A few months ago, Facebook rolled out a new feature for those searching for vaccine information on its platform — a prominently displayed educational banner at the top of the results. “Looking for Vaccine Info?” it asks, before directing users in the United States to the Centers for Disease Control and everyone else to the World Health Organisation (WHO) website.

This is part of a larger effort from social media giants and certain online forums to work with the public sector in combating false and misleading information about the efficacy and safety of vaccinations. But as the private sector begins to make change on the issue, what role can governments play?

The right information

The WHO cites immunisation as “one of modern medicine’s greatest success stories,” preventing 2 to 3 million deaths a year across all ages. Yet, false online information has taken a toll on immunisation rates, sometimes even halving vaccination uptake. Another 1.5 million deaths could be avoided if vaccination coverage improved, says the WHO.

In January, researchers at the University of North Carolina at Chapel Hill published a study on HPV vaccination rates in Denmark following negative coverage of the HPV vaccine from 2013 to 2016.

False information about the vaccine was shared on prominent mainstream media outlets, and led to just over a 50% drop in HPV vaccinations.

An information campaign led by health authorities tried to mitigate the damage by increasing coverage of vaccine preventable diseases, particularly cervical cancer. While this helped improve HPV vaccination rates, coverage has not returned to its previous levels.

Dr Peter R. Hansen, who co-authored the report, said that a key problem was media coverage on personal stories, where negative health was anecdotally linked to the vaccine. He expressed concern that journalists don’t always understand the science they are reporting on.

However, sending the correct messages around vaccines may not be enough to create healthy communities, says Dr. Bolette Søborg, the Chief Physician and Programme Manager for the Danish Childhood Vaccination Programme at the Danish Health Authority.

"I think the time where you can put something out and focus on the nitty gritty, and perfect referencing, is dead. The intersection between health, science and communication is much more important.”

Dr. Søborg argued that effective communication has to come from the heart. It is not enough to share technical peer-reviewed pieces that the public doesn’t understand.

In the Danish case, additional funding from the government — which was earmarked for mitigating against vaccine misinformation — gave health authorities the resources to make better, evidence-based decisions on how to regain people’s trust through online channels.

Effective media campaigns have been shown to effectively mitigate against some vaccine skepticism. Ireland is often cited as a case where powerful cross-sectoral alliances” led to a “rapid improvement in vaccine uptake.”

In Ireland, these efforts were lead by over 35 health, women’s rights, child welfare, and civil society groups committed to raising awareness of HPV vaccination. Laura Brennan, a campaigner for the HPV vaccine, was credited for acting as a particularly effective and moving spokesperson for the vaccine, reaching people on a “visceral emotional level” by speaking about her life with terminal cervical cancer.

Shifting contexts

Public education is often given as the prescription for vaccine misinformation. Surprisingly, according to the Wellcome Global Monitor — the world’s largest study into how people around the world think and feel about science and major health challenges — there is “no obvious global relationship between levels of science education and vaccine confidence.”

However, the Monitor did find that people who trust a doctor or nurse more than any other source of information — such as family, friends, or religious leaders — are more likely to strongly or somewhat agree that vaccines are safe.

Louise Hougaard Loft, the Danish Cancer Society’s project manager for the HPV campaign, highlighted the importance of creating a trustworthy “network of stakeholders and ambassadors” who could combat vaccination misinformation, which she said was useful in the Denmark case.

“We experienced that one-way communication is not a good way to handle vaccine hesitancy. It is important to listen to the parents’ concerns and tailor information to their needs,” she said.

This point was also made by Kate Joynes-Burgess, a DPhil candidate and Wellcome Trust scholar at the University of Oxford investigating “infectious content” on social media in the UK, and its impact on parental attitudes to vaccination.

“There is a need for public health officials to directly, or working with researchers, get closer to digital channels and develop understanding of how antivaxx content, claims and communities evolve in order to developed a more informed and targeted communications response to the challenge in hand,” she said.

Ms. Joynes-Burgess stressed that the way online information is shared is dynamic, with new hashtags and forums being used to share information in response to platforms’ suppression of anti-vaxx material.

“This is a challenging approach for public health organisations to match through top down communications campaigns without creating a different kind of partnership with digital influencers and content creators who can speak to target communities in an authentic way,” she said.

Prevention, not cure

Sometimes, however, the best means of combating misinformation is creating an infrastructure to stop it before it spreads. And this means improving media literacy.

The Media Literacy Index, which ranks the countries best equipped to withstand the impact of fake news, has put Finland at the top for three years in a row.

Marin Lessenski, the program director for the European Policies Program at the Open Society Institute in Sofia, said that Finland enjoyed high media literacy because of “the high quality of education, free media and not least the high level of trust among people in the country.”

Mr. Lessenski argued that Finland has a comprehensive and long-term plan to promote media literacy which involves institutions ranging from the government to kindergartens and libraries.

It also includes looking at media literacy through the lens of cyber security. Finland recently created an Ambassador for Hybrid Affairs, who focuses on cyber security threats and cooperation. Helsinki also hosts the European Centre of Excellence for Countering Hybrid Threats, a joint NATO and EU intergovernmental think tank that works on everything from election intereference to terrorism.

“The key advantage, I believe, is that Finland decided to bet on education rather than restrictive regulation, though regulation is necessary too,” Mr. Lessenski said. “Educational approaches act as an ‘inoculation’ to develop immunity against fake news.”
Finland has a National Core Curriculum for Basic Education which includes guidelines on promoting media literacy.

While the paths to combating vaccine misinformation may vary, it is crucial that reputable authorities — be they journalists, doctors, or government officials — are trusted and heard.

“Our latest Media Literacy Index showed that there tends to be a correlation between trust in scientists or journalists on the one hand and the Media Literacy Index scores. And what we have observed in recent years is that the rise in fake news and disinformation has been accompanied by a significant decrease in trust in experts and authority figures. This means that restoring trust is paramount in dealing with disinformation campaigns.” — Ana Baric

(Picture credit: Unsplash)