood vaccination. While Sears acknowledges the efficacy of vaccines—for instance, he supports the claim that Chicken pox, measles, whooping cough, polio, diphtheria have all disappeared because of vaccines—he has proposed alternative vaccination schedules that depart from accepted medical recommendations. His proposals have enjoyed celebrity endorsement but are not supported by medical evidence and have contributed to dangerous under-vaccination in the national child population. While he denies being anti-vaccine, Sears has been described by many as anti-vaccine and as a vaccine delayer.

Vaccine shedding is a form of viral shedding which can occasionally occur following a viral infection caused by an attenuated vaccine. Illness in others resulting from transmission through this type of viral shedding is rare. Most vaccines are not attenuated vaccines, and therefore cannot cause vaccine-induced viral shedding, though the idea of shedding is a popular anti-vaccination myth.

In early months of 2019, a measles outbreak occurred in the Portland metropolitan area, including the Clark County, Washington suburbs, in the United States. At the time, the outbreak was the largest outbreak in more than two decades; outbreaks in 2019 in areas including Brooklyn and Rockland County, New York have since seen far greater numbers of cases.

Extensive investigation into vaccines and autism has shown that there is no relationship between the two, causal or otherwise, and that vaccine ingredients do not cause autism. Vaccinologist Peter Hotez researched the growth of the false claim and concluded that its spread originated with Andrew Wakefield's fraudulent 1998 paper, with no prior paper supporting a link.

<span class="mw-page-title-main">COVID-19 vaccine hesitancy in the United States</span> Reluctance by those living in the USA to be vaccinated with a COVID-19 vaccine

COVID-19 vaccine hesitancy in the United States is the sociocultural phenomenon of individuals refusing or displaying hesitance towards receiving the COVID-19 vaccine. COVID-19 vaccine hesitancy in the United States can be considered as part of the broader history of vaccine hesitancy.

<span class="mw-page-title-main">COVID-19 vaccine misinformation and hesitancy</span> Misinformation regarding the SARS-CoV-2 vaccine and the resulting hesitancy towards it

Anti-vaccination activists and other people in many countries have spread a variety of unfounded conspiracy theories and other misinformation about COVID-19 vaccines based on misunderstood or misrepresented science, religion, and law. These have included exaggerated claims about side effects, misrepresentations about how the immune system works and when and how COVID-19 vaccines are made, a story about COVID-19 being spread by 5G, and other false or distorted information. This misinformation has proliferated and may have made many people averse to vaccination. This has led to governments and private organizations around the world introducing measures to incentivize or coerce vaccination, such as lotteries, mandates, and free entry to events, which has in turn led to further misinformation about the legality and effect of these measures themselves.

<span class="mw-page-title-main">Anti-vaccine activism</span>

Anti-vaccine activism, also called the "anti-vax" movement, is organized activity designed to increase vaccine hesitancy, often by disseminating misinformation or disinformation. Although myths, conspiracy theories, misinformation and disinformation spread by the anti-vaccination movement and fringe doctors increases vaccine hesitancy and public debates around the medical, ethical, and legal issues related to vaccines, there is no serious hesitancy or debate within mainstream medical and scientific circles about the benefits of vaccination.

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