The anti-vaccine movement in the United States threatens to undermine herd immunity to preventable infectious diseases through circulation of false fears. Pockets of susceptible populations — who have refused vaccination for childhood disease like measles or seasonal infections like flu — can set off outbreaks that threaten vulnerable individuals.
In the wake of these outbreaks and the ensuing controversy about vaccination, social media has become a battlefield of divisive rhetoric, some of it posted just to create the illusion of a “debate” and keep people divided. To establish this false equivalency, some tweets from the same sources have posted both negative and positive messages about vaccines, a recent study1 found.
Researchers looked at vaccine-related messages posted online from July 2014 through September 2017. The analysis included “#VaccinateUS” tweets, which were “uniquely identified with Russian troll accounts linked to the Internet Research Agency — a company backed by the Russian government specializing in online influence operations,” they reported.
“Whereas bots that spread malware and unsolicited content disseminated antivaccine messages, Russian trolls promoted discord,” they concluded. “Accounts masquerading as legitimate users create false equivalency, eroding public consensus on vaccination.”
New Normal?
Hospital Infection Control & Prevention sought further information in an interview with the lead author of the study, David A. Broniatowski, PhD, a professor of engineering and applied science at George Washington University in Washington, DC.
HIC: While the antivaccine movement has been going on for years in the U.S., some of the tweets you analyzed were from the same sources in Russia charged with sending divisive posts during the buildup to the 2016 U.S. presidential election.
Broniatowski: We can’t really say anything explicitly about intent, but we can look at patterns of behavior. What we know is that these particular accounts had been involved in transmitting messages that were divisive along a range of different topics. They were identified by NBC News as traced to the Internet Research Agency, [according to] the Justice Department. We found there were several tweets and retweets about vaccines coming from these accounts.
They were about vaccines but generally linked to known issues within American society, such as racial, religious, and gender issues. You don’t usually see this type of discourse about vaccines, so it really did seem to be trying to establish a kind of linkage.
HIC: You also report links between the vaccine tweets and conspiracy theories, criticism of the U.S. government, criticism of science, etc.
Broniatowski: A lot of the messages seem to reflect a lack of trust in government. Although, you also have messages that say something like “vaccines work” or “science works.” There were also a fair number of messages about “elites vs. normal people.” The focus seemed to be on stirring up dissent and discord.
HIC: Did you see any specific posts about widely refuted allegations, such as the MMR vaccine causes autism?
Broniatowski: We certainly saw that messages such as those were retweeted by these accounts, but most of messages that were generated by these [Russian] accounts were very general. It takes more in-depth knowledge to know that is happening in the U.S. On the other hand, the general idea that vaccines are bad doesn’t take much background cultural knowledge. We didn’t see as many [claims against specific vaccines] in the novel tweets that were generated by these accounts.
HIC: Was it possible to assess the effect of this social messaging on vaccinations?
Broniatowski: Our study was primarily observational, but that would be a valuable direction for future work. We do know that exposure to this so-called vaccine “debate” does reduce confidence in vaccination. Even if people believe vaccines are safe and effective, it creates hesitance. Although we didn’t explicitly measure whether these tweets had that effect, it is a known outcome of exposure to a “debate” that makes it seem to appear that there are two valid sides.
HIC: You conclude with colleagues that “beyond attempting to prevent bots from spreading messages over social media, public health practitioners should focus on combating the messages themselves while not feeding the trolls.” That seems like a very fine line to draw in dealing with this.
Broniatowski: It is a fine line. The specific details of how to do that is another important area for future research. These messages at a very high level suggest that there is a debate to be had [on vaccines].
On the other hand, by engaging in that you create the impression that there is a debate. If you find yourself confronted with a troll who is giving you either pro- or anti-vaccine messages, simply acknowledging that debate may be counterproductive.
Pro, Con, and Chaos
The tweets that follow were cited in the study. They were linked to Russian troll operations. The study notes that themes include, among others, “Can’t trust government on vaccines,” “Natural immunity is better,” and “Vaccines cause autism.” Pro-vaccination tweets also were disseminated, “consistent with a strategy of promoting political discord.”
Some of the anti-vaccine tweets:
• “... Mandatory #vaccines infringe on constitutionally protected religious freedoms.”
• “Did you know there was a secret government database of #vaccine-damaged children?”
• “Pharmacy companies want to develop #vaccines [for] cash, not to prevent deaths.”
• “Natural infection almost always causes better immunity than #vaccines.”
• “Don’t get #vaccines. Illuminati are behind it.”
• “Did you know #vaccines caused autism?”
• “#Vaccines contain mercury! Deadly poison!”
• “Most diseases that #vaccines target are relatively harmless in many cases, thus making #vaccines unnecessary.”
Some of the pro-vaccine tweets:
• “Vaccines save 2.5 million children from preventable diseases every year.”
• “Your kids are not your property! You have to #vaccinate them to protect them and all the others!”
• “You can’t fix stupidity. Let them die from measles, and I’m for #vaccination!”
• “My freedom ends where another person’s begins. Then children should be #vaccinated if disease is dangerous for OTHER children.”
• “#Vaccines cause autism — Bye, you are not my friend anymore. And try to think with your brain next.”
• “Do you still treat your kids with leaves? No? And why don’t you #vaccinate them? It’s medicine!”
- Broniatowski DA, Jamison AM, Qi S, et al. Weaponized Health Communication: Twitter Bots and Russian Trolls Amplify the Vaccine Debate. Am J Public Health 2018;108:1378–1384.
