Fake news: a threat to curbing vaccine-preventable diseases in the UK

In a guest blog, Dr Rakhee Shah looks at the rise of online misinformation on vaccine safety and the dangers it represents – and advises how to tackle the problem.

Blog post

Published: 28/01/2019

Please note that views expressed in guest articles on our website are the authors' own and do not necessarily reflect the views of the Nuffield Trust.

Doctor: “Is 15-month-old Sam up to date with his immunisations?”

Sam’s mother: “I have read several articles on the internet that the MMR (measles, mumps and rubella) vaccine causes autism and so I do not want to take the risk.”

As a paediatric registrar this is unfortunately a common conversation in my everyday practice, and I suspect I’m not alone. Last week a Royal Society for Public Health report highlighted that social media was propagating “negative messages around vaccinations, especially for parents”. Two in five reported that they were “often or sometimes exposed” to negative messages about vaccines on social media, which increased to one in two among parents with children under five years old.

Last year, there was a shocking 30% rise in the global number of cases of measles. In Europe, there were 64,946 measles cases between November 2017 and October 2018 – over twice the figure for the whole of 2017. And in England alone, there were 913 cases of laboratory-confirmed measles between 1 January and 31 October 2018, which was three times higher than in 2017. This is concerning, given that the complications of measles lead to several poor outcomes including, in severe cases, brain infections and even death. Yet it is a vaccine-preventable disease.

Low immunisation rates against measles in Europe have been linked to claims originally published in the Lancet – then spread by vocal anti-vaccination groups – that the MMR vaccine causes autism. This claim, subsequently debunked in 2010 by the Lancet itself, nonetheless continues to circulate on new online channels.

Separating truth from fiction

Fake news is described as “sensational information disseminated under the guise of news reporting”. Such news stories include those out of proportion with reality and amplify statistically rare adverse vaccine events, which makes it difficult for the public to disentangle what’s accurate from what’s false.

In 2013, The World Economic Forum described "digital wildfires" in our hyper-connected world as one of the top three global health risks. Their report highlighted that, despite the benefits of living in a connected world, there is an immense risk of the viral spread of intentionally or unintentionally misleading health information.

When it comes to vaccine safety, the rapid digital spread of misinformation has serious implications for vaccine confidence in the UK. Over five years on from that report, such misleading information is causing the public to increasingly mistrust scientists and is a very real threat to thwarting vaccine-preventable deaths.

Why is fake news on vaccine safety such a threat now?

Children and young people and their parents are increasingly encouraged to obtain health information from the internet, with technological advances over the past decade leading to dramatic changes in both modes and the speed of exchanging information. Misleading information can rapidly reach millions of social media users worldwide, affecting vaccine confidence within hours.

Technological advances have also enabled virtual ‘communities’, who share anti-vaccination sentiment, to overcome geographical barriers and organise themselves to become more powerful. There has also been a shift in where people access news, with the public increasingly using social media as a news source. At the same time, people’s perceptions about themselves and their relationship with public institutions are changing. Public trust in UK institutions such as the government is at an all-time low, creating uncertainty and therefore fertile ground for fake news to spread. 

How should we tackle fake news on vaccine safety?

Traditional policies aimed at increasing public trust in vaccines remain important. They include: giving the public adequate information so they can weigh up the benefits and risks and make informed choices about immunisation; training health professionals in effective communication techniques; and involving local communities, parent groups and religious leaders to advocate for immunisation. However, due to the rapid spread of online misinformation, more innovative policies are required to tackle new ways in which fake news can spread.

Addressing the problem

There is an urgent need for real-time monitoring of ‘fast-data’ for the publicly available content being shared on popular social networking and news media sites. This real-time monitoring of data has been shown to represent public vaccine sentiment, so could serve as an early warning function, indicating when vaccine confidence is dropping. This could then provide opportunities for public health specialists to intervene earlier. But as ‘fast-data’ monitoring could be perceived by the public as a ‘nanny state’ intervention, it is important to have transparent communication about the motivations for monitoring in this way.

Breaking online echo chambers

Social science research also suggests that to break online echo chambers of fake news about vaccine safety, scientists simply providing more facts can make the situation worse and strengthen anti-vaccine beliefs. In such situations, it is important for scientists to communicate in a way that can open conversations with people of opposing views. To increase trust and break echo chambers, recruiting more diverse citizens to vaccine advisory boards should be considered, provided it doesn’t dilute scientific expertise.

Digital literacy

It is clear that large technology giants, such as Google and Facebook, need to be involved in offering potential solutions, such as flagging up fake news stories or giving additional weight to accurate stories during search engine use. But digital literacy needs to go further and educate people on how social media firms are financed and how they fit within the current political climate. With the help of an expert group, a national media literacy plan should be established, including a focus on health media. Increasing individual fact-checking skills on vaccine safety in the UK will be crucial for tackling the spread of wrong information and to increase vaccine confidence.

Such action is vital if we are to keep fake news at bay and maintain our successes in preventing life-threatening infectious diseases.

Dr Rakhee Shah (@shahrakhee) is a paediatric registrar and a research assistant at the Association for Young People’s Health.

Please note that views expressed in guest articles on our website are the authors' own and do not necessarily reflect the views of the Nuffield Trust.

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