In June 2019, celebrity Jessica Biel lobbied against a pro-vaccine bill. She received intense backlash almost immediately, and the resulting scrutiny made international headlines. The exchange took place primarily on social media, where those against and those in favor of vaccines clashed—far from the first time such issues were aired loudly and publicly.
Vish Viswanath, Lee Kum Kee Professor of Health Communication and director of the Applied Risk Communication for the 21st Century program at the Harvard T.H. Chan School of Public Health, works to address this and other issues with social media and other platforms in the realm of public health. Such work focuses on the ways in which unverified information enters these popular platforms, and the impact of such information on public health. In order for public health professionals to understand how to combat these effects, they must first know the dangers of social media in relation to risk, and the effects these platforms have on large populations.
The Relationship Between Social Media and Public Health
Social media platforms are usually free and accessible, and information is not vetted as with a news source. “We always had writers and journalists as critical gatekeepers who were able to filter some of this information. But now, because of social media, we do not have this very critical intermediary,” says Viswanath. Thus, social media has been proven to facilitate the spread of false information and risk.
There are two basic types of false information that flourish:
- Misinformation, or inadvertently drawing conclusions based on wrong or incomplete facts
- Disinformation, the deliberate spread of falsehoods to promote an agenda
The two are addressed differently—misinformation can be corrected with factual information, but disinformation requires a different, more complex strategy.
Beyond public figures who use their fame to speak about subjects in which they are not experts, there are also social media influencers who spread and amplify inflammatory information through the social media megaphone. Social media can be a breeding ground for hate and intolerance around hot-button issues. Furthermore, activists can exploit fragile emotions of those impacted by the issue and provide misleading causal explanations.
“A large number of them are doing this anonymously: anonymity makes them uninhibited in expressing their opinions,” explains Viswanath. The problem is compounded by “influence bots,” anonymous, automated agents unattached to a real individual and sharing disinformation.
Treating the Source of Vaccine Misinformation
Vaccines are already a divisive topic, in part because the subject can be a very personal one. The blame, shame, and fear that can be inherent in parenthood, as well as the desire to protect one’s child, are important aspects of understanding vaccine resistance.
The now-popular myth that vaccines cause autism comes from a simple mistake that’s easy to make, according to Viswanath. “Most of us confuse correlation with causation. In general, a health care professional discovers symptoms of autism at about the same age period as when a child’s undergoing immunization. Parents are genuinely struggling to make sense of what is happening to their kids, and they latch onto the explanation that’s available to them. As a society, it’s incumbent on us to be empathetic to parents who are going through this struggle.”
Vaccine-resistant individuals have come to be known as “anti-vaxxers,” but Viswanath believes this only creates more division. “Labeling only alienates people. We should be very careful how we categorize,” he warns. In a similar way, providing purely scientific reasons for vaccinations without delving into the emotions and stories behind the reasoning is ineffective at driving change.
The Public Health Challenge of Communicating Vaccine Truth
Ironically, the vast majority of the U.S. public complies with vaccinations, but they don’t speak up—leaving influencers to fill in the blank space with false information. “There has been some complacency. If you haven’t seen polio in your life, you are not affected by it. Even if people who are against vaccinations are a very small group, they speak with a very amplified voice,” Viswanath says.
Social media platforms themselves struggle with misinformation and disinformation—stuck between trying to find and address the problem, and existing within a democratic system that tolerates different beliefs. “The people who are spreading the information are always a few steps ahead—we are always in reactive mode,” says Viswanath.
In May, Instagram announced that it would filter anti-vaccination misinformation (though they didn’t specify when they would begin doing so). However, algorithms are not yet effective at allowing legitimate discussion while also blocking misinformation and disinformation effectively. Algorithms that are too wide-ranging might stifle legitimate questions and discussions. At this stage, they can only catch the most obvious instances of misinformation and disinformation.
An Effective Social Media Communications Strategy for Public Health Professionals
There’s no magic bullet: no fail-safe, constantly successful tool that will always work against the spread of false information. “We need a multisectoral, multilevel strategy,” explains Viswanath. “We want these platforms to take this seriously and put their resources and investments to minimize the problem as much as possible.
“We also have to equip our health care providers with resources to address these issues when they come up. More critical is to educate the parents right at the beginning even before these issues come up.” Research has shown that when providers make recommendations on whether parents should vaccinate their children as a routine procedure, it helps parents feel comfortable trusting the professional. When doctors and professionals open it up for discussion, then parents can become hesitant or confused.
Understanding how vaccine resistance is reported and written about is another element of the strategy—giving voice to misinformation, even if the goal is to disprove it, can lead to more confusion. The better tactic is to starve it of oxygen, figuratively speaking, by not repeating the falsehood or giving validation to the person espousing it.
Doubling up on evidence-based, scientific communication strategies, and then tailoring the message to be most effective in each community, can be one of the most effective counterpoints to misinformation and disinformation.
“We have to work with community groups and organizations—schools, parent-teacher organizations, religious institutions—in making sure community norms include vaccinations and also counter the disinformation that is out there,” Viswanath explains. “We don’t want to wait for a crisis. And if one comes up, we want to have these relationships already in place to help.”
Highlighting the manifold vaccine successes over time can remind the public of their impact—in other words, social media can also be a useful tool to provide real, factual information. For entities and corporations responsible for conveying this, the challenge is to present the truth neutrally, positively, and without blame. In other words, “We have to tone down the rhetoric, yet be proactive in promoting immunization,” says Viswanath.
Dr. Viswanath directs Applied Risk Communication for the 21st Century at the Harvard T.H. Chan School of Public Health.