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Why don't facts kill the anti-vax movement?

Aleksandar Brezar

There is a veritable epidemic worldwide, presenting an unparalleled threat to everyone’s health, especially children. This life-and-death situation, however, is not what you'd expect - an outbreak of an unknown deadly disease or a new, incurable strain of treatable bacteria or viruses. Quite the opposite: it is the anti-vaccination sentiment that is plaguing Western societies, with horrifying results. As of August, the number of children and adults in Europe with measles, for instance, reached 41,000, and 37 people had died, as reported by the World Health Organization. With further outbreaks in the United States occurring each year, each time larger in scope, we can only expect the situation to get worse.

How is it possible that one of the main battles for our health and the health of our children in the 21st century doesn't revolve around a lack of access to medication, but around a myth that more and more people are accepting as truth, and which no one has been able to successfully dispel? Looking more closely, we can safely conclude that disinformation and propaganda at the very heart of this layered and complex matter. Praying on the uninformed and those with a pronounced individualist outlook, this is a case where the work of online disinformation agents has severe consequences in the real world.

But let's first examine the roots of the issue: anti-vaccination movements seem to have be present since the appearance of the first vaccine, most of them based on religious or ideological sentiments. In truth, these movements, if they can be labeled as such, were quite limited in scope and localized to small religious or ideological communities. However, the recent uptick in anti-vaccination sentiment can be tracked back to a study published in The Lancet, one of the world's oldest and most prestigious medical journals. In February 1998, The Lancet published a study by the now-discredited doctor and researcher Andrew Wakefield, in which he claimed that there was link between the MMR vaccine and autism.

The vaccine is administered to millions of children worldwide and is incredibly effective. The US Center for Disease Control states that two doses of MMR vaccine are 97% effective against measles, 88% effective against mumps and 97% effective against rubella.

All this didn't stop Wakefield conducting a study that has been widely debunked and which The Lancet had to retract in the end. The deeply flawed study was conducted with as few as 12 children, and further investigation proved that even with that small sample, his methods were questionable. Unfortunately, Wakefield and the media propagated it further. It is claimed that it wasn't The Lancet article, but the subsequent press conference and a series of interviews, one of them on the prominent CBS ‘60 Minutes’ programme, that ended up putting the story in the spotlight and giving it unwarranted attention. The Lancet's retraction and debunking of Wakefield and his study were too late. The damage had been done.

There are two things at play in the human psyche that make this a very powerful, yet dangerous fallacy to believe in. The first thing that we need to understand and accept is that there will always be people who will believe in either conspiracy theories or flawed or false claims by alleged experts. This can be ascribed to the psychological need of humans to be "in the know" or better informed than others. A certain sense of power and superiority is in fact gained from the fact that we appear to know better than others. At the same time, we in the fact-checking community are aware of the so-called ’Backfire Effect’: as shown in a study by Brendan Nyhan and Jason Reifler at The University of Michigan and Georgia State University, contrary to our expectation that people are more likely to change their mind after being confronted with actual facts, when their deepest convictions are challenged by contradictory evidence, their beliefs grow stronger. Since this particular issue also creates a highly emotional response due to it being about the health of children, it becomes extremely hard to dissuade someone to at least think twice, making it a very persistent and resilient narrative.

Also, unlike other falsehoods or conspiracy theories which are easier to debunk as pure nonsense, such as the ‘flat earth’ belief, the anti-vaccination sentiment is closely connected to an anti-science and/or alternative medicine worldview, both of which a priori reject any medical or scientific proof. So it doesn’t help to explain that there is plethora of evidence that shows that vaccinations a) do not cause other health issues, especially autism, and b) by choosing not to vaccinate your child, you are not only putting your child's health at risk, but everyone else’s. Measles, in addition to being deadly, for instance, is also extremely contagious, with one estimate showing that an average person infects 18 other people before they get better. Vaccination, as a form of so-called herd immunity, aside from helping individuals avoid infection, also ensures that illnesses like measles are stopped in their tracks, which is what makes immunization so effective. But, as we have seen, these and other arguments can be easily dismissed with fake narratives using the combined effect of fear, conviction and a false sense of superiority of belonging to those who "know the truth." Herd immunity is no match for herd mentality.

It also creates very fertile ground for manipulation through malign interference: as a study published in the American Journal of Public Health in October shows, there is an unprecedented level of activity by bots and Russian trolls in discussions on the subject on social media. The study, titled "Weaponized Health Communication: Twitter Bots and Russian Trolls Amplify the Vaccine Debate", analyzed a set of 1.793,690 tweets from July 2014 through September 2017, and the results were quite telling. The results showed that both Twitter bots, sophisticated and otherwise, as well as Russian trolls, have been showing more interest in the vaccination debate, and that bots or content polluters in particular "posted anti-vaccine messages 75% more often than the average non-bot Twitter user.

Russian trolls, however, posted content that paid almost equal attention to both pro and anti-vaccination content. This clever approach achieves much more than posting simply anti-vaccination arguments: first, it keeps the argument going, potentially reaching more people in the long run, while promoting discord, which is one of the key goals of Kremlin malign interference. While bots might have been used by anti-vaccination proponents to further propagate their content, the study concludes, the strategy employed by the Russian troll network was more insidious, legitimizing anti-vaccination stances by creating the appearance of a valid discussion, essentially by feeding its own trolls - tactics congruent with those seen during the 2016 US elections. Our own independent research likewise showed that the vaccination debate on Twitter is still alive in late 2018 and fueled by Russian trolls using the same method: one side argues against vaccines citing dubious sources, while the other side appears to try to be the voice of reason.

It is also of interest to note that Russia has its own vaccination problem. In 2017, the Federal Center of Hygiene and Epidemiology reportedly determined that 48.7 percent of Russian children born in 2016 had not been vaccinated comprehensively or according to the medically prescribed schedule, as reported by the Moscow Times. Meanwhile, cases of measles have jumped 13-fold this year, making Russia one of seven European countries with more than 1,000 measles infections this year. This can partly be explained by the possibility of “getting a taste of your own medicine”: it is probable that Russian citizens are being reached by the same content via social networks. Some of it, however, comes from what could be seen as a deep-rooted distrust in authority, where not vaccinating your children, as mentioned in the Moscow Times article, is almost as an expression of agency. Despite that, additional evidence that Kremlin malign interference in the West is partially to blame for the rising trend of measles infections in Russia can be found if we take a look at other countries on the list. Ukraine accounted for 23,000 of the 41,000 cases, while Serbia leads the pack with the highest rate of infections and deaths per capita. Both countries, as we are all well aware, have long been targeted by the Kremlin disinformation machine.

This anti-vaccination rebellion in Russia also comes on the tail of a seemingly parallel anti-GMO sentiment, which was labeled as a part of a "wider war on science" by Cornell University's Alliance for Science. As reported by the Alliance, Russian-owned media sites had been among the most prominent proponents of anti-GMO stories and memes, "aiming to undermine scientific consensus and public trust in academic institutions." The specific aim is to produce doubt, while the wider purpose is to undermine the concept of truth. In a broader sense, as we have witnessed in recent times, this has been picked up by populist movements in the West (which are, incidentally, often directly or indirectly supported by Vladimir Putin's Kremlin) - all of them keen on propagating anti-scientific views.

There is no quick fix to a false belief based on fraudulent data that might prove to be quite costly for the future generations. Constant attempts at debunking seem to also put the burden of proof on the “pro-vaccine camp,” which in itself gives additional legitimacy to anti-vaccination proponents’ claims. So, what should we do? The best course of action seems to be the facts themselves: in addition to promoting a more critical thinking-oriented environment, the facts as outlined in this article might help those who are not sure what to believe. Facts don’t lie: in a matter of life or death situation, vaccination is the best solution, both for individuals and for society as a whole. 

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