0:00:01.888,0:00:03.582
I study rumors.

0:00:04.136,0:00:05.567
Not tabloid gossip

0:00:05.567,0:00:08.718
or the kind of rumors that are making[br]stock markets crash --

0:00:08.718,0:00:10.684
or soar,

0:00:10.684,0:00:13.640
but the kind of rumors[br]that effect your health ...

0:00:13.640,0:00:15.039
and the world's health.

0:00:15.418,0:00:17.938
Like eating a lot of garlic

0:00:17.938,0:00:19.233
or drinking a lot of water

0:00:19.233,0:00:22.274
is going to help protect[br]us from coronavirus --

0:00:22.274,0:00:23.474
if only.

0:00:23.824,0:00:26.169
Rumors have a bad reputation.

0:00:27.014,0:00:32.347
There seen as "not fact," wrong[br]or "just a rumor."

0:00:33.439,0:00:35.903
But I've studied rumors for years,

0:00:35.903,0:00:39.721
and one thing I've learned[br]is that they all have a story,

0:00:39.721,0:00:41.893
and often, an important story.

0:00:42.392,0:00:48.346
One of the most moving or alarming[br]rumor episodes that I investigated

0:00:48.346,0:00:50.245
was in Northern Nigeria.

0:00:50.870,0:00:54.057
I was working with UNICEF's global[br]immunization program.

0:00:55.123,0:00:59.139
And it wasn't the rumors themselves[br]that I found so alarming;

0:00:59.139,0:01:01.757
it was the global impact of those rumors.

0:01:03.225,0:01:05.075
The rumors were suspecting

0:01:05.075,0:01:09.572
that the polio vaccine[br]was actually a contraceptive;

0:01:09.572,0:01:12.403
it was controlling populations --

0:01:12.403,0:01:15.340
or maybe it caused AIDS.

0:01:16.295,0:01:20.364
No, no, maybe it's the CIA[br]spying on them or counting them.

0:01:20.690,0:01:26.419
I mean, why else would they have people[br]knocking on their door again and again

0:01:26.419,0:01:29.375
with the same polio vaccine?

0:01:29.855,0:01:32.702
When children were dying of measles,

0:01:32.702,0:01:35.412
no one was coming with measles vaccines.

0:01:37.890,0:01:41.157
This wasn't about getting the facts right.

0:01:41.157,0:01:42.805
This was about trust.

0:01:43.238,0:01:44.976
It was about broken trust.

0:01:45.607,0:01:47.501
Why so much distrust?

0:01:48.240,0:01:51.713
It wasn't the mothers who were[br]particularly distrusting, actually.

0:01:51.968,0:01:53.853
It was the local leaders,

0:01:53.853,0:01:55.511
the religious leaders,

0:01:55.511,0:01:57.024
the local political leaders.

0:01:57.356,0:02:00.645
It was the governor of the state of Kano

0:02:00.645,0:02:02.486
who decided to boycott

0:02:02.486,0:02:07.221
the entire polio eradication[br]effort in that state ...

0:02:07.221,0:02:09.142
for 11 months.

0:02:10.194,0:02:12.240
Why such distrust?

0:02:12.679,0:02:14.803
Well, it was 2003.

0:02:15.238,0:02:18.482
It was two years after 9/11.

0:02:18.752,0:02:21.897
And they were convinced that the West,

0:02:21.897,0:02:24.191
and particularly the United States,

0:02:24.191,0:02:26.042
was at war with Muslims.

0:02:26.481,0:02:28.733
And they knew that the West,

0:02:28.733,0:02:30.988
and particularly the United States,

0:02:30.988,0:02:32.673
was a huge supporter --

0:02:32.673,0:02:34.121
and funder --

0:02:34.121,0:02:36.828
of the global polio[br]eradication initiative.

0:02:37.220,0:02:39.121
They had their reasoning.

0:02:39.906,0:02:42.787
That lack of trust,

0:02:42.787,0:02:46.282
that "just a rumor or two"

0:02:46.282,0:02:52.481
cost the polio eradication program[br]500 million dollars

0:02:52.481,0:02:54.091
to reset the clock,

0:02:54.091,0:02:58.134
to regain the progress lost[br]during those 11 months

0:02:58.134,0:02:59.609
and beyond.

0:02:59.795,0:03:05.623
The Nigerian strain of the polio virus[br]traveled to over 20 countries

0:03:05.623,0:03:07.473
as far as Indonesia.

0:03:08.900,0:03:10.617
The cost of a rumor.

0:03:11.923,0:03:16.117
The Nigeria episode was one[br]of many episodes that I investigated

0:03:16.117,0:03:17.700
when I was with UNICEF

0:03:17.700,0:03:22.113
and earned the title of the director[br]of UNICEF's fire department.

0:03:25.075,0:03:28.166
At that point I realized I never[br]really had enough time.

0:03:28.395,0:03:30.468
I was too busy putting out the fires

0:03:30.468,0:03:32.547
and not enough time to understand

0:03:32.547,0:03:36.567
what was driving not just[br]the individual episodes,

0:03:36.567,0:03:40.636
but why was there an epidemic[br]of these happening around the world.

0:03:41.445,0:03:45.142
I left UNICEF and went[br]back to research --

0:03:45.142,0:03:47.378
applied research --

0:03:47.378,0:03:54.300
and I set up in 2010 what I called[br]the Vaccine Confidence Project

0:03:54.300,0:03:57.451
at the London School of Hygiene[br]and Tropical Medicine.

0:03:58.403,0:04:00.189
I convened antrhopologists,

0:04:00.189,0:04:01.688
epidemiologists,

0:04:01.688,0:04:03.223
psychologists,

0:04:03.223,0:04:06.236
digital media specialists

0:04:06.236,0:04:08.237
and mathematical modelers.

0:04:08.527,0:04:11.032
We set ourselves the task

0:04:11.032,0:04:15.229
to investigate historic[br]episodes of rumors

0:04:15.229,0:04:17.234
and their impacts,

0:04:17.234,0:04:21.281
from trying to figure out[br]what were the early signals,

0:04:21.281,0:04:23.151
what were the amplifying factors

0:04:23.151,0:04:24.830
and the impacts,

0:04:24.830,0:04:26.647
how did they get traction,

0:04:26.647,0:04:30.582
so we could start to understand[br]what we should be looking for,

0:04:30.582,0:04:32.371
how we could help governments

0:04:32.371,0:04:36.649
and immunization programs[br]be more alert and responsive

0:04:36.649,0:04:39.454
to early signals of problems.

0:04:40.241,0:04:42.137
It was an early warning system.

0:04:42.834,0:04:46.955
In 2015 we developed[br]a vaccine confidence index.

0:04:47.647,0:04:53.737
It's a survey trying to investigate[br]to what extent do people agree

0:04:53.737,0:04:56.924
or disagree that vaccines are important,

0:04:56.924,0:04:58.336
they're safe,

0:04:58.336,0:04:59.434
they're effective --

0:04:59.434,0:05:00.480
they work --

0:05:00.480,0:05:03.763
and somehow they're compatible[br]with my religious beliefs.

0:05:04.049,0:05:08.625
We've run this with over hundreds[br]of thousands of people around the world,

0:05:08.625,0:05:13.609
trying to get our finger on the pulse[br]of confidence and trust,

0:05:13.609,0:05:20.006
but also, more importantly, looking[br]at when that trust goes up or down,

0:05:20.006,0:05:23.538
because we want to see[br]when it starts to decline,

0:05:23.538,0:05:25.941
that's the time to jump in,

0:05:25.941,0:05:30.505
to get there before there's a crisis[br]like the Nigerian one.

0:05:31.786,0:05:36.957
We also set up 24/7 media and social media[br]monitoring around the world --

0:05:36.957,0:05:38.715
multilanguage,

0:05:38.715,0:05:43.052
listening for what's going on[br]on vaccine conversations,

0:05:43.052,0:05:46.524
trying to pick up early concerns[br]or changes in sentiment

0:05:46.524,0:05:48.996
that we should be paying attention to.

0:05:49.488,0:05:54.298
We've created an ecosystem[br]of different types of information

0:05:54.298,0:05:58.055
to try to understand[br]what are the public thinking

0:05:58.055,0:05:59.736
and how can we engage?

0:06:00.522,0:06:01.891
We look for early signals.

0:06:02.122,0:06:03.487
When we find one,

0:06:03.487,0:06:07.202
we have global network of collaborators[br]in a number of countries

0:06:07.202,0:06:09.910
who have more local [br]intelligence in that setting,

0:06:09.910,0:06:11.626
to try to understand:

0:06:11.626,0:06:13.981
is this signal misinformation

0:06:13.981,0:06:16.690
or is something brewing[br]that we should know about?

0:06:17.703,0:06:19.573
In London, we have a bigger picture;

0:06:19.573,0:06:23.757
we watch the swarms of rumors[br]not just traveling locally

0:06:23.757,0:06:25.476
but jumping countires.

0:06:25.686,0:06:29.328
We've seen them jump[br]from Japan over to Columbia,

0:06:29.328,0:06:31.127
through Europe and around.

0:06:31.391,0:06:32.580
They move.

0:06:32.782,0:06:35.591
We live in a hyper-connected environment.

0:06:36.239,0:06:39.178
One of the things[br]that we found fascinating,

0:06:39.178,0:06:41.429
and we've learned[br]a lot in the last 10 years --

0:06:41.429,0:06:43.933
this is our 10th anniversary,

0:06:43.933,0:06:45.470
this didn't start yesterday,

0:06:45.470,0:06:47.061
this rumor problem --

0:06:47.061,0:06:48.895
and one of the things we learned

0:06:48.895,0:06:51.156
is in our global monitoring,

0:06:51.156,0:06:54.974
that Europe is the most[br]skeptical region in the world.

0:06:55.581,0:06:57.394
France won the prize actually.

0:06:57.566,0:06:58.558
(Laughter)

0:06:58.729,0:06:59.776
By far.

0:07:00.294,0:07:04.218
And actually some of those rumors[br]have traveled to other parts of the world.

0:07:05.277,0:07:07.583
But we were trying to understand Europe.

0:07:07.741,0:07:08.409
Hm.

0:07:08.617,0:07:09.576
Why Europe?

0:07:09.781,0:07:11.444
I thought the US was really --

0:07:11.444,0:07:13.277
had some of the most skepticism,

0:07:13.277,0:07:15.284
but boy, I was wrong.

0:07:15.663,0:07:17.041
And a political scientist,

0:07:17.041,0:07:18.662
a colleague we work with,

0:07:18.662,0:07:20.299
John Kennedy,

0:07:20.299,0:07:24.370
he took our data from 28[br]European countries

0:07:24.370,0:07:25.626
and he looked at it

0:07:25.626,0:07:28.416
and correlated it[br]with political opinion polling.

0:07:29.428,0:07:30.862
And what did he find?

0:07:31.095,0:07:37.367
He found that people who are most likely[br]to vote for a populous party

0:07:37.367,0:07:40.901
also were the ones the most likely[br]to strongly disagree

0:07:40.901,0:07:43.844
that vaccines were important,[br]safe or effective.

0:07:44.530,0:07:45.749
What did we learn?

0:07:46.116,0:07:51.236
Vaccines cannot escape[br]the politcal and social turbulance

0:07:51.236,0:07:52.762
that surrounds it.

0:07:52.949,0:07:58.182
Scientists were unprepared[br]for this tsunami of doubt

0:07:58.182,0:07:59.218
and questions

0:07:59.218,0:08:00.617
and distrust.

0:08:00.897,0:08:01.929
What --

0:08:01.929,0:08:05.567
why are vaccines so ripe for resistance?

0:08:06.379,0:08:08.283
Well, we identified a number of things,

0:08:08.283,0:08:09.533
but one:

0:08:09.533,0:08:14.261
they're highly mediated by government[br]that require, regulates

0:08:14.261,0:08:18.077
and sometimes recommmends vaccines,

0:08:18.077,0:08:20.901
or often recommends or sometimes requires.

0:08:22.238,0:08:24.473
Big business makes vaccines,

0:08:24.473,0:08:26.016
and neither institution,

0:08:26.016,0:08:28.080
government or big business,

0:08:28.080,0:08:30.618
are high in the trust ranks these days.

0:08:31.364,0:08:35.084
And then there's scientists[br]who discover and develop vaccines,

0:08:35.084,0:08:37.015
and they're pretty elite

0:08:37.015,0:08:39.630
and not accessible to the general public,

0:08:39.630,0:08:41.580
at least the language they speak.

0:08:42.820,0:08:48.436
Third, we're in a hyper-connected[br]environment with social media these days,

0:08:48.436,0:08:55.364
and people can share their unfettered[br]views, concerns, anxieties and worries

0:08:55.364,0:08:58.755
and find a lot of people[br]that think the way they do,

0:08:58.755,0:09:04.414
and think maybe their worries[br]are worth paying attention to.

0:09:05.057,0:09:06.373
And finally,

0:09:06.373,0:09:10.708
vaccines touch every single[br]life on the planet.

0:09:11.248,0:09:13.710
What other health intervention,

0:09:13.710,0:09:15.407
besides water,

0:09:15.407,0:09:18.406
touches every single life?

0:09:19.171,0:09:22.204
So if you're looking[br]for something to disrupt,

0:09:22.204,0:09:23.902
it's a perfect stage.

0:09:25.122,0:09:29.689
Perhaps that's one of the reasons[br]that we need to pay more attention

0:09:29.689,0:09:32.726
and rebuild our trust in issues.

0:09:33.318,0:09:35.728
People are asking all kinds of questions.

0:09:36.720,0:09:38.354
They're asking,

0:09:38.354,0:09:40.209
why are vaccines --

0:09:40.209,0:09:44.237
and these are the kinds of things[br]we're hearing in our social media --

0:09:44.237,0:09:49.356
why can't my child have[br]a personalized vaccination schedule?

0:09:50.223,0:09:52.642
What the wisdom of so many vaccines?

0:09:54.171,0:09:57.148
What about all those ingredients[br]and preservatives?

0:09:57.925,0:10:00.080
These are not crazy people,

0:10:00.080,0:10:02.337
they're not uneducated;

0:10:02.337,0:10:04.510
they're actually worried mothers.

0:10:05.443,0:10:10.658
But some of them have come[br]to me and said we feel ignored,

0:10:10.658,0:10:13.922
we feel judged if we ask a question,

0:10:13.922,0:10:15.604
and we even feel demonized

0:10:15.604,0:10:18.942
that maybe we're part of some[br]antivaccine group.

0:10:20.126,0:10:22.147
So we have some listening to do.

0:10:22.726,0:10:25.305
And maybe that's why last year,

0:10:25.305,0:10:27.324
there was research that found

0:10:27.324,0:10:33.608
that in six months in 2019,

0:10:33.608,0:10:34.888
online --

0:10:34.888,0:10:36.297
this was with hundreds --

0:10:36.297,0:10:40.343
100 million different users[br]on social media --

0:10:40.343,0:10:46.073
although the numbers of individuals[br]who expressed in their online groups

0:10:46.073,0:10:47.734
they were positive,

0:10:47.734,0:10:49.126
as groups,

0:10:49.126,0:10:51.611
the ones who are the most negative

0:10:51.611,0:10:55.446
were recruiting[br]the conversations in the middle

0:10:55.446,0:10:59.513
that were undecided about whether[br]they wanted to get vaccines.

0:10:59.779,0:11:01.293
The highly negative --

0:11:01.293,0:11:03.640
what we might call the antivaccine groups,

0:11:03.640,0:11:11.463
were recruiting the undecided[br]at a rate 500 percent faster

0:11:11.463,0:11:13.491
than the pro-vaccine groups.

0:11:14.179,0:11:15.974
500 percent faster.

0:11:16.750,0:11:17.878
They were more nimble,

0:11:17.878,0:11:19.278
they were responsive

0:11:19.278,0:11:20.964
and they were listening.

0:11:21.164,0:11:24.367
Most people believe that vaccines are good

0:11:24.367,0:11:26.330
and they believe in their importance.

0:11:26.730,0:11:28.866
But that belief is under attack.

0:11:29.529,0:11:33.553
We need to build in more[br]opportunities for conversation.

0:11:34.059,0:11:35.788
And there are ways to do it.

0:11:35.988,0:11:38.445
It's not easy for some[br]health professionals

0:11:38.445,0:11:41.933
to have conversations where[br]their authority is questioned.

0:11:42.565,0:11:43.944
It's uncomfortable.

0:11:44.435,0:11:47.682
And they're just too busy[br]to listen to all these questions.

0:11:48.446,0:11:50.758
But we need to to do something about that

0:11:50.758,0:11:54.364
because we're losing[br]a lot of concerned parents

0:11:54.364,0:11:56.633
that just want a conversation.

0:11:57.496,0:12:01.770
We should get volunteers trained[br]to sit in waiting rooms,

0:12:01.770,0:12:03.700
to be on hotlines,

0:12:03.700,0:12:06.067
to have online chat forums,

0:12:06.067,0:12:07.686
to have chat boxes.

0:12:08.299,0:12:09.619
In younger kids,

0:12:09.619,0:12:11.602
with younger kids in school,

0:12:11.602,0:12:13.937
teach them about immune systems

0:12:13.937,0:12:15.690
and teach them that actually,

0:12:15.690,0:12:17.982
you know that vaccine[br]your little brother got?

0:12:18.187,0:12:22.620
Well, it just inspired[br]your natural immune system.

0:12:23.579,0:12:26.400
It's a great thing and this is why.

0:12:27.663,0:12:29.454
We need to build that confidence;

0:12:29.454,0:12:30.823
we need to listen.

0:12:32.620,0:12:35.352
Despite all this questioning --

0:12:35.352,0:12:36.820
and there's a lot of it --

0:12:36.820,0:12:41.003
I probably hear more[br]than a lot of people --

0:12:41.003,0:12:42.320
I am an optimist.

0:12:42.570,0:12:46.484
And my optimism is with[br]a younger generation.

0:12:47.175,0:12:52.802
The younger generation who actually now[br]are becoming very aware

0:12:52.802,0:12:55.115
of the risks of social media,

0:12:55.115,0:12:56.638
the false news,

0:12:56.638,0:12:59.904
the false identities,

0:12:59.904,0:13:02.259
and they're starting to embrace science.

0:13:02.884,0:13:08.215
And some of them are a group of children[br]whose mothers refused to vaccinate them.

0:13:10.040,0:13:13.477
Last spring of 2019,

0:13:13.477,0:13:18.672
18-year-old Ethan Lindenburg[br]went on Reddit

0:13:18.672,0:13:20.414
and put out a post.

0:13:21.974,0:13:24.859
"My mother doesn't believe in vaccines.

0:13:24.859,0:13:27.550
She's really worried they cause autism.

0:13:27.550,0:13:29.501
In fact, she strong believes that.

0:13:30.168,0:13:31.388
But I'm 18.

0:13:31.980,0:13:33.658
I'm a senior in high school.

0:13:33.977,0:13:35.418
I can drive a car,

0:13:35.418,0:13:36.524
I can vote,

0:13:36.524,0:13:38.659
and I can go get my own vaccine.

0:13:38.840,0:13:40.955
Can someone tell me where to get it?"

0:13:41.556,0:13:43.742
That post went viral.

0:13:44.174,0:13:47.600
It started to get a whole[br]younger movement going.

0:13:49.538,0:13:52.378
I saw Ethan speak at a conference,

0:13:52.378,0:13:55.825
the Global Vaccine Summit[br]at the EU last fall.

0:13:56.667,0:13:58.635
He spoke eloquently,

0:13:58.635,0:14:00.193
and I was impressed

0:14:00.193,0:14:02.125
in front of a whole forum.

0:14:03.005,0:14:04.967
He told his personal story,

0:14:04.967,0:14:06.593
and then he said to the group,

0:14:06.593,0:14:10.089
he said, "You know, everybody[br]talks about misinformation,

0:14:10.089,0:14:14.247
but I want to tell you about[br]a different kind of misinformation,

0:14:14.247,0:14:19.575
and that's misinformation that says[br]that people like my mother,

0:14:19.575,0:14:21.472
who is loving mother,

0:14:21.472,0:14:25.270
is bad person because[br]she doesn't give me vaccines.

0:14:26.296,0:14:31.189
Well, I want to tell all of you[br]that she didn't give me a vaccine

0:14:31.189,0:14:33.208
because she loves me

0:14:33.208,0:14:37.639
and because she believed that that[br]was the best thing for me.

0:14:38.271,0:14:39.738
I think differently

0:14:39.738,0:14:42.393
and I will never change her mind,

0:14:42.393,0:14:44.465
but she's not a bad person."

0:14:45.506,0:14:48.121
That was the message from a teenager.

0:14:48.806,0:14:52.057
Empathy, kindness and understanding.

0:14:53.123,0:14:56.699
We have an abundance[br]of scientific information

0:14:56.699,0:14:58.640
to debunk false rumors.

0:14:59.616,0:15:01.125
That's not our problem.

0:15:01.838,0:15:04.348
We have a relationship problem,

0:15:04.348,0:15:06.524
not a misinformation problem.

0:15:06.848,0:15:09.461
Misiniformation is a symptom,

0:15:09.461,0:15:10.887
not the cause.

0:15:11.112,0:15:13.075
If people trust,

0:15:13.075,0:15:16.679
they'll put up with a little risk[br]to avert a much bigger one.

0:15:17.613,0:15:21.243
The one thing that I want and I hope for

0:15:21.243,0:15:24.814
is that we as a medical[br]and health community

0:15:24.814,0:15:29.091
have the moral courage and humility

0:15:29.091,0:15:31.443
to productively engage,

0:15:31.443,0:15:32.779
like Ethan,

0:15:32.779,0:15:35.102
with those who disagree with us.

0:15:35.970,0:15:37.098
I hope so.

0:15:37.379,0:15:38.484
Thank you.

0:15:38.732,0:15:40.211
(Applause and cheers)