‘Fake news’ may be the latest buzzword, but there’s nothing new about it. It’s been around for decades and vaccine safety is one of its oldest targets. For years, cynical anti-vaccine groups have attempted to manipulate public opinion and undermine public trust with fabricated stories and appeals to emotion over hard fact, and in doing so they have put lives at risk.
In 1998 immunisation rates plummeted in the UK and cases of measles soared, after research was published falsely claiming that the measles-mumps-rubella (MMR) vaccine caused autism. Two decades later Andrew Wakefield, the author of that report – a British surgeon who has since been struck off – is continuing his relentless campaign via social media. Despite the mountains of scientific evidence to the contrary, too many people are buying into it.
As a result immunisation levels have fallen to dangerous levels across Europe and North America, leading to outbreaks of vaccine-preventable disease in the US, Italy, France and Germany and beyond. The largest outbreak has been in Romania, with more than 7,000 cases of measles and 30 deaths in the last year. In the UK uptake of human papillomavirus, which protects girls against the main cause of cervical cancer, has dropped in places like Derbyshire to below 50 per cent.
Opposition to vaccines is not new either. It dates back more than a century, most notably with Minnesotan seamstress Lora Little and her campaign against smallpox vaccinations. Little’s conviction was grounded in her firm belief that the vaccine was responsible for the death of her son. She used arguments uncannily similar to modern anti-vaccine groups, combining heart-rending personal tales with conspiracy theories implicating doctors, politicians and the health industry. It worked. Little successfully campaigned to have legislation introduced in 1903 prohibiting compulsory vaccination as a pre-condition to attend school. Three years later Minnesota experienced a major smallpox epidemic that infected 28,000 people.
So why was Little’s campaign so successful? Was it due to a lack of knowledge of the scientific evidence available? Recent experience would suggest not. The internet has given us unprecedented access to information. Yet all too often we use the vast amount of knowledge and new ideas now freely available to reinforce what we already believe.
One reason for this is ‘confirmation bias’, the natural human tendency to seek out and embrace information supporting pre-existing beliefs, while ignoring anything that opposes them. This is one reason why so many people are so willing to believe Wakefield’s fraudulent claims. By playing on the inherent desire of parents to protect their children, it is possible to use misinformation to foster fear. Pleas by public health officials citing decades of solid scientific research fall on deaf ears.
In the late 1990s this enabled anti-vaxxers to campaign successfully for the removal of the preservative thiomersal from almost all vaccines in the UK, Europe and the US, on the mistaken grounds that it was responsible for an increase in cases of autism. Yet cases of autism continued to rise long after thiomersal was removed from vaccines.
This confirmation bias is now compounded by social media, where advertising algorithms point us to news and content that are similar to what we’ve viewed before. This effectively turns our social media feeds into echo chambers. For anti-vaccine campaigners this is great news; social media isn’t just a new platform to reach the public, it also gives this very vocal minority a means to massively amplify their message.
The proliferation of free news means it’s going to become increasingly difficult to know what is real and what is not. Public health workers must rethink how they communicate to tackle hesitancy over vaccination. That means focussing on the positive gains, rather than trying to counter anti-vaccine claims, which can often have the opposite effect, reinforcing the fallacy. But ultimately it is up to all of us to ask ourselves if we are giving more weight to articles we read online which confirm our beliefs. If not, we could end up paying for fake news with real children’s lives.
Seth Berkley is the CEO of Gavi, the Vaccine Alliance