WEBVTT 00:00:01.888 --> 00:00:03.582 I study rumors. 00:00:04.136 --> 00:00:05.567 Not tabloid gossip 00:00:05.567 --> 00:00:08.718 or the kind of rumors that are making stock markets crash -- 00:00:08.718 --> 00:00:10.684 or soar, 00:00:10.684 --> 00:00:13.640 but the kind of rumors that effect your health ... 00:00:13.640 --> 00:00:15.039 and the world's health. 00:00:15.418 --> 00:00:17.938 Like eating a lot of garlic 00:00:17.938 --> 00:00:19.233 or drinking a lot of water 00:00:19.233 --> 00:00:22.274 is going to help protect us from coronavirus -- 00:00:22.274 --> 00:00:23.474 if only. 00:00:23.824 --> 00:00:26.169 Rumors have a bad reputation. 00:00:27.014 --> 00:00:32.347 There seen as "not fact," wrong or "just a rumor." 00:00:33.439 --> 00:00:35.903 But I've studied rumors for years, 00:00:35.903 --> 00:00:39.721 and one thing I've learned is that they all have a story, 00:00:39.721 --> 00:00:41.893 and often, an important story. 00:00:42.392 --> 00:00:48.346 One of the most moving or alarming rumor episodes that I investigated 00:00:48.346 --> 00:00:50.245 was in Northern Nigeria. 00:00:50.870 --> 00:00:54.057 I was working with UNICEF's global immunization program. 00:00:55.123 --> 00:00:59.139 And it wasn't the rumors themselves that I found so alarming; 00:00:59.139 --> 00:01:01.757 it was the global impact of those rumors. 00:01:03.225 --> 00:01:05.075 The rumors were suspecting 00:01:05.075 --> 00:01:09.572 that the polio vaccine was actually a contraceptive; 00:01:09.572 --> 00:01:12.403 it was controlling populations -- 00:01:12.403 --> 00:01:15.340 or maybe it caused AIDS. 00:01:16.295 --> 00:01:20.364 No, no, maybe it's the CIA spying on them or counting them. 00:01:20.690 --> 00:01:26.419 I mean, why else would they have people knocking on their door again and again 00:01:26.419 --> 00:01:29.375 with the same polio vaccine? 00:01:29.855 --> 00:01:32.702 When children were dying of measles, 00:01:32.702 --> 00:01:35.412 no one was coming with measles vaccines. 00:01:37.890 --> 00:01:41.157 This wasn't about getting the facts right. 00:01:41.157 --> 00:01:42.805 This was about trust. 00:01:43.238 --> 00:01:44.976 It was about broken trust. 00:01:45.607 --> 00:01:47.501 Why so much distrust? 00:01:48.240 --> 00:01:51.713 It wasn't the mothers who were particularly distrusting, actually. 00:01:51.968 --> 00:01:53.853 It was the local leaders, 00:01:53.853 --> 00:01:55.511 the religious leaders, 00:01:55.511 --> 00:01:57.024 the local political leaders. 00:01:57.356 --> 00:02:00.645 It was the governor of the state of Kano 00:02:00.645 --> 00:02:02.486 who decided to boycott 00:02:02.486 --> 00:02:07.221 the entire polio eradication effort in that state ... 00:02:07.221 --> 00:02:09.142 for 11 months. 00:02:10.194 --> 00:02:12.240 Why such distrust? 00:02:12.679 --> 00:02:14.803 Well, it was 2003. 00:02:15.238 --> 00:02:18.482 It was two years after 9/11. 00:02:18.752 --> 00:02:21.897 And they were convinced that the West, 00:02:21.897 --> 00:02:24.191 and particularly the United States, 00:02:24.191 --> 00:02:26.042 was at war with Muslims. 00:02:26.481 --> 00:02:28.733 And they knew that the West, 00:02:28.733 --> 00:02:30.988 and particularly the United States, 00:02:30.988 --> 00:02:32.673 was a huge supporter -- 00:02:32.673 --> 00:02:34.121 and funder -- 00:02:34.121 --> 00:02:36.828 of the global polio eradication initiative. 00:02:37.220 --> 00:02:39.121 They had their reasoning. 00:02:39.906 --> 00:02:42.787 That lack of trust, 00:02:42.787 --> 00:02:46.282 that "just a rumor or two" 00:02:46.282 --> 00:02:52.481 cost the polio eradication program 500 million dollars 00:02:52.481 --> 00:02:54.091 to reset the clock, 00:02:54.091 --> 00:02:58.134 to regain the progress lost during those 11 months 00:02:58.134 --> 00:02:59.609 and beyond. 00:02:59.795 --> 00:03:05.623 The Nigerian strain of the polio virus traveled to over 20 countries 00:03:05.623 --> 00:03:07.473 as far as Indonesia. 00:03:08.900 --> 00:03:10.617 The cost of a rumor. 00:03:11.923 --> 00:03:16.117 The Nigeria episode was one of many episodes that I investigated 00:03:16.117 --> 00:03:17.700 when I was with UNICEF 00:03:17.700 --> 00:03:22.113 and earned the title of the director of UNICEF's fire department. 00:03:25.075 --> 00:03:28.166 At that point I realized I never really had enough time. 00:03:28.395 --> 00:03:30.468 I was too busy putting out the fires 00:03:30.468 --> 00:03:32.547 and not enough time to understand 00:03:32.547 --> 00:03:36.567 what was driving not just the individual episodes, 00:03:36.567 --> 00:03:40.636 but why was there an epidemic of these happening around the world. 00:03:41.445 --> 00:03:45.142 I left UNICEF and went back to research -- 00:03:45.142 --> 00:03:47.378 applied research -- 00:03:47.378 --> 00:03:54.300 and I set up in 2010 what I called the Vaccine Confidence Project 00:03:54.300 --> 00:03:57.451 at the London School of Hygiene and Tropical Medicine. 00:03:58.403 --> 00:04:00.189 I convened antrhopologists, 00:04:00.189 --> 00:04:01.688 epidemiologists, 00:04:01.688 --> 00:04:03.223 psychologists, 00:04:03.223 --> 00:04:06.236 digital media specialists 00:04:06.236 --> 00:04:08.237 and mathematical modelers. 00:04:08.527 --> 00:04:11.032 We set ourselves the task 00:04:11.032 --> 00:04:15.229 to investigate historic episodes of rumors 00:04:15.229 --> 00:04:17.234 and their impacts, 00:04:17.234 --> 00:04:21.281 from trying to figure out what were the early signals, 00:04:21.281 --> 00:04:23.151 what were the amplifying factors 00:04:23.151 --> 00:04:24.830 and the impacts, 00:04:24.830 --> 00:04:26.647 how did they get traction, 00:04:26.647 --> 00:04:30.582 so we could start to understand what we should be looking for, 00:04:30.582 --> 00:04:32.371 how we could help governments 00:04:32.371 --> 00:04:36.649 and immunization programs be more alert and responsive 00:04:36.649 --> 00:04:39.454 to early signals of problems. 00:04:40.241 --> 00:04:42.137 It was an early warning system. 00:04:42.834 --> 00:04:46.955 In 2015 we developed a vaccine confidence index. 00:04:47.647 --> 00:04:53.737 It's a survey trying to investigate to what extent do people agree 00:04:53.737 --> 00:04:56.924 or disagree that vaccines are important, 00:04:56.924 --> 00:04:58.336 they're safe, 00:04:58.336 --> 00:04:59.434 they're effective -- 00:04:59.434 --> 00:05:00.480 they work -- 00:05:00.480 --> 00:05:03.763 and somehow they're compatible with my religious beliefs. 00:05:04.049 --> 00:05:08.625 We've run this with over hundreds of thousands of people around the world, 00:05:08.625 --> 00:05:13.609 trying to get our finger on the pulse of confidence and trust, 00:05:13.609 --> 00:05:20.006 but also, more importantly, looking at when that trust goes up or down, 00:05:20.006 --> 00:05:23.538 because we want to see when it starts to decline, 00:05:23.538 --> 00:05:25.941 that's the time to jump in, 00:05:25.941 --> 00:05:30.505 to get there before there's a crisis like the Nigerian one. 00:05:31.786 --> 00:05:36.957 We also set up 24/7 media and social media monitoring around the world -- 00:05:36.957 --> 00:05:38.715 multilanguage, 00:05:38.715 --> 00:05:43.052 listening for what's going on on vaccine conversations, 00:05:43.052 --> 00:05:46.524 trying to pick up early concerns or changes in sentiment 00:05:46.524 --> 00:05:48.996 that we should be paying attention to. 00:05:49.488 --> 00:05:54.298 We've created an ecosystem of different types of information 00:05:54.298 --> 00:05:58.055 to try to understand what are the public thinking 00:05:58.055 --> 00:05:59.736 and how can we engage? 00:06:00.522 --> 00:06:01.891 We look for early signals. 00:06:02.122 --> 00:06:03.487 When we find one, 00:06:03.487 --> 00:06:07.202 we have global network of collaborators in a number of countries 00:06:07.202 --> 00:06:09.910 who have more local intelligence in that setting, 00:06:09.910 --> 00:06:11.626 to try to understand: 00:06:11.626 --> 00:06:13.981 is this signal misinformation 00:06:13.981 --> 00:06:16.690 or is something brewing that we should know about? 00:06:17.703 --> 00:06:19.573 In London, we have a bigger picture; 00:06:19.573 --> 00:06:23.757 we watch the swarms of rumors not just traveling locally 00:06:23.757 --> 00:06:25.476 but jumping countires. 00:06:25.686 --> 00:06:29.328 We've seen them jump from Japan over to Columbia, 00:06:29.328 --> 00:06:31.127 through Europe and around. 00:06:31.391 --> 00:06:32.580 They move. 00:06:32.782 --> 00:06:35.591 We live in a hyper-connected environment. 00:06:36.239 --> 00:06:39.178 One of the things that we found fascinating, 00:06:39.178 --> 00:06:41.429 and we've learned a lot in the last 10 years -- 00:06:41.429 --> 00:06:43.933 this is our 10th anniversary, 00:06:43.933 --> 00:06:45.470 this didn't start yesterday, 00:06:45.470 --> 00:06:47.061 this rumor problem -- 00:06:47.061 --> 00:06:48.895 and one of the things we learned 00:06:48.895 --> 00:06:51.156 is in our global monitoring, 00:06:51.156 --> 00:06:54.974 that Europe is the most skeptical region in the world. 00:06:55.581 --> 00:06:57.394 France won the prize actually. 00:06:57.566 --> 00:06:58.558 (Laughter) 00:06:58.729 --> 00:06:59.776 By far. 00:07:00.294 --> 00:07:04.218 And actually some of those rumors have traveled to other parts of the world. 00:07:05.277 --> 00:07:07.583 But we were trying to understand Europe. 00:07:07.741 --> 00:07:08.409 Hm. 00:07:08.617 --> 00:07:09.576 Why Europe? 00:07:09.781 --> 00:07:11.444 I thought the US was really -- 00:07:11.444 --> 00:07:13.277 had some of the most skepticism, 00:07:13.277 --> 00:07:15.284 but boy, I was wrong. 00:07:15.663 --> 00:07:17.041 And a political scientist, 00:07:17.041 --> 00:07:18.662 a colleague we work with, 00:07:18.662 --> 00:07:20.299 John Kennedy, 00:07:20.299 --> 00:07:24.370 he took our data from 28 European countries 00:07:24.370 --> 00:07:25.626 and he looked at it 00:07:25.626 --> 00:07:28.416 and correlated it with political opinion polling. 00:07:29.428 --> 00:07:30.862 And what did he find? 00:07:31.095 --> 00:07:37.367 He found that people who are most likely to vote for a populous party 00:07:37.367 --> 00:07:40.901 also were the ones the most likely to strongly disagree 00:07:40.901 --> 00:07:43.844 that vaccines were important, safe or effective. 00:07:44.530 --> 00:07:45.749 What did we learn? 00:07:46.116 --> 00:07:51.236 Vaccines cannot escape the politcal and social turbulance 00:07:51.236 --> 00:07:52.762 that surrounds it. 00:07:52.949 --> 00:07:58.182 Scientists were unprepared for this tsunami of doubt 00:07:58.182 --> 00:07:59.218 and questions 00:07:59.218 --> 00:08:00.617 and distrust. 00:08:00.897 --> 00:08:01.929 What -- 00:08:01.929 --> 00:08:05.567 why are vaccines so ripe for resistance? 00:08:06.379 --> 00:08:08.283 Well, we identified a number of things, 00:08:08.283 --> 00:08:09.533 but one: 00:08:09.533 --> 00:08:14.261 they're highly mediated by government that require, regulates 00:08:14.261 --> 00:08:18.077 and sometimes recommmends vaccines, 00:08:18.077 --> 00:08:20.901 or often recommends or sometimes requires. 00:08:22.238 --> 00:08:24.473 Big business makes vaccines, 00:08:24.473 --> 00:08:26.016 and neither institution, 00:08:26.016 --> 00:08:28.080 government or big business, 00:08:28.080 --> 00:08:30.618 are high in the trust ranks these days. 00:08:31.364 --> 00:08:35.084 And then there's scientists who discover and develop vaccines, 00:08:35.084 --> 00:08:37.015 and they're pretty elite 00:08:37.015 --> 00:08:39.630 and not accessible to the general public, 00:08:39.630 --> 00:08:41.580 at least the language they speak. 00:08:42.820 --> 00:08:48.436 Third, we're in a hyper-connected environment with social media these days, 00:08:48.436 --> 00:08:55.364 and people can share their unfettered views, concerns, anxieties and worries 00:08:55.364 --> 00:08:58.755 and find a lot of people that think the way they do, 00:08:58.755 --> 00:09:04.414 and think maybe their worries are worth paying attention to. 00:09:05.057 --> 00:09:06.373 And finally, 00:09:06.373 --> 00:09:10.708 vaccines touch every single life on the planet. 00:09:11.248 --> 00:09:13.710 What other health intervention, 00:09:13.710 --> 00:09:15.407 besides water, 00:09:15.407 --> 00:09:18.406 touches every single life? 00:09:19.171 --> 00:09:22.204 So if you're looking for something to disrupt, 00:09:22.204 --> 00:09:23.902 it's a perfect stage. 00:09:25.122 --> 00:09:29.689 Perhaps that's one of the reasons that we need to pay more attention 00:09:29.689 --> 00:09:32.726 and rebuild our trust in issues. 00:09:33.318 --> 00:09:35.728 People are asking all kinds of questions. 00:09:36.720 --> 00:09:38.354 They're asking, 00:09:38.354 --> 00:09:40.209 why are vaccines -- 00:09:40.209 --> 00:09:44.237 and these are the kinds of things we're hearing in our social media -- 00:09:44.237 --> 00:09:49.356 why can't my child have a personalized vaccination schedule? 00:09:50.223 --> 00:09:52.642 What the wisdom of so many vaccines? 00:09:54.171 --> 00:09:57.148 What about all those ingredients and preservatives? 00:09:57.925 --> 00:10:00.080 These are not crazy people, 00:10:00.080 --> 00:10:02.337 they're not uneducated; 00:10:02.337 --> 00:10:04.510 they're actually worried mothers. 00:10:05.443 --> 00:10:10.658 But some of them have come to me and said we feel ignored, 00:10:10.658 --> 00:10:13.922 we feel judged if we ask a question, 00:10:13.922 --> 00:10:15.604 and we even feel demonized 00:10:15.604 --> 00:10:18.942 that maybe we're part of some antivaccine group. 00:10:20.126 --> 00:10:22.147 So we have some listening to do. 00:10:22.726 --> 00:10:25.305 And maybe that's why last year, 00:10:25.305 --> 00:10:27.324 there was research that found 00:10:27.324 --> 00:10:33.608 that in six months in 2019, 00:10:33.608 --> 00:10:34.888 online -- 00:10:34.888 --> 00:10:36.297 this was with hundreds -- 00:10:36.297 --> 00:10:40.343 100 million different users on social media -- 00:10:40.343 --> 00:10:46.073 although the numbers of individuals who expressed in their online groups 00:10:46.073 --> 00:10:47.734 they were positive, 00:10:47.734 --> 00:10:49.126 as groups, 00:10:49.126 --> 00:10:51.611 the ones who are the most negative 00:10:51.611 --> 00:10:55.446 were recruiting the conversations in the middle 00:10:55.446 --> 00:10:59.513 that were undecided about whether they wanted to get vaccines. 00:10:59.779 --> 00:11:01.293 The highly negative -- 00:11:01.293 --> 00:11:03.640 what we might call the antivaccine groups, 00:11:03.640 --> 00:11:11.463 were recruiting the undecided at a rate 500 percent faster 00:11:11.463 --> 00:11:13.491 than the pro-vaccine groups. 00:11:14.179 --> 00:11:15.974 500 percent faster. 00:11:16.750 --> 00:11:17.878 They were more nimble, 00:11:17.878 --> 00:11:19.278 they were responsive 00:11:19.278 --> 00:11:20.964 and they were listening. 00:11:21.164 --> 00:11:24.367 Most people believe that vaccines are good 00:11:24.367 --> 00:11:26.330 and they believe in their importance. 00:11:26.730 --> 00:11:28.866 But that belief is under attack. 00:11:29.529 --> 00:11:33.553 We need to build in more opportunities for conversation. 00:11:34.059 --> 00:11:35.788 And there are ways to do it. 00:11:35.988 --> 00:11:38.445 It's not easy for some health professionals 00:11:38.445 --> 00:11:41.933 to have conversations where their authority is questioned. 00:11:42.565 --> 00:11:43.944 It's uncomfortable. 00:11:44.435 --> 00:11:47.682 And they're just too busy to listen to all these questions. 00:11:48.446 --> 00:11:50.758 But we need to to do something about that 00:11:50.758 --> 00:11:54.364 because we're losing a lot of concerned parents 00:11:54.364 --> 00:11:56.633 that just want a conversation. 00:11:57.496 --> 00:12:01.770 We should get volunteers trained to sit in waiting rooms, 00:12:01.770 --> 00:12:03.700 to be on hotlines, 00:12:03.700 --> 00:12:06.067 to have online chat forums, 00:12:06.067 --> 00:12:07.686 to have chat boxes. 00:12:08.299 --> 00:12:09.619 In younger kids, 00:12:09.619 --> 00:12:11.602 with younger kids in school, 00:12:11.602 --> 00:12:13.937 teach them about immune systems 00:12:13.937 --> 00:12:15.690 and teach them that actually, 00:12:15.690 --> 00:12:17.982 you know that vaccine your little brother got? 00:12:18.187 --> 00:12:22.620 Well, it just inspired your natural immune system. 00:12:23.579 --> 00:12:26.400 It's a great thing and this is why. 00:12:27.663 --> 00:12:29.454 We need to build that confidence; 00:12:29.454 --> 00:12:30.823 we need to listen. 00:12:32.620 --> 00:12:35.352 Despite all this questioning -- 00:12:35.352 --> 00:12:36.820 and there's a lot of it -- 00:12:36.820 --> 00:12:41.003 I probably hear more than a lot of people -- 00:12:41.003 --> 00:12:42.320 I am an optimist. 00:12:42.570 --> 00:12:46.484 And my optimism is with a younger generation. 00:12:47.175 --> 00:12:52.802 The younger generation who actually now are becoming very aware 00:12:52.802 --> 00:12:55.115 of the risks of social media, 00:12:55.115 --> 00:12:56.638 the false news, 00:12:56.638 --> 00:12:59.904 the false identities, 00:12:59.904 --> 00:13:02.259 and they're starting to embrace science. 00:13:02.884 --> 00:13:08.215 And some of them are a group of children whose mothers refused to vaccinate them. 00:13:10.040 --> 00:13:13.477 Last spring of 2019, 00:13:13.477 --> 00:13:18.672 18-year-old Ethan Lindenburg went on Reddit 00:13:18.672 --> 00:13:20.414 and put out a post. 00:13:21.974 --> 00:13:24.859 "My mother doesn't believe in vaccines. 00:13:24.859 --> 00:13:27.550 She's really worried they cause autism. 00:13:27.550 --> 00:13:29.501 In fact, she strong believes that. 00:13:30.168 --> 00:13:31.388 But I'm 18. 00:13:31.980 --> 00:13:33.658 I'm a senior in high school. 00:13:33.977 --> 00:13:35.418 I can drive a car, 00:13:35.418 --> 00:13:36.524 I can vote, 00:13:36.524 --> 00:13:38.659 and I can go get my own vaccine. 00:13:38.840 --> 00:13:40.955 Can someone tell me where to get it?" 00:13:41.556 --> 00:13:43.742 That post went viral. 00:13:44.174 --> 00:13:47.600 It started to get a whole younger movement going. 00:13:49.538 --> 00:13:52.378 I saw Ethan speak at a conference, 00:13:52.378 --> 00:13:55.825 the Global Vaccine Summit at the EU last fall. 00:13:56.667 --> 00:13:58.635 He spoke eloquently, 00:13:58.635 --> 00:14:00.193 and I was impressed 00:14:00.193 --> 00:14:02.125 in front of a whole forum. 00:14:03.005 --> 00:14:04.967 He told his personal story, 00:14:04.967 --> 00:14:06.593 and then he said to the group, 00:14:06.593 --> 00:14:10.089 he said, "You know, everybody talks about misinformation, 00:14:10.089 --> 00:14:14.247 but I want to tell you about a different kind of misinformation, 00:14:14.247 --> 00:14:19.575 and that's misinformation that says that people like my mother, 00:14:19.575 --> 00:14:21.472 who is loving mother, 00:14:21.472 --> 00:14:25.270 is bad person because she doesn't give me vaccines. 00:14:26.296 --> 00:14:31.189 Well, I want to tell all of you that she didn't give me a vaccine 00:14:31.189 --> 00:14:33.208 because she loves me 00:14:33.208 --> 00:14:37.639 and because she believed that that was the best thing for me. 00:14:38.271 --> 00:14:39.738 I think differently 00:14:39.738 --> 00:14:42.393 and I will never change her mind, 00:14:42.393 --> 00:14:44.465 but she's not a bad person." 00:14:45.506 --> 00:14:48.121 That was the message from a teenager. 00:14:48.806 --> 00:14:52.057 Empathy, kindness and understanding. 00:14:53.123 --> 00:14:56.699 We have an abundance of scientific information 00:14:56.699 --> 00:14:58.640 to debunk false rumors. 00:14:59.616 --> 00:15:01.125 That's not our problem. 00:15:01.838 --> 00:15:04.348 We have a relationship problem, 00:15:04.348 --> 00:15:06.524 not a misinformation problem. 00:15:06.848 --> 00:15:09.461 Misiniformation is a symptom, 00:15:09.461 --> 00:15:10.887 not the cause. 00:15:11.112 --> 00:15:13.075 If people trust, 00:15:13.075 --> 00:15:16.679 they'll put up with a little risk to avert a much bigger one. 00:15:17.613 --> 00:15:21.243 The one thing that I want and I hope for 00:15:21.243 --> 00:15:24.814 is that we as a medical and health community 00:15:24.814 --> 00:15:29.091 have the moral courage and humility 00:15:29.091 --> 00:15:31.443 to productively engage, 00:15:31.443 --> 00:15:32.779 like Ethan, 00:15:32.779 --> 00:15:35.102 with those who disagree with us. 00:15:35.970 --> 00:15:37.098 I hope so. 00:15:37.379 --> 00:15:38.484 Thank you. 00:15:38.732 --> 00:15:40.211 (Applause and cheers)