In any epidemic, it is essential that there is high vaccination rates so as to limit transmission, protect high-risk groups and reduce the number of severe outcomes in order to not overwhelm the healthcare system [1]. Many individuals use the internet to obtain health information including vaccines. This readily available information is disseminated not only by public health communicators and pharmaceutical companies but by anti-vaccination groups as well. Vaccine information on social media focuses predominantly on the negative experiences [2] instead of the benefits of vaccination (ie. absence of disease). This results in increasing disbelief in the efficacy of vaccines and mistrust in public health officials and pharmaceutical companies. They fear that a new vaccine has been rushed to production with insufficient trials or that they haven’t been tested adequately, and more long-term studies are needed.  This reached a pinnacle in 1999 when The Lancet published (and retracted 12 years later) an article by Dr. Andrew Wakefield, which claimed a correlation of the measles vaccine with autism. Since then, the anti-vaccine movement (commonly referred to as anti-vaxxers) have gained considerable momentum in their messages, playing on emotional outrage rather than fact. There have been unsubstantiated claims of an association between hepatitis B vaccination and multiple sclerosis in France; human papilloma virus immunizations and convulsions/ sudden death. Members of these anti-vaccine groups tend to be very active and vocal on social media websites such as Twitter and Facebook [3]. Social media has the reach of traditional mass media (such as print or television) as well as the interactivity and dynamism of interpersonal communications, making it a very effective communication tool, with the potential of major amplification on effects, perceptions, attitudes and behavior through ‘word-of-mouth’ 

In order to address the growing ‘anti-vaxxer movement’, a sustained campaign is needed to calm the fears of the public, and provide accurate information. Efforts should be made to address any legitimate safety concerns.

Pharmaceutical and Public Health officials should be transparent about the vaccine development process in efforts to re-gain the trust of the public [1].  Anti-vaccine campaigns have been followed by falling immunization rates and outbreaks of vaccine-preventable diseases [4] . Other than the purely public health goal that vaccines prevent disease, it has been well-documented that outbreaks of vaccine-preventable diseases contributes significantly to disease burden and has a significant economic cost. Outbreaks require a vigorous public health response.  As exemplified by the 2011 measles outbreak, these economic costs are substantial. Efforts to contain an outbreak of 16 measles cases in 2011 required 42,635-83,133 personnel hours and $2.7 to $5.3 million US dollars [5]. Associated costs include:

1. Investigation
2. Contact tracking

• Screening

1. Laboratory
2. Emergency Response
3. Surveillance

The responses to this particular outbreak had a tremendous impact on local and state public health departments not only in cost, but also in diverting needed personnel and public health resources from other priority investigations. The costs of these outbreaks is compounded by subpopulations of unvaccinated individuals.

The public health campaign to fact-check the anti-vaccine movement and ultimately increase the rates of vaccine will involve a multi-pronged approach:

1. Anti-vaccination Website Research: in order to gather and categorize the popular message themes amongst anti-vaxxers, we will use machine learning to examine the content of the 100 most popular anti-vaccination websites [4].
2. Algorithms will be created to extract explicit claims about vaccines so as to create targeted ‘factoids’ to dispel these rumors. These algorithms will target specific claims and tactics used in the anti-vaxxer movement: skewing science, shifting hypothesis, censoring opposition and claiming vaccines are ‘toxic’ or unnatural [6].
3. Educating the Public Health Workforce: In order for the campaign to be effective, it is essential that the public health workforce knows the facts. Utilizing the data gathered from the website research, targeted fact-pages will be created for distribution amongst healthcare providers. These one-page flyers will be printed on laminated paper so as to last longer, but will contain the popular myths and rumors used in the Anti-vaccine websites and provide effective messages to respectfully counter their arguments. In addition to fact sheets, we will have targeted trainings of 1 hour ‘working-lunch’ sessions in which a bagged lunch will be provided while trainings are conducted. Specific learning objectives of the training sessions include:
4. Definitions of common vaccine terms
5. Safety of Vaccines

• Herd Immunity

https://imgur.com/a/8M7q8

1. Altruistic nature of vaccines

 

1. Critical Thinking for Children and Adolescents: Because most of the anti-vaxxers tend to be rigid in their views, they will not be the main focus of this campaign. With the rarity of vaccine-preventable diseases in developed countries, there is an associated lack of awareness about them. We hope to spread the messages to children and adolescents [2] Studies teaching children about second-hand smoke were very effective and also had a positive influence on their parents. We hope to replicate this by focusing on children and adolescents with age-appropriate factual material with the hopes of introducing these children to thinking critically and how to verify authenticity.
2. Mass Media and Social Media Postings: Billboards and YouTube videos will be created with interviews of recent anti-vaxxers that decided to get vaccinated.

Fact-Checking the Anti-vaccine movement – Part II

 

 

References

1. Neil Seeman, A.I. and R. Carlos, Assessing and Responding in Real Time to Online Anti-vaccine Sentiment during a Flu Pandemic. Healthcare Quarterly, 2010. 13(Sp): p. 8-15.
2. Arede, M., et al., Combating Vaccine Hesitancy: Teaching the Next Generation to Navigate Through the Post Truth Era. 2019. 6(381).
3. Betsch, C., et al., Opportunities and challenges of Web 2.0 for vaccination decisions. Vaccine, 2012. 30(25): p. 3727-3733.
4. Davies, P., S. Chapman, and J. Leask, Antivaccination activists on the world wide web. 2002. 87(1): p. 22-25.
5. Ortega-Sanchez, I.R., et al., The economic burden of sixteen measles outbreaks on United States public health departments in 2011. Vaccine, 2014. 32(11): p. 1311-1317.
6. Azhar Hussain, S.A., Madiha Ahmed, Sheharyar Hussain, The Anti-vaccination Movement: A Regression in Modern Medicine. Cureus, 2018. 10(7).