By Iain Macleod Briongos, Ph.D.
Introduction
Misinformation – the spread of incorrect, inaccurate, incomplete, or misleading information – has become an increasingly pervasive issue globally, affecting everything from politics to public health. Thanks in large part to the rise of social media and other forms of instant communication, misinformation can quickly go viral, leading to harmful changes in public behavior and opinion. Healthcare is, by its nature, a complex field, in which cutting-edge research can sometimes produce contradictory results, and groups with vested interests may deliberately spread false information (or disinformation). This has had a pronounced effect across the field, particularly when it comes to vaccines.
In this post, we will discuss what vaccine misinformation looks like and how it can spread. We will examine notable cases and their consequences. Finally, we will discuss strategies for combating existing misinformation and preventing the dissemination of new misinformation.
Vaccine misinformation
Misinformation about vaccines involves the spread of false claims about their safety, efficacy, necessity, or intent. Misinformation can be rooted in fear, honest misunderstanding, or conspiracy theories. This can be particularly concerning in regions that are at high risk of vaccine-preventable diseases.
During the COVID-19 pandemic, a significant portion of misinformation was driven by social media. One study showed that social media spread 50% of all misinformation analyzed. The next major driver was word-of-mouth, where opinions might also have been sourced from social media. Another study showed that up to 65% of all COVID-19-related social media misinformation was driven by a small group of twelve anti-vaccine influencers. Dubbed the “disinformation dozen,” these influencers have a large number of followers on X, Facebook, YouTube, and Instagram, through which misinformation can be shared and proliferate. Widespread and false claims that COVID-19 vaccines caused infertility (particularly in women) contributed to vaccine hesitancy among those of childbearing age. Other sources of misinformation claimed that governments and prominent figures such as Bill Gates were using microchip- or nanobot-laced vaccines to track and control the population. A third common rumor was that the COVID-19 vaccine had been developed too quickly to be safe and that vaccination, rather than the virus itself, was driving excess deaths. Some of these influencers may have had competing interests, as they profited from selling alternative remedies and supplements.
Misinformation is not just shared by individuals; governments are also not immune from participating. In mid-2020, Tanzania’s then-President, John Magufuli, claimed that God favored their country and they had removed coronavirus through prayer. By January 2021, the majority of sub-Saharan African countries had joined the COVAX COVID-19 vaccination program, but the Tanzanian president resisted, adopting an anti-vax stance and promoting alternative remedies. Although Tanzania later joined COVAX after Magufuli’s death, the country struggled to counteract the increase in vaccine hesitancy partly driven by the previous government’s statements, with one study showing only 37% of respondents willing to vaccinate compared to 80.3% in other LMIC countries.
The exact consequences of misinformation are complex and understudied. Studies on the impact of misinformation do, however, indicate that it can lead to serious harm. One COVID-19 research paper suggests that misinformation in the US and UK led to a 6% decrease in vaccine acceptance rates. Another study found that the spreading of misinformation suggesting that drinking methanol was an effective cure for COVID-19 led to 800 deaths and 5,876 hospitalizations in Iran. During the early stages of the HIV epidemic in South Africa, misinformation claiming that the virus was fake or that treatments were toxic to humans led to delays in seeking treatment and an estimated 343,000 avoidable deaths.
Combating misinformation
Improving media literacy is a promising method for fighting misinformation. Deploying news literacy messages (such as those sometimes found under videos on YouTube or posts on X) can affect the perception of credibility of the statement. This was found to be most effective when messaging was sustained over longer periods of time. Another study focused on Facebook showed that unflagged misinformation was much more likely to increase vaccine hesitancy than misinformation that had been identified and flagged. Although highlighting misinformation has been found to increase skepticism in response to social media claims, the efficacy of this approach is limited due to the vast wealth of misinformation available on platforms such as Facebook and the ease with which it spreads. Governments and social media providers could work together to further limit the harm caused by the spread of misinformation on these platforms.
The tone of communication when combating misinformation appears to have a role in audience receptiveness. Humor has been shown to reduce psychological resistance among individuals with false beliefs regarding vaccine safety, leading to lower vaccine hesitancy. Conversely, there is some evidence that using dramatic messaging (such as images of sick children or anecdotes with negative outcomes) can have a negative effect. This led to an increase in the association between vaccines and autism or side effects. There is also evidence against fear-driven sensitization backfiring, suggesting that the efficacy of a particular messaging strategy may be dependent on the cultural norms of the audience. Regionally and culturally tailored messaging may be more effective than a “one method fits all” approach.
On a local level, trusted community figureheads such as faith leaders and faith-based organizations can be a powerful tool against both misinformation and vaccine hesitancy, as found by two recent studies of the role of local religious leaders in India and Ethiopia during the COVID-19 pandemic.
These strategies are crucial for both existing and emerging vaccines, such as the recently introduced malaria vaccine.
Malaria vaccines and misinformation
The malaria vaccine is still in early deployment, and while there is limited data, we can already see echoes of what happened during the COVID-19 pandemic. False claims – for example, that Bill Gates is creating mosquitoes for financial gain, that vaccines are causing men’s libido to “denature” to drive African depopulation, and that vaccines are being used as a tool for Western exploitation of Africa – are being spread and receiving engagement online. These types of misinformation drive vaccine hesitancy and mistrust in healthcare and governmental institutions and are already having an effect on potential recipients’ views of the malaria vaccine. In a 2023 study addressing hesitancy over the malaria vaccine in Nigeria, 30% of participants expressed hesitancy. Fear of adverse effects was cited by 35% of those participants as the main cause for hesitancy.
In 2019, the WHO identified vaccine hesitancy as one of the ten major threats to global health – a concern that the COVID-19 pandemic amplified. Malaria vaccine misinformation already exists and will likely be a driver of hesitancy among families eligible for the vaccines. Lessons from COVID-19 suggest that by leveraging real-time monitoring of misinformation, partnering with (or regulating) social media platforms, and ensuring that accurate information is shared through trusted sources, we can mitigate the negative effects of misinformation and protect public health. These efforts can be driven by increasing funding and resources for malaria vaccination programs, encouraging collaboration between governments and NGOs, and promoting community engagement.