WEBVTT 00:00:01.739 --> 00:00:03.248 I study rumors. 00:00:03.904 --> 00:00:05.468 Not tabloid gossip 00:00:05.468 --> 00:00:08.978 or the kind of rumors that are making stock markets crash -- 00:00:08.978 --> 00:00:10.577 or soar -- 00:00:10.577 --> 00:00:13.442 but the kind of rumors that affect your health ... 00:00:13.442 --> 00:00:14.934 and the world's health. 00:00:15.302 --> 00:00:17.822 Like eating a lot of garlic 00:00:17.822 --> 00:00:19.117 or drinking a lot of water 00:00:19.117 --> 00:00:22.158 is going to help protect us from coronavirus -- 00:00:22.158 --> 00:00:23.358 if only. 00:00:24.325 --> 00:00:26.324 Rumors have a bad reputation. 00:00:26.947 --> 00:00:28.950 They're seen as not fact, 00:00:28.950 --> 00:00:30.484 wrong, 00:00:30.484 --> 00:00:32.607 or "just a rumor." 00:00:33.199 --> 00:00:35.799 But I've studied rumors for years, 00:00:35.799 --> 00:00:39.617 and one thing I've learned is that they all have a story, 00:00:39.617 --> 00:00:41.945 and often, an important story. NOTE Paragraph 00:00:42.190 --> 00:00:48.253 One of the most moving or alarming rumor episodes that I investigated 00:00:48.253 --> 00:00:50.286 was in northern Nigeria. 00:00:50.604 --> 00:00:53.961 I was working with UNICEF's Global Immunization programme. 00:00:55.002 --> 00:00:59.018 And it wasn't the rumors themselves that I found so alarming; 00:00:59.018 --> 00:01:01.798 It was the global impact of those rumors. 00:01:03.079 --> 00:01:04.929 The rumors were suspecting 00:01:04.929 --> 00:01:09.325 that the polio vaccine was actually a contraceptive. 00:01:09.325 --> 00:01:12.244 It was controlling populations -- 00:01:12.244 --> 00:01:15.379 or maybe it caused AIDS. 00:01:16.225 --> 00:01:20.220 No, no, maybe it's the CIA spying on them or counting them. 00:01:20.505 --> 00:01:26.297 I mean, why else would they have people knocking on their door again and again 00:01:26.297 --> 00:01:29.411 with the same polio vaccine? 00:01:29.665 --> 00:01:32.550 When children were dying of measles, 00:01:32.550 --> 00:01:35.550 no one was coming with measles vaccines. 00:01:37.693 --> 00:01:40.890 This wasn't about getting the facts right. 00:01:40.890 --> 00:01:42.608 This was about trust. 00:01:42.964 --> 00:01:44.826 It was about broken trust. 00:01:45.475 --> 00:01:47.510 Why so much distrust? 00:01:47.999 --> 00:01:51.652 It wasn't the mothers who were particularly distrusting, actually. 00:01:51.842 --> 00:01:53.644 It was the local leaders, 00:01:53.644 --> 00:01:55.385 the religious leaders, 00:01:55.385 --> 00:01:56.957 the local political leaders. 00:01:57.231 --> 00:02:00.520 It was the governor of the state of Kano 00:02:00.520 --> 00:02:02.361 who decided to boycott 00:02:02.361 --> 00:02:07.096 the entire polio eradication effort in that state ... 00:02:07.096 --> 00:02:09.239 for 11 months. NOTE Paragraph 00:02:10.002 --> 00:02:12.048 Why such distrust? 00:02:12.609 --> 00:02:14.663 Well, it was 2003. 00:02:15.127 --> 00:02:18.111 It was two years after 9/11. 00:02:18.592 --> 00:02:21.951 And they were convinced that the West, 00:02:21.951 --> 00:02:24.035 and particularly the United States, 00:02:24.035 --> 00:02:26.042 was at war with Muslims. 00:02:26.393 --> 00:02:28.645 And they knew that the West, 00:02:28.645 --> 00:02:30.900 and particularly the United States, 00:02:30.900 --> 00:02:32.621 was a huge supporter -- 00:02:32.621 --> 00:02:33.993 and funder -- 00:02:33.993 --> 00:02:36.672 of the global polio eradication initiative. 00:02:36.950 --> 00:02:38.851 They had their reasoning. 00:02:39.700 --> 00:02:42.670 That lack of trust, 00:02:42.670 --> 00:02:46.165 that "just a rumor or two" 00:02:46.165 --> 00:02:52.364 cost the polio eradication program 500 million dollars 00:02:52.364 --> 00:02:54.054 to reset the clock, 00:02:54.054 --> 00:02:57.990 to regain the progress lost during those 11 months 00:02:57.990 --> 00:02:59.342 and beyond. 00:02:59.603 --> 00:03:05.507 The Nigerian strain of the polio virus traveled to over 20 countries, 00:03:05.507 --> 00:03:07.567 as far as Indonesia. 00:03:08.706 --> 00:03:10.655 The cost of a rumor. NOTE Paragraph 00:03:11.795 --> 00:03:15.989 The Nigeria episode was one of many episodes that I investigated 00:03:15.989 --> 00:03:17.432 when I was with UNICEF 00:03:17.432 --> 00:03:22.258 and earned the title of the "director of UNICEF's fire department." NOTE Paragraph 00:03:22.891 --> 00:03:23.886 (Laughing) NOTE Paragraph 00:03:23.886 --> 00:03:24.848 We -- 00:03:24.848 --> 00:03:27.939 at that point I realized I never really had enough time. 00:03:28.309 --> 00:03:30.396 I was too busy putting out the fires, 00:03:30.396 --> 00:03:32.475 and not enough time to understand 00:03:32.475 --> 00:03:36.495 what was driving not just the individual episodes, 00:03:36.495 --> 00:03:40.727 but why was there an epidemic of these happening around the world. NOTE Paragraph 00:03:41.289 --> 00:03:45.086 I left UNICEF and went back to research -- 00:03:45.086 --> 00:03:47.274 applied research -- 00:03:47.274 --> 00:03:54.189 and I set up in 2010 what I called the Vaccine Confidence Project 00:03:54.189 --> 00:03:57.575 at the London School of Hygiene and Tropical Medicine. 00:03:58.251 --> 00:04:00.189 I convened anthropologists, 00:04:00.189 --> 00:04:01.501 epidemiologists, 00:04:01.501 --> 00:04:03.022 psychologists, 00:04:03.022 --> 00:04:06.023 digital media specialists 00:04:06.023 --> 00:04:07.898 and mathematical modelers. 00:04:08.499 --> 00:04:10.878 We set ourselves the task 00:04:10.878 --> 00:04:15.196 to investigate historic episodes of rumors 00:04:15.196 --> 00:04:17.133 and their impacts, 00:04:17.133 --> 00:04:21.185 from trying to figure out what were the early signals, 00:04:21.185 --> 00:04:22.990 what were the amplifying factors 00:04:22.990 --> 00:04:24.734 and the impacts, 00:04:24.734 --> 00:04:26.551 how did they get traction, 00:04:26.551 --> 00:04:30.486 so we could start to understand what we should be looking for, 00:04:30.486 --> 00:04:32.160 how we could help governments 00:04:32.160 --> 00:04:37.101 and immunization programs be more alert and responsive 00:04:37.101 --> 00:04:39.588 to early signals of problems. 00:04:40.067 --> 00:04:42.060 It was an early warning system. NOTE Paragraph 00:04:42.622 --> 00:04:46.943 In 2015, we developed a vaccine confidence index. 00:04:47.540 --> 00:04:53.737 It's a survey trying to investigate to what extent do people agree 00:04:53.737 --> 00:04:56.811 or disagree that vaccines are important, 00:04:56.811 --> 00:04:58.148 they're safe, 00:04:58.148 --> 00:04:59.259 they're effective -- 00:04:59.259 --> 00:05:00.391 they work -- 00:05:00.391 --> 00:05:03.448 and somehow they're compatible with my religious beliefs. 00:05:03.888 --> 00:05:08.585 We've run this with over hundreds of thousands of people around the world, 00:05:08.585 --> 00:05:13.817 trying to get our finger on the pulse of confidence and trust, 00:05:13.817 --> 00:05:19.819 but also, more importantly, looking at when that trust goes up or down, 00:05:19.819 --> 00:05:23.411 because we want to see when it starts to decline, 00:05:23.411 --> 00:05:25.773 that's the time to jump in, 00:05:25.773 --> 00:05:30.769 to get there before there's a crisis like the Nigerian one. 00:05:31.667 --> 00:05:36.838 We also set up 24-7 media and social media monitoring around the world -- 00:05:36.838 --> 00:05:38.596 multilanguage -- 00:05:38.596 --> 00:05:42.956 listening for what's going on in vaccine conversations, 00:05:42.956 --> 00:05:46.861 trying to pick up early concerns or changes in sentiment 00:05:46.861 --> 00:05:48.996 that we should be paying attention to. 00:05:49.344 --> 00:05:54.236 We've created an ecosystem of different types of information 00:05:54.236 --> 00:05:55.983 to try to understand: 00:05:55.983 --> 00:05:59.749 what are the public thinking and how can we engage? 00:06:00.289 --> 00:06:01.760 We look for early signals. 00:06:01.760 --> 00:06:03.222 When we find one, 00:06:03.222 --> 00:06:07.012 we have a global network of collaborators in a number of countries 00:06:07.012 --> 00:06:09.794 who have more local intelligence in that setting 00:06:09.794 --> 00:06:11.510 to try to understand -- 00:06:11.510 --> 00:06:13.865 is this signal misinformation, 00:06:13.865 --> 00:06:16.654 or is something brewing that we should know about? NOTE Paragraph 00:06:17.449 --> 00:06:19.338 In London, we have a bigger picture. 00:06:19.338 --> 00:06:23.609 We watch the swarms of rumors not just traveling locally 00:06:23.609 --> 00:06:25.245 but jumping countries. 00:06:25.563 --> 00:06:29.221 We've seen them jump from Japan over to Columbia, 00:06:29.221 --> 00:06:31.097 through Europe and around. 00:06:31.270 --> 00:06:32.459 They move. 00:06:32.499 --> 00:06:35.563 We live in a hyper-connected environment. 00:06:36.053 --> 00:06:38.992 One of the things that we found fascinating, 00:06:38.992 --> 00:06:41.326 and we've learned a lot in the last 10 years -- 00:06:41.326 --> 00:06:43.830 this is our 10th anniversary, 00:06:43.830 --> 00:06:45.367 this didn't start yesterday, 00:06:45.367 --> 00:06:46.958 this rumor problem -- 00:06:46.958 --> 00:06:48.752 and one of the things we've learned 00:06:48.752 --> 00:06:51.053 is in our global monitoring, 00:06:51.053 --> 00:06:55.081 that Europe is the most skeptical region in the world. 00:06:55.357 --> 00:06:57.324 France won the prize, actually. NOTE Paragraph 00:06:57.503 --> 00:06:58.495 (Laughter) NOTE Paragraph 00:06:58.495 --> 00:06:59.631 By far. 00:07:00.119 --> 00:07:04.246 And actually some of those rumors have traveled to other parts of the world. 00:07:05.114 --> 00:07:07.261 But we were trying to understand Europe. 00:07:07.261 --> 00:07:08.258 Hmm. 00:07:08.258 --> 00:07:09.257 Why Europe? 00:07:09.257 --> 00:07:11.229 I thought the US was really -- 00:07:11.229 --> 00:07:13.093 had some of the most skepticism, 00:07:13.093 --> 00:07:15.253 but boy, I was wrong. 00:07:15.492 --> 00:07:16.923 And a political scientist, 00:07:16.923 --> 00:07:18.564 a colleague we work with, 00:07:18.564 --> 00:07:20.248 Jon Kennedy, 00:07:20.248 --> 00:07:24.242 he took our data from 28 European countries 00:07:24.242 --> 00:07:25.528 and he looked at it 00:07:25.528 --> 00:07:28.447 and correlated it with political opinion polling. 00:07:29.323 --> 00:07:30.896 And what did he find? 00:07:31.095 --> 00:07:37.242 He found that people who are most likely to vote for a populist party 00:07:37.242 --> 00:07:40.795 also were the ones most likely to strongly disagree 00:07:40.795 --> 00:07:43.844 that vaccines were important, safe or effective. 00:07:44.439 --> 00:07:45.798 What did we learn? 00:07:46.116 --> 00:07:51.187 Vaccines cannot escape the politcal and social turbulance 00:07:51.187 --> 00:07:52.562 that surrounds it. 00:07:52.726 --> 00:07:57.978 Scientists were unprepared for this tsunami of doubt 00:07:57.978 --> 00:07:59.173 and questions 00:07:59.173 --> 00:08:00.462 and distrust. NOTE Paragraph 00:08:00.757 --> 00:08:01.842 What -- 00:08:01.842 --> 00:08:05.592 why are vaccines so ripe for resistance? 00:08:06.229 --> 00:08:08.133 Well, we identified a number of things, 00:08:08.133 --> 00:08:09.401 but one: 00:08:09.401 --> 00:08:14.129 they're highly mediated by government that requires, regulates 00:08:14.129 --> 00:08:17.973 and sometimes recommends vaccines -- 00:08:17.973 --> 00:08:20.933 or often recommends and sometimes requires. 00:08:22.114 --> 00:08:24.446 Big business makes vaccines, 00:08:24.446 --> 00:08:25.989 and neither institution, 00:08:25.989 --> 00:08:27.981 government or big business, 00:08:27.981 --> 00:08:30.783 are high in the trust ranks these days. 00:08:31.231 --> 00:08:34.951 And then there's scientists who discover and develop vaccines, 00:08:34.951 --> 00:08:36.882 and they're pretty elite 00:08:36.882 --> 00:08:39.540 and not accessible to the general public, 00:08:39.540 --> 00:08:41.617 at least the language they speak. 00:08:42.780 --> 00:08:48.396 Third, we're in a hyper-connected environment with social media these days, 00:08:48.396 --> 00:08:55.324 and people can share their unfettered views, concerns, anxieties and worries 00:08:55.324 --> 00:08:58.607 and find a lot of people that think the way they do, 00:08:58.607 --> 00:09:04.374 and think maybe their worries are worth paying attention to. 00:09:04.982 --> 00:09:06.332 And finally, 00:09:06.332 --> 00:09:10.667 vaccines touch every single life on the planet. 00:09:11.190 --> 00:09:13.652 What other health intervention, 00:09:13.652 --> 00:09:15.824 besides water, 00:09:15.824 --> 00:09:18.406 touches every single life? 00:09:19.078 --> 00:09:22.155 So if you're looking for something to disrupt, 00:09:22.155 --> 00:09:23.998 it's a perfect stage. NOTE Paragraph 00:09:25.089 --> 00:09:29.567 Perhaps that's one of the reasons that we need to pay more attention 00:09:29.567 --> 00:09:32.772 and rebuild our trust in issues. 00:09:33.177 --> 00:09:35.824 People are asking all kinds of questions. 00:09:36.558 --> 00:09:38.241 They're asking, 00:09:38.241 --> 00:09:40.209 why are vaccines -- 00:09:40.209 --> 00:09:44.091 and these are the kinds of things we're hearing in our social media -- 00:09:44.091 --> 00:09:49.356 why can't my child have a personalized vaccination schedule? 00:09:50.151 --> 00:09:52.807 What's the wisdom of so many vaccines? 00:09:54.010 --> 00:09:57.207 What about all those ingredients and preservatives? 00:09:57.784 --> 00:09:59.939 These are not crazy people, 00:09:59.939 --> 00:10:02.307 they're not uneducated; 00:10:02.307 --> 00:10:04.480 they're actually worried mothers. 00:10:05.363 --> 00:10:10.578 But some of them have come to me and said we feel ignored, 00:10:10.578 --> 00:10:13.842 we feel judged if we ask a question, 00:10:13.842 --> 00:10:15.524 and we even feel demonized 00:10:15.524 --> 00:10:18.732 that maybe we're part of some antivaccine group. NOTE Paragraph 00:10:20.067 --> 00:10:22.088 So we have some listening to do. 00:10:22.651 --> 00:10:25.230 And maybe that's why last year, 00:10:25.230 --> 00:10:27.249 there was research that found 00:10:27.249 --> 00:10:33.450 that in six months in 2019, 00:10:33.450 --> 00:10:34.732 online -- 00:10:34.732 --> 00:10:36.223 this was with hundreds -- 00:10:36.223 --> 00:10:40.269 100 million different users on social media -- 00:10:40.269 --> 00:10:45.999 although the numbers of individuals who expressed in their online groups 00:10:45.999 --> 00:10:47.720 they were positive, 00:10:47.720 --> 00:10:49.112 as groups, 00:10:49.112 --> 00:10:51.478 the ones who are the most negative 00:10:51.478 --> 00:10:55.402 were recruiting the conversations in the middle 00:10:55.402 --> 00:10:59.173 that were undecided about whether they wanted to get vaccines. 00:10:59.642 --> 00:11:01.156 The highly negative -- 00:11:01.156 --> 00:11:03.605 what we might call the antivaccine groups -- 00:11:03.605 --> 00:11:06.727 were recruiting the undecided 00:11:06.727 --> 00:11:11.324 at a rate 500 percent faster 00:11:11.324 --> 00:11:13.566 than the pro-vaccine groups. 00:11:14.096 --> 00:11:15.891 500 percent faster. 00:11:16.591 --> 00:11:17.839 They were more nimble, 00:11:17.839 --> 00:11:19.278 they were responsive 00:11:19.278 --> 00:11:20.772 and they were listening. 00:11:20.772 --> 00:11:24.222 Most people believe that vaccines are good 00:11:24.222 --> 00:11:26.185 and they believe in their importance. 00:11:26.663 --> 00:11:28.799 But that belief is under attack. 00:11:29.410 --> 00:11:33.434 We need to build in more opportunities for conversation. 00:11:33.869 --> 00:11:35.598 And there are ways to do it. NOTE Paragraph 00:11:35.841 --> 00:11:38.518 It's not easy for some health professionals 00:11:38.518 --> 00:11:41.933 to have conversations where their authority is questioned. 00:11:42.380 --> 00:11:44.047 It's uncomfortable. 00:11:44.362 --> 00:11:47.815 And they're just too busy to listen to all these questions. 00:11:48.338 --> 00:11:50.520 But we need to to do something about that 00:11:50.520 --> 00:11:54.191 because we're losing a lot of concerned parents 00:11:54.191 --> 00:11:56.709 that just want a conversation. 00:11:57.321 --> 00:12:01.700 We should get volunteers trained to sit in waiting rooms, 00:12:01.700 --> 00:12:03.630 to be on hotlines, 00:12:03.630 --> 00:12:05.997 to have online chat forums, 00:12:05.997 --> 00:12:07.616 to have chat boxes. 00:12:08.099 --> 00:12:09.541 In younger kids, 00:12:09.541 --> 00:12:11.548 with younger kids in school, 00:12:11.548 --> 00:12:13.908 teach them about immune systems 00:12:13.908 --> 00:12:15.607 and teach them that actually, 00:12:15.607 --> 00:12:18.159 you know that vaccine your little brother got? 00:12:18.159 --> 00:12:22.858 Well, it just inspired your natural immune system. 00:12:23.479 --> 00:12:26.551 It's a great thing and this is why. 00:12:27.494 --> 00:12:29.346 We need to build that confidence; 00:12:29.346 --> 00:12:30.883 we need to listen. NOTE Paragraph 00:12:32.482 --> 00:12:35.214 Despite all this questioning -- 00:12:35.214 --> 00:12:36.775 and there's a lot of it -- 00:12:36.775 --> 00:12:40.867 I hear probably more than a lot of people -- 00:12:40.867 --> 00:12:42.275 I am an optimist. 00:12:42.526 --> 00:12:46.677 And my optimism is with a younger generation. 00:12:47.094 --> 00:12:52.641 The younger generation who actually now are becoming very aware 00:12:52.641 --> 00:12:55.091 of the risks of social media, 00:12:55.091 --> 00:12:56.887 the false news, 00:12:56.887 --> 00:12:59.705 the false identities, 00:12:59.705 --> 00:13:02.259 and they're starting to embrace science. 00:13:02.753 --> 00:13:08.386 And some of them are a group of children whose mothers refused to vaccinate them. 00:13:09.879 --> 00:13:13.385 Last spring of 2019, 00:13:13.385 --> 00:13:18.491 18-year-old Ethan Lindenberger went on Reddit 00:13:18.491 --> 00:13:20.020 and put out a post. 00:13:21.930 --> 00:13:24.637 "My mother doesn't believe in vaccines. 00:13:24.637 --> 00:13:27.328 She's really worried they cause autism. 00:13:27.550 --> 00:13:29.677 In fact, she strongly believes that. 00:13:30.017 --> 00:13:31.407 But I'm 18. 00:13:31.904 --> 00:13:33.582 I'm a senior in high school. 00:13:33.767 --> 00:13:35.297 I can drive a car, 00:13:35.297 --> 00:13:36.361 I can vote 00:13:36.361 --> 00:13:38.538 and I could go get my own vaccine. 00:13:38.809 --> 00:13:41.127 Can someone tell me where to get it?" 00:13:41.453 --> 00:13:43.639 That post went viral. 00:13:43.990 --> 00:13:47.746 It started to get a whole younger movement going. NOTE Paragraph 00:13:49.397 --> 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. 00:13:56.600 --> 00:13:58.568 He spoke eloquently, 00:13:58.568 --> 00:14:00.126 and I was impressed 00:14:00.126 --> 00:14:02.272 in front of a whole forum. 00:14:02.809 --> 00:14:04.877 He told his personal story, 00:14:04.877 --> 00:14:06.614 and then he said to the group, 00:14:06.614 --> 00:14:10.130 he said, "You know, everybody talks about misinformation, 00:14:10.130 --> 00:14:14.164 but I want to tell you about a different kind of misinformation, 00:14:14.164 --> 00:14:19.475 and that's misinformation that says that people like my mother, 00:14:19.475 --> 00:14:21.472 who is a loving mother, 00:14:21.472 --> 00:14:25.566 is a bad person because she doesn't give me vaccines. 00:14:26.237 --> 00:14:31.075 Well, I want to tell all of you that she didn't give me a vaccine 00:14:31.075 --> 00:14:33.149 because she loves me 00:14:33.149 --> 00:14:37.719 and because she believed that that was the best thing for me. 00:14:38.162 --> 00:14:39.629 I think differently 00:14:39.629 --> 00:14:42.284 and I will never change her mind, 00:14:42.284 --> 00:14:44.560 but she's not a bad person." 00:14:45.324 --> 00:14:48.096 That was the message from a teenager. 00:14:48.731 --> 00:14:51.982 Empathy, kindness and understanding. NOTE Paragraph 00:14:53.068 --> 00:14:56.644 We have an abundance of scientific information 00:14:56.644 --> 00:14:58.842 to debunk false rumors. 00:14:59.616 --> 00:15:01.195 That's not our problem. 00:15:01.696 --> 00:15:04.266 We have a relationship problem, 00:15:04.266 --> 00:15:06.442 not a misinformation problem. 00:15:06.739 --> 00:15:09.352 Misinformation is the symptom, 00:15:09.352 --> 00:15:10.678 not the cause. 00:15:11.038 --> 00:15:13.001 If people trust, 00:15:13.001 --> 00:15:16.846 they'll put up with a little risk to avert a much bigger one. 00:15:17.489 --> 00:15:21.119 The one thing that I want and I hope for 00:15:21.119 --> 00:15:24.716 is that we as a medical and health community 00:15:24.716 --> 00:15:28.970 have the moral courage and humility 00:15:28.970 --> 00:15:31.398 to productively engage, 00:15:31.398 --> 00:15:32.801 like Ethan, 00:15:32.801 --> 00:15:35.328 with those who disagree with us. 00:15:35.889 --> 00:15:37.007 I hope so. NOTE Paragraph 00:15:37.306 --> 00:15:38.411 Thank you. NOTE Paragraph 00:15:38.550 --> 00:15:40.335 (Applause and cheers)