0:00:01.739,0:00:03.248
I study rumors.

0:00:03.904,0:00:05.468
Not tabloid gossip

0:00:05.468,0:00:08.978
or the kind of rumors that are making[br]stock markets crash --

0:00:08.978,0:00:10.577
or soar --

0:00:10.577,0:00:13.442
but the kind of rumors[br]that affect your health ...

0:00:13.442,0:00:14.934
and the world's health.

0:00:15.302,0:00:17.822
Like eating a lot of garlic

0:00:17.822,0:00:19.117
or drinking a lot of water

0:00:19.117,0:00:22.158
is going to help protect[br]us from coronavirus --

0:00:22.158,0:00:23.358
if only.

0:00:24.325,0:00:26.324
Rumors have a bad reputation.

0:00:26.947,0:00:28.950
They're seen as not fact,

0:00:28.950,0:00:30.484
wrong,

0:00:30.484,0:00:32.607
or "just a rumor."

0:00:33.199,0:00:35.799
But I've studied rumors for years,

0:00:35.799,0:00:39.617
and one thing I've learned[br]is that they all have a story,

0:00:39.617,0:00:41.945
and often, an important story.

0:00:42.190,0:00:48.253
One of the most moving or alarming[br]rumor episodes that I investigated

0:00:48.253,0:00:50.286
was in northern Nigeria.

0:00:50.604,0:00:53.961
I was working with UNICEF's Global[br]Immunization programme.

0:00:55.002,0:00:59.018
And it wasn't the rumors themselves[br]that I found so alarming;

0:00:59.018,0:01:01.798
It was the global impact of those rumors.

0:01:03.079,0:01:04.929
The rumors were suspecting

0:01:04.929,0:01:09.325
that the polio vaccine[br]was actually a contraceptive.

0:01:09.325,0:01:12.244
It was controlling populations --

0:01:12.244,0:01:15.379
or maybe it caused AIDS.

0:01:16.225,0:01:20.220
No, no, maybe it's the CIA[br]spying on them or counting them.

0:01:20.505,0:01:26.297
I mean, why else would they have people[br]knocking on their door again and again

0:01:26.297,0:01:29.411
with the same polio vaccine?

0:01:29.665,0:01:32.550
When children were dying of measles,

0:01:32.550,0:01:35.550
no one was coming with measles vaccines.

0:01:37.693,0:01:40.890
This wasn't about getting the facts right.

0:01:40.890,0:01:42.608
This was about trust.

0:01:42.964,0:01:44.826
It was about broken trust.

0:01:45.475,0:01:47.510
Why so much distrust?

0:01:47.999,0:01:51.652
It wasn't the mothers who were[br]particularly distrusting, actually.

0:01:51.842,0:01:53.644
It was the local leaders,

0:01:53.644,0:01:55.385
the religious leaders,

0:01:55.385,0:01:56.957
the local political leaders.

0:01:57.231,0:02:00.520
It was the governor of the state of Kano

0:02:00.520,0:02:02.361
who decided to boycott

0:02:02.361,0:02:07.096
the entire polio eradication[br]effort in that state ...

0:02:07.096,0:02:09.239
for 11 months.

0:02:10.002,0:02:12.048
Why such distrust?

0:02:12.609,0:02:14.663
Well, it was 2003.

0:02:15.127,0:02:18.111
It was two years after 9/11.

0:02:18.592,0:02:21.951
And they were convinced that the West,

0:02:21.951,0:02:24.035
and particularly the United States,

0:02:24.035,0:02:26.042
was at war with Muslims.

0:02:26.393,0:02:28.645
And they knew that the West,

0:02:28.645,0:02:30.900
and particularly the United States,

0:02:30.900,0:02:32.621
was a huge supporter --

0:02:32.621,0:02:33.993
and funder --

0:02:33.993,0:02:36.672
of the global polio[br]eradication initiative.

0:02:36.950,0:02:38.851
They had their reasoning.

0:02:39.700,0:02:42.670
That lack of trust,

0:02:42.670,0:02:46.165
that "just a rumor or two"

0:02:46.165,0:02:52.364
cost the polio eradication program[br]500 million dollars

0:02:52.364,0:02:54.054
to reset the clock,

0:02:54.054,0:02:57.990
to regain the progress lost[br]during those 11 months

0:02:57.990,0:02:59.342
and beyond.

0:02:59.603,0:03:05.507
The Nigerian strain of the polio virus[br]traveled to over 20 countries,

0:03:05.507,0:03:07.567
as far as Indonesia.

0:03:08.706,0:03:10.655
The cost of a rumor.

0:03:11.795,0:03:15.989
The Nigeria episode was one[br]of many episodes that I investigated

0:03:15.989,0:03:17.432
when I was with UNICEF

0:03:17.432,0:03:22.258
and earned the title of the "director[br]of UNICEF's fire department."

0:03:22.891,0:03:23.886
(Laughing)

0:03:23.886,0:03:24.848
We --

0:03:24.848,0:03:27.939
at that point I realized[br]I never really had enough time.

0:03:28.309,0:03:30.396
I was too busy putting out the fires,

0:03:30.396,0:03:32.475
and not enough time to understand

0:03:32.475,0:03:36.495
what was driving not just[br]the individual episodes,

0:03:36.495,0:03:40.727
but why was there an epidemic[br]of these happening around the world.

0:03:41.289,0:03:45.086
I left UNICEF and went[br]back to research --

0:03:45.086,0:03:47.274
applied research --

0:03:47.274,0:03:54.189
and I set up in 2010 what I called[br]the Vaccine Confidence Project

0:03:54.189,0:03:57.575
at the London School of Hygiene[br]and Tropical Medicine.

0:03:58.251,0:04:00.189
I convened anthropologists,

0:04:00.189,0:04:01.501
epidemiologists,

0:04:01.501,0:04:03.022
psychologists,

0:04:03.022,0:04:06.023
digital media specialists

0:04:06.023,0:04:07.898
and mathematical modelers.

0:04:08.499,0:04:10.878
We set ourselves the task

0:04:10.878,0:04:15.196
to investigate historic[br]episodes of rumors

0:04:15.196,0:04:17.133
and their impacts,

0:04:17.133,0:04:21.185
from trying to figure out[br]what were the early signals,

0:04:21.185,0:04:22.990
what were the amplifying factors

0:04:22.990,0:04:24.734
and the impacts,

0:04:24.734,0:04:26.551
how did they get traction,

0:04:26.551,0:04:30.486
so we could start to understand[br]what we should be looking for,

0:04:30.486,0:04:32.160
how we could help governments

0:04:32.160,0:04:37.101
and immunization programs[br]be more alert and responsive

0:04:37.101,0:04:39.588
to early signals of problems.

0:04:40.067,0:04:42.060
It was an early warning system.

0:04:42.622,0:04:46.943
In 2015, we developed[br]a vaccine confidence index.

0:04:47.540,0:04:53.737
It's a survey trying to investigate[br]to what extent do people agree

0:04:53.737,0:04:56.811
or disagree that vaccines are important,

0:04:56.811,0:04:58.148
they're safe,

0:04:58.148,0:04:59.259
they're effective --

0:04:59.259,0:05:00.391
they work --

0:05:00.391,0:05:03.448
and somehow they're compatible[br]with my religious beliefs.

0:05:03.888,0:05:08.585
We've run this with over hundreds[br]of thousands of people around the world,

0:05:08.585,0:05:13.817
trying to get our finger on the pulse[br]of confidence and trust,

0:05:13.817,0:05:19.819
but also, more importantly, looking[br]at when that trust goes up or down,

0:05:19.819,0:05:23.411
because we want to see[br]when it starts to decline,

0:05:23.411,0:05:25.773
that's the time to jump in,

0:05:25.773,0:05:30.769
to get there before there's a crisis[br]like the Nigerian one.

0:05:31.667,0:05:36.838
We also set up 24-7 media and social media[br]monitoring around the world --

0:05:36.838,0:05:38.596
multilanguage --

0:05:38.596,0:05:42.956
listening for what's going on[br]in vaccine conversations,

0:05:42.956,0:05:46.861
trying to pick up early concerns[br]or changes in sentiment

0:05:46.861,0:05:48.996
that we should be paying attention to.

0:05:49.344,0:05:54.236
We've created an ecosystem[br]of different types of information

0:05:54.236,0:05:55.983
to try to understand:

0:05:55.983,0:05:59.749
what are the public thinking[br]and how can we engage?

0:06:00.289,0:06:01.760
We look for early signals.

0:06:01.760,0:06:03.222
When we find one,

0:06:03.222,0:06:07.012
we have a global network of collaborators[br]in a number of countries

0:06:07.012,0:06:09.794
who have more local [br]intelligence in that setting

0:06:09.794,0:06:11.510
to try to understand --

0:06:11.510,0:06:13.865
is this signal misinformation,

0:06:13.865,0:06:16.654
or is something brewing[br]that we should know about?

0:06:17.449,0:06:19.338
In London, we have a bigger picture.

0:06:19.338,0:06:23.609
We watch the swarms of rumors[br]not just traveling locally

0:06:23.609,0:06:25.245
but jumping countries.

0:06:25.563,0:06:29.221
We've seen them jump[br]from Japan over to Columbia,

0:06:29.221,0:06:31.097
through Europe and around.

0:06:31.270,0:06:32.459
They move.

0:06:32.499,0:06:35.563
We live in a hyper-connected environment.

0:06:36.053,0:06:38.992
One of the things[br]that we found fascinating,

0:06:38.992,0:06:41.326
and we've learned[br]a lot in the last 10 years --

0:06:41.326,0:06:43.830
this is our 10th anniversary,

0:06:43.830,0:06:45.367
this didn't start yesterday,

0:06:45.367,0:06:46.958
this rumor problem --

0:06:46.958,0:06:48.752
and one of the things we've learned

0:06:48.752,0:06:51.053
is in our global monitoring,

0:06:51.053,0:06:55.081
that Europe is the most[br]skeptical region in the world.

0:06:55.357,0:06:57.324
France won the prize, actually.

0:06:57.503,0:06:58.495
(Laughter)

0:06:58.495,0:06:59.631
By far.

0:07:00.119,0:07:04.246
And actually some of those rumors[br]have traveled to other parts of the world.

0:07:05.114,0:07:07.261
But we were trying to understand Europe.

0:07:07.261,0:07:08.258
Hmm.

0:07:08.258,0:07:09.257
Why Europe?

0:07:09.257,0:07:11.229
I thought the US was really --

0:07:11.229,0:07:13.093
had some of the most skepticism,

0:07:13.093,0:07:15.253
but boy, I was wrong.

0:07:15.492,0:07:16.923
And a political scientist,

0:07:16.923,0:07:18.564
a colleague we work with,

0:07:18.564,0:07:20.248
Jon Kennedy,

0:07:20.248,0:07:24.242
he took our data from 28[br]European countries

0:07:24.242,0:07:25.528
and he looked at it

0:07:25.528,0:07:28.447
and correlated it[br]with political opinion polling.

0:07:29.323,0:07:30.896
And what did he find?

0:07:31.095,0:07:37.242
He found that people who are most likely[br]to vote for a populist party

0:07:37.242,0:07:40.795
also were the ones most likely[br]to strongly disagree

0:07:40.795,0:07:43.844
that vaccines were important,[br]safe or effective.

0:07:44.439,0:07:45.798
What did we learn?

0:07:46.116,0:07:51.187
Vaccines cannot escape[br]the politcal and social turbulance

0:07:51.187,0:07:52.562
that surrounds it.

0:07:52.726,0:07:57.978
Scientists were unprepared[br]for this tsunami of doubt

0:07:57.978,0:07:59.173
and questions

0:07:59.173,0:08:00.462
and distrust.

0:08:00.757,0:08:01.842
What --

0:08:01.842,0:08:05.592
why are vaccines so ripe for resistance?

0:08:06.229,0:08:08.133
Well, we identified a number of things,

0:08:08.133,0:08:09.401
but one:

0:08:09.401,0:08:14.129
they're highly mediated by government[br]that requires, regulates

0:08:14.129,0:08:17.973
and sometimes recommends vaccines --

0:08:17.973,0:08:20.933
or often recommends[br]and sometimes requires.

0:08:22.114,0:08:24.446
Big business makes vaccines,

0:08:24.446,0:08:25.989
and neither institution,

0:08:25.989,0:08:27.981
government or big business,

0:08:27.981,0:08:30.783
are high in the trust ranks these days.

0:08:31.231,0:08:34.951
And then there's scientists[br]who discover and develop vaccines,

0:08:34.951,0:08:36.882
and they're pretty elite

0:08:36.882,0:08:39.540
and not accessible to the general public,

0:08:39.540,0:08:41.617
at least the language they speak.

0:08:42.780,0:08:48.396
Third, we're in a hyper-connected[br]environment with social media these days,

0:08:48.396,0:08:55.324
and people can share their unfettered[br]views, concerns, anxieties and worries

0:08:55.324,0:08:58.607
and find a lot of people[br]that think the way they do,

0:08:58.607,0:09:04.374
and think maybe their worries[br]are worth paying attention to.

0:09:04.982,0:09:06.332
And finally,

0:09:06.332,0:09:10.667
vaccines touch every single[br]life on the planet.

0:09:11.190,0:09:13.652
What other health intervention,

0:09:13.652,0:09:15.824
besides water,

0:09:15.824,0:09:18.406
touches every single life?

0:09:19.078,0:09:22.155
So if you're looking[br]for something to disrupt,

0:09:22.155,0:09:23.998
it's a perfect stage.

0:09:25.089,0:09:29.567
Perhaps that's one of the reasons[br]that we need to pay more attention

0:09:29.567,0:09:32.772
and rebuild our trust in issues.

0:09:33.177,0:09:35.824
People are asking all kinds of questions.

0:09:36.558,0:09:38.241
They're asking,

0:09:38.241,0:09:40.209
why are vaccines --

0:09:40.209,0:09:44.091
and these are the kinds of things[br]we're hearing in our social media --

0:09:44.091,0:09:49.356
why can't my child have[br]a personalized vaccination schedule?

0:09:50.151,0:09:52.807
What's the wisdom of so many vaccines?

0:09:54.010,0:09:57.207
What about all those ingredients[br]and preservatives?

0:09:57.784,0:09:59.939
These are not crazy people,

0:09:59.939,0:10:02.307
they're not uneducated;

0:10:02.307,0:10:04.480
they're actually worried mothers.

0:10:05.363,0:10:10.578
But some of them have come[br]to me and said we feel ignored,

0:10:10.578,0:10:13.842
we feel judged if we ask a question,

0:10:13.842,0:10:15.524
and we even feel demonized

0:10:15.524,0:10:18.732
that maybe we're part of some[br]antivaccine group.

0:10:20.067,0:10:22.088
So we have some listening to do.

0:10:22.651,0:10:25.230
And maybe that's why last year,

0:10:25.230,0:10:27.249
there was research that found

0:10:27.249,0:10:33.450
that in six months in 2019,

0:10:33.450,0:10:34.732
online --

0:10:34.732,0:10:36.223
this was with hundreds --

0:10:36.223,0:10:40.269
100 million different users[br]on social media --

0:10:40.269,0:10:45.999
although the numbers of individuals[br]who expressed in their online groups

0:10:45.999,0:10:47.720
they were positive,

0:10:47.720,0:10:49.112
as groups,

0:10:49.112,0:10:51.478
the ones who are the most negative

0:10:51.478,0:10:55.402
were recruiting[br]the conversations in the middle

0:10:55.402,0:10:59.173
that were undecided about whether[br]they wanted to get vaccines.

0:10:59.642,0:11:01.156
The highly negative --

0:11:01.156,0:11:03.605
what we might call[br]the antivaccine groups --

0:11:03.605,0:11:06.727
were recruiting the undecided

0:11:06.727,0:11:11.324
at a rate 500 percent faster

0:11:11.324,0:11:13.566
than the pro-vaccine groups.

0:11:14.096,0:11:15.891
500 percent faster.

0:11:16.591,0:11:17.839
They were more nimble,

0:11:17.839,0:11:19.278
they were responsive

0:11:19.278,0:11:20.772
and they were listening.

0:11:20.772,0:11:24.222
Most people believe that vaccines are good

0:11:24.222,0:11:26.185
and they believe in their importance.

0:11:26.663,0:11:28.799
But that belief is under attack.

0:11:29.410,0:11:33.434
We need to build in more[br]opportunities for conversation.

0:11:33.869,0:11:35.598
And there are ways to do it.

0:11:35.841,0:11:38.518
It's not easy for some[br]health professionals

0:11:38.518,0:11:41.933
to have conversations where[br]their authority is questioned.

0:11:42.380,0:11:44.047
It's uncomfortable.

0:11:44.362,0:11:47.815
And they're just too busy[br]to listen to all these questions.

0:11:48.338,0:11:50.520
But we need to to do something about that

0:11:50.520,0:11:54.191
because we're losing[br]a lot of concerned parents

0:11:54.191,0:11:56.709
that just want a conversation.

0:11:57.321,0:12:01.700
We should get volunteers[br]trained to sit in waiting rooms,

0:12:01.700,0:12:03.630
to be on hotlines,

0:12:03.630,0:12:05.997
to have online chat forums,

0:12:05.997,0:12:07.616
to have chat boxes.

0:12:08.099,0:12:09.541
In younger kids,

0:12:09.541,0:12:11.548
with younger kids in school,

0:12:11.548,0:12:13.908
teach them about immune systems

0:12:13.908,0:12:15.607
and teach them that actually,

0:12:15.607,0:12:18.159
you know that vaccine[br]your little brother got?

0:12:18.159,0:12:22.858
Well, it just inspired[br]your natural immune system.

0:12:23.479,0:12:26.551
It's a great thing and this is why.

0:12:27.494,0:12:29.346
We need to build that confidence;

0:12:29.346,0:12:30.883
we need to listen.

0:12:32.482,0:12:35.214
Despite all this questioning --

0:12:35.214,0:12:36.775
and there's a lot of it --

0:12:36.775,0:12:40.867
I hear probably more[br]than a lot of people --

0:12:40.867,0:12:42.275
I am an optimist.

0:12:42.526,0:12:46.677
And my optimism is with[br]a younger generation.

0:12:47.094,0:12:52.641
The younger generation who actually now[br]are becoming very aware

0:12:52.641,0:12:55.091
of the risks of social media,

0:12:55.091,0:12:56.887
the false news,

0:12:56.887,0:12:59.705
the false identities,

0:12:59.705,0:13:02.259
and they're starting to embrace science.

0:13:02.753,0:13:08.386
And some of them are a group of children[br]whose mothers refused to vaccinate them.

0:13:09.879,0:13:13.385
Last spring of 2019,

0:13:13.385,0:13:18.491
18-year-old Ethan[br]Lindenberger went on Reddit

0:13:18.491,0:13:20.020
and put out a post.

0:13:21.930,0:13:24.637
"My mother doesn't believe in vaccines.

0:13:24.637,0:13:27.328
She's really worried they cause autism.

0:13:27.550,0:13:29.677
In fact, she strongly believes that.

0:13:30.017,0:13:31.407
But I'm 18.

0:13:31.904,0:13:33.582
I'm a senior in high school.

0:13:33.767,0:13:35.297
I can drive a car,

0:13:35.297,0:13:36.361
I can vote

0:13:36.361,0:13:38.538
and I could go get my own vaccine.

0:13:38.809,0:13:41.127
Can someone tell me where to get it?"

0:13:41.453,0:13:43.639
That post went viral.

0:13:43.990,0:13:47.746
It started to get a whole[br]younger movement going.

0:13:49.397,0:13:52.378
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.

0:13:56.600,0:13:58.568
He spoke eloquently,

0:13:58.568,0:14:00.126
and I was impressed

0:14:00.126,0:14:02.272
in front of a whole forum.

0:14:02.809,0:14:04.877
He told his personal story,

0:14:04.877,0:14:06.614
and then he said to the group,

0:14:06.614,0:14:10.130
he said, "You know, everybody[br]talks about misinformation,

0:14:10.130,0:14:14.164
but I want to tell you about[br]a different kind of misinformation,

0:14:14.164,0:14:19.475
and that's misinformation that says[br]that people like my mother,

0:14:19.475,0:14:21.472
who is a loving mother,

0:14:21.472,0:14:25.566
is a bad person because[br]she doesn't give me vaccines.

0:14:26.237,0:14:31.075
Well, I want to tell all of you[br]that she didn't give me a vaccine

0:14:31.075,0:14:33.149
because she loves me

0:14:33.149,0:14:37.719
and because she believed that[br]that was the best thing for me.

0:14:38.162,0:14:39.629
I think differently

0:14:39.629,0:14:42.284
and I will never change her mind,

0:14:42.284,0:14:44.560
but she's not a bad person."

0:14:45.324,0:14:48.096
That was the message from a teenager.

0:14:48.731,0:14:51.982
Empathy, kindness and understanding.

0:14:53.068,0:14:56.644
We have an abundance[br]of scientific information

0:14:56.644,0:14:58.842
to debunk false rumors.

0:14:59.616,0:15:01.195
That's not our problem.

0:15:01.696,0:15:04.266
We have a relationship problem,

0:15:04.266,0:15:06.442
not a misinformation problem.

0:15:06.739,0:15:09.352
Misinformation is the symptom,

0:15:09.352,0:15:10.678
not the cause.

0:15:11.038,0:15:13.001
If people trust,

0:15:13.001,0:15:16.846
they'll put up with a little risk[br]to avert a much bigger one.

0:15:17.489,0:15:21.119
The one thing that I want and I hope for

0:15:21.119,0:15:24.716
is that we as a medical[br]and health community

0:15:24.716,0:15:28.970
have the moral courage and humility

0:15:28.970,0:15:31.398
to productively engage,

0:15:31.398,0:15:32.801
like Ethan,

0:15:32.801,0:15:35.328
with those who disagree with us.

0:15:35.889,0:15:37.007
I hope so.

0:15:37.306,0:15:38.411
Thank you.

0:15:38.550,0:15:40.335
(Applause and cheers)