1 00:00:01,625 --> 00:00:03,893 I study rumors. 2 00:00:03,917 --> 00:00:05,309 Not tabloid gossip 3 00:00:05,333 --> 00:00:08,851 or the kind of rumors that are making stock markets crash -- 4 00:00:08,875 --> 00:00:10,434 or soar -- 5 00:00:10,458 --> 00:00:13,351 but the kind of rumors that affect your health ... 6 00:00:13,375 --> 00:00:15,143 and the world's health. 7 00:00:15,167 --> 00:00:17,643 Like eating a lot of garlic 8 00:00:17,667 --> 00:00:18,976 or drinking a lot of water 9 00:00:19,000 --> 00:00:21,976 is going to help protect us from coronavirus -- 10 00:00:22,000 --> 00:00:23,458 if only. 11 00:00:24,167 --> 00:00:26,768 Rumors have a bad reputation. 12 00:00:26,792 --> 00:00:28,684 They're seen as not fact, 13 00:00:28,708 --> 00:00:30,476 wrong, 14 00:00:30,500 --> 00:00:32,083 or "just a rumor." 15 00:00:33,125 --> 00:00:35,601 But I've studied rumors for years, 16 00:00:35,625 --> 00:00:39,434 and one thing I've learned is that they all have a story, 17 00:00:39,458 --> 00:00:41,976 and often, an important story. 18 00:00:42,000 --> 00:00:48,143 One of the most moving or alarming rumor episodes that I investigated 19 00:00:48,167 --> 00:00:50,559 was in northern Nigeria. 20 00:00:50,583 --> 00:00:54,208 I was working with UNICEF's Global Immunization programme. 21 00:00:54,792 --> 00:00:58,851 And it wasn't the rumors themselves that I found so alarming; 22 00:00:58,875 --> 00:01:02,000 It was the global impact of those rumors. 23 00:01:02,917 --> 00:01:04,726 The rumors were suspecting 24 00:01:04,750 --> 00:01:09,226 that the polio vaccine was actually a contraceptive. 25 00:01:09,250 --> 00:01:12,143 It was controlling populations -- 26 00:01:12,167 --> 00:01:15,333 or maybe it caused AIDS. 27 00:01:16,042 --> 00:01:20,351 No, no, maybe it's the CIA spying on them or counting them. 28 00:01:20,375 --> 00:01:26,268 I mean, why else would they have people knocking on their door again and again 29 00:01:26,292 --> 00:01:29,434 with the same polio vaccine? 30 00:01:29,458 --> 00:01:32,434 When children were dying of measles, 31 00:01:32,458 --> 00:01:35,167 no one was coming with measles vaccines. 32 00:01:37,667 --> 00:01:40,768 This wasn't about getting the facts right. 33 00:01:40,792 --> 00:01:42,893 This was about trust. 34 00:01:42,917 --> 00:01:45,309 It was about broken trust. 35 00:01:45,333 --> 00:01:47,768 Why so much distrust? 36 00:01:47,792 --> 00:01:51,684 It wasn't the mothers who were particularly distrusting, actually. 37 00:01:51,708 --> 00:01:53,601 It was the local leaders, 38 00:01:53,625 --> 00:01:55,226 the religious leaders, 39 00:01:55,250 --> 00:01:57,184 the local political leaders. 40 00:01:57,208 --> 00:02:00,393 It was the governor of the state of Kano 41 00:02:00,417 --> 00:02:02,226 who decided to boycott 42 00:02:02,250 --> 00:02:06,934 the entire polio eradication effort in that state ... 43 00:02:06,958 --> 00:02:09,976 for 11 months. 44 00:02:10,000 --> 00:02:12,434 Why such distrust? 45 00:02:12,458 --> 00:02:14,934 Well, it was 2003. 46 00:02:14,958 --> 00:02:18,476 It was two years after 9/11. 47 00:02:18,500 --> 00:02:21,809 And they were convinced that the West, 48 00:02:21,833 --> 00:02:24,018 and particularly the United States, 49 00:02:24,042 --> 00:02:26,143 was at war with Muslims. 50 00:02:26,167 --> 00:02:28,476 And they knew that the West, 51 00:02:28,500 --> 00:02:30,809 and particularly the United States, 52 00:02:30,833 --> 00:02:32,434 was a huge supporter -- 53 00:02:32,458 --> 00:02:33,851 and funder -- 54 00:02:33,875 --> 00:02:36,934 of the global polio eradication initiative. 55 00:02:36,958 --> 00:02:38,458 They had their reasoning. 56 00:02:39,667 --> 00:02:42,518 That lack of trust, 57 00:02:42,542 --> 00:02:46,018 that "just a rumor or two" 58 00:02:46,042 --> 00:02:52,184 cost the polio eradication program 500 million dollars 59 00:02:52,208 --> 00:02:53,851 to reset the clock, 60 00:02:53,875 --> 00:02:57,976 to regain the progress lost during those 11 months 61 00:02:58,000 --> 00:02:59,393 and beyond. 62 00:02:59,417 --> 00:03:05,518 The Nigerian strain of the polio virus traveled to over 20 countries, 63 00:03:05,542 --> 00:03:07,417 as far as Indonesia. 64 00:03:08,667 --> 00:03:10,625 The cost of a rumor. 65 00:03:11,708 --> 00:03:15,976 The Nigeria episode was one of many episodes that I investigated 66 00:03:16,000 --> 00:03:17,351 when I was with UNICEF 67 00:03:17,375 --> 00:03:21,792 and earned the title of the "director of UNICEF's fire department." 68 00:03:22,792 --> 00:03:23,851 (Laughs) 69 00:03:23,875 --> 00:03:28,143 We -- at that point I realized I never really had enough time. 70 00:03:28,167 --> 00:03:32,309 I was too busy putting out the fires, and not enough time to understand 71 00:03:32,333 --> 00:03:36,351 what was driving not just the individual episodes, 72 00:03:36,375 --> 00:03:41,101 but why was there an epidemic of these happening around the world. 73 00:03:41,125 --> 00:03:44,893 I left UNICEF and went back to research -- 74 00:03:44,917 --> 00:03:47,018 applied research -- 75 00:03:47,042 --> 00:03:53,976 and I set up in 2010 what I called the Vaccine Confidence Project 76 00:03:54,000 --> 00:03:58,101 at the London School of Hygiene and Tropical Medicine. 77 00:03:58,125 --> 00:04:01,268 I convened anthropologists, epidemiologists, 78 00:04:01,292 --> 00:04:02,934 psychologists, 79 00:04:02,958 --> 00:04:05,976 digital media specialists 80 00:04:06,000 --> 00:04:08,351 and mathematical modelers. 81 00:04:08,375 --> 00:04:10,726 We set ourselves the task 82 00:04:10,750 --> 00:04:15,184 to investigate historic episodes of rumors 83 00:04:15,208 --> 00:04:17,018 and their impacts, 84 00:04:17,042 --> 00:04:20,976 from trying to figure out what were the early signals, 85 00:04:21,000 --> 00:04:22,976 what were the amplifying factors 86 00:04:23,000 --> 00:04:24,601 and the impacts, 87 00:04:24,625 --> 00:04:26,434 how did they get traction, 88 00:04:26,458 --> 00:04:30,351 so we could start to understand what we should be looking for, 89 00:04:30,375 --> 00:04:31,934 how we could help governments 90 00:04:31,958 --> 00:04:36,976 and immunization programs be more alert and responsive 91 00:04:37,000 --> 00:04:39,976 to early signals of problems. 92 00:04:40,000 --> 00:04:42,601 It was an early warning system. 93 00:04:42,625 --> 00:04:47,309 In 2015, we developed a vaccine confidence index. 94 00:04:47,333 --> 00:04:53,559 It's a survey trying to investigate to what extent do people agree 95 00:04:53,583 --> 00:04:56,684 or disagree that vaccines are important, 96 00:04:56,708 --> 00:04:59,018 they're safe, they're effective -- 97 00:04:59,042 --> 00:05:00,351 they work -- 98 00:05:00,375 --> 00:05:03,768 and somehow they're compatible with my religious beliefs. 99 00:05:03,792 --> 00:05:08,393 We've run this with over hundreds of thousands of people around the world, 100 00:05:08,417 --> 00:05:13,643 trying to get our finger on the pulse of confidence and trust, 101 00:05:13,667 --> 00:05:19,768 but also, more importantly, looking at when that trust goes up or down, 102 00:05:19,792 --> 00:05:23,351 because we want to see when it starts to decline, 103 00:05:23,375 --> 00:05:25,726 that's the time to jump in, 104 00:05:25,750 --> 00:05:30,458 to get there before there's a crisis like the Nigerian one. 105 00:05:31,500 --> 00:05:36,726 We also set up 24-7 media and social media monitoring around the world -- 106 00:05:36,750 --> 00:05:38,393 multilanguage -- 107 00:05:38,417 --> 00:05:42,768 listening for what's going on in vaccine conversations, 108 00:05:42,792 --> 00:05:46,684 trying to pick up early concerns or changes in sentiment 109 00:05:46,708 --> 00:05:49,143 that we should be paying attention to. 110 00:05:49,167 --> 00:05:54,059 We've created an ecosystem of different types of information 111 00:05:54,083 --> 00:05:55,893 to try to understand: 112 00:05:55,917 --> 00:06:00,226 what are the public thinking and how can we engage? 113 00:06:00,250 --> 00:06:01,601 We look for early signals. 114 00:06:01,625 --> 00:06:02,976 When we find one, 115 00:06:03,000 --> 00:06:06,809 we have a global network of collaborators in a number of countries 116 00:06:06,833 --> 00:06:09,684 who have more local intelligence in that setting 117 00:06:09,708 --> 00:06:11,476 to try to understand -- 118 00:06:11,500 --> 00:06:13,601 is this signal misinformation, 119 00:06:13,625 --> 00:06:16,542 or is something brewing that we should know about? 120 00:06:17,417 --> 00:06:19,268 In London, we have a bigger picture. 121 00:06:19,292 --> 00:06:23,518 We watch the swarms of rumors not just traveling locally 122 00:06:23,542 --> 00:06:25,309 but jumping countries. 123 00:06:25,333 --> 00:06:29,101 We've seen them jump from Japan over to Columbia, 124 00:06:29,125 --> 00:06:31,143 through Europe and around. 125 00:06:31,167 --> 00:06:32,434 They move. 126 00:06:32,458 --> 00:06:35,934 We live in a hyperconnected environment. 127 00:06:35,958 --> 00:06:38,893 One of the things that we found fascinating, 128 00:06:38,917 --> 00:06:41,226 and we've learned a lot in the last 10 years -- 129 00:06:41,250 --> 00:06:43,643 this is our 10th anniversary, 130 00:06:43,667 --> 00:06:46,643 this didn't start yesterday, this rumor problem -- 131 00:06:46,667 --> 00:06:48,476 and one of the things we've learned 132 00:06:48,500 --> 00:06:50,893 is in our global monitoring, 133 00:06:50,917 --> 00:06:55,268 that Europe is the most skeptical region in the world. 134 00:06:55,292 --> 00:06:57,476 France won the prize, actually. 135 00:06:57,500 --> 00:06:58,559 (Laughter) 136 00:06:58,583 --> 00:06:59,976 By far. 137 00:07:00,000 --> 00:07:04,250 And actually some of those rumors have traveled to other parts of the world. 138 00:07:05,083 --> 00:07:07,101 But we were trying to understand Europe. 139 00:07:07,125 --> 00:07:08,643 Hmm. Why Europe? 140 00:07:08,667 --> 00:07:11,059 I thought the US was really -- 141 00:07:11,083 --> 00:07:12,893 had some of the most skepticism, 142 00:07:12,917 --> 00:07:15,351 but boy, I was wrong. 143 00:07:15,375 --> 00:07:18,434 And a political scientist, a colleague we work with, 144 00:07:18,458 --> 00:07:20,059 Jon Kennedy, 145 00:07:20,083 --> 00:07:24,226 he took our data from 28 European countries 146 00:07:24,250 --> 00:07:25,518 and he looked at it 147 00:07:25,542 --> 00:07:28,458 and correlated it with political opinion polling. 148 00:07:29,167 --> 00:07:30,934 And what did he find? 149 00:07:30,958 --> 00:07:37,101 He found that people who are most likely to vote for a populist party 150 00:07:37,125 --> 00:07:40,684 also were the ones most likely to strongly disagree 151 00:07:40,708 --> 00:07:44,268 that vaccines were important, safe or effective. 152 00:07:44,292 --> 00:07:45,934 What did we learn? 153 00:07:45,958 --> 00:07:51,059 Vaccines cannot escape the political and social turbulence 154 00:07:51,083 --> 00:07:52,518 that surrounds it. 155 00:07:52,542 --> 00:07:57,934 Scientists were unprepared for this tsunami of doubt 156 00:07:57,958 --> 00:08:00,684 and questions and distrust. 157 00:08:00,708 --> 00:08:06,101 What -- why are vaccines so ripe for resistance? 158 00:08:06,125 --> 00:08:08,101 Well, we identified a number of things, 159 00:08:08,125 --> 00:08:09,393 but one: 160 00:08:09,417 --> 00:08:11,893 they're highly mediated by government 161 00:08:11,917 --> 00:08:17,809 that requires, regulates and sometimes recommends vaccines -- 162 00:08:17,833 --> 00:08:21,000 or often recommends and sometimes requires. 163 00:08:22,042 --> 00:08:24,434 Big business makes vaccines, 164 00:08:24,458 --> 00:08:27,809 and neither institution, government or big business, 165 00:08:27,833 --> 00:08:30,976 are high in the trust ranks these days. 166 00:08:31,000 --> 00:08:34,934 And then there's scientists who discover and develop vaccines, 167 00:08:34,958 --> 00:08:36,643 and they're pretty elite 168 00:08:36,667 --> 00:08:39,351 and not accessible to the general public, 169 00:08:39,375 --> 00:08:41,583 at least the language they speak. 170 00:08:42,583 --> 00:08:48,184 Third, we're in a hyperconnected environment with social media these days, 171 00:08:48,208 --> 00:08:50,976 and people can share their unfettered views, 172 00:08:51,000 --> 00:08:55,143 concerns, anxieties and worries 173 00:08:55,167 --> 00:08:58,518 and find a lot of people that think the way they do, 174 00:08:58,542 --> 00:09:04,851 and think maybe their worries are worth paying attention to. 175 00:09:04,875 --> 00:09:06,184 And finally, 176 00:09:06,208 --> 00:09:11,018 vaccines touch every single life on the planet. 177 00:09:11,042 --> 00:09:13,434 What other health intervention, 178 00:09:13,458 --> 00:09:15,684 besides water, 179 00:09:15,708 --> 00:09:18,851 touches every single life? 180 00:09:18,875 --> 00:09:21,893 So if you're looking for something to disrupt, 181 00:09:21,917 --> 00:09:23,667 it's a perfect stage. 182 00:09:24,708 --> 00:09:29,393 Perhaps that's one of the reasons that we need to pay more attention 183 00:09:29,417 --> 00:09:32,976 and rebuild our trust in issues. 184 00:09:33,000 --> 00:09:36,434 People are asking all kinds of questions. 185 00:09:36,458 --> 00:09:38,059 They're asking, 186 00:09:38,083 --> 00:09:39,976 why are vaccines -- 187 00:09:40,000 --> 00:09:44,018 and these are the kinds of things we're hearing in our social media -- 188 00:09:44,042 --> 00:09:50,018 why can't my child have a personalized vaccination schedule? 189 00:09:50,042 --> 00:09:52,792 What's the wisdom of so many vaccines? 190 00:09:53,917 --> 00:09:57,643 What about all those ingredients and preservatives? 191 00:09:57,667 --> 00:09:59,809 These are not crazy people, 192 00:09:59,833 --> 00:10:02,101 they're not uneducated; 193 00:10:02,125 --> 00:10:04,167 they're actually worried mothers. 194 00:10:05,208 --> 00:10:10,434 But some of them have come to me and said, "We feel ignored, 195 00:10:10,458 --> 00:10:13,601 we feel judged if we ask a question, 196 00:10:13,625 --> 00:10:15,434 and we even feel demonized 197 00:10:15,458 --> 00:10:18,750 that maybe we're part of some antivaccine group." 198 00:10:19,792 --> 00:10:22,518 So we have some listening to do. 199 00:10:22,542 --> 00:10:25,018 And maybe that's why last year, 200 00:10:25,042 --> 00:10:27,101 there was research that found 201 00:10:27,125 --> 00:10:31,042 that in six months in 2019, 202 00:10:33,333 --> 00:10:34,643 online -- 203 00:10:34,667 --> 00:10:35,976 this was with hundreds -- 204 00:10:36,000 --> 00:10:40,101 100 million different users on social media -- 205 00:10:40,125 --> 00:10:45,851 although the numbers of individuals who expressed in their online groups, 206 00:10:45,875 --> 00:10:47,393 they were positive, 207 00:10:47,417 --> 00:10:48,851 as groups, 208 00:10:48,875 --> 00:10:51,351 the ones who were the most negative 209 00:10:51,375 --> 00:10:55,143 were recruiting the conversations in the middle 210 00:10:55,167 --> 00:10:59,518 that were undecided about whether they wanted to get vaccines. 211 00:10:59,542 --> 00:11:00,934 The highly negative -- 212 00:11:00,958 --> 00:11:03,559 what we might call the antivaccine groups -- 213 00:11:03,583 --> 00:11:06,476 were recruiting the undecided 214 00:11:06,500 --> 00:11:11,226 at a rate 500 percent faster 215 00:11:11,250 --> 00:11:13,893 than the provaccine groups. 216 00:11:13,917 --> 00:11:16,518 500 percent faster. 217 00:11:16,542 --> 00:11:18,976 They were more nimble, they were responsive 218 00:11:19,000 --> 00:11:20,684 and they were listening. 219 00:11:20,708 --> 00:11:24,101 Most people believe that vaccines are good 220 00:11:24,125 --> 00:11:26,434 and they believe in their importance. 221 00:11:26,458 --> 00:11:29,309 But that belief is under attack. 222 00:11:29,333 --> 00:11:33,809 We need to build in more opportunities for conversation. 223 00:11:33,833 --> 00:11:35,518 And there are ways to do it. 224 00:11:35,542 --> 00:11:38,351 It's not easy for some health professionals 225 00:11:38,375 --> 00:11:42,268 to have conversations where their authority is questioned. 226 00:11:42,292 --> 00:11:44,143 It's uncomfortable. 227 00:11:44,167 --> 00:11:48,143 And they're just too busy to listen to all these questions. 228 00:11:48,167 --> 00:11:50,226 But we need to do something about that 229 00:11:50,250 --> 00:11:54,184 because we're losing a lot of concerned parents 230 00:11:54,208 --> 00:11:57,184 that just want a conversation. 231 00:11:57,208 --> 00:12:01,559 We should get volunteers trained to sit in waiting rooms, 232 00:12:01,583 --> 00:12:03,518 to be on hotlines, 233 00:12:03,542 --> 00:12:05,934 to have online chat forums, 234 00:12:05,958 --> 00:12:08,059 to have chat boxes. 235 00:12:08,083 --> 00:12:11,309 In younger kids, with younger kids in school, 236 00:12:11,333 --> 00:12:13,726 teach them about immune systems 237 00:12:13,750 --> 00:12:15,476 and teach them that actually, 238 00:12:15,500 --> 00:12:17,976 you know that vaccine your little brother got? 239 00:12:18,000 --> 00:12:23,351 Well, it just inspired your natural immune system. 240 00:12:23,375 --> 00:12:25,917 It's a great thing and this is why. 241 00:12:27,333 --> 00:12:29,143 We need to build that confidence; 242 00:12:29,167 --> 00:12:30,625 we need to listen. 243 00:12:32,417 --> 00:12:35,143 Despite all this questioning -- 244 00:12:35,167 --> 00:12:36,518 and there's a lot of it -- 245 00:12:36,542 --> 00:12:39,833 I hear probably more than a lot of people -- 246 00:12:40,792 --> 00:12:42,309 I am an optimist. 247 00:12:42,333 --> 00:12:46,893 And my optimism is with a younger generation. 248 00:12:46,917 --> 00:12:52,601 The younger generation who actually now are becoming very aware 249 00:12:52,625 --> 00:12:54,934 of the risks of social media, 250 00:12:54,958 --> 00:12:56,726 the false news, 251 00:12:56,750 --> 00:12:58,500 the false identities, 252 00:12:59,708 --> 00:13:02,601 and they're starting to embrace science. 253 00:13:02,625 --> 00:13:08,208 And some of them are a group of children whose mothers refused to vaccinate them. 254 00:13:09,750 --> 00:13:13,226 Last spring of 2019, 255 00:13:13,250 --> 00:13:16,768 18-year-old Ethan Lindenberger 256 00:13:16,792 --> 00:13:20,000 went on Reddit and put out a post. 257 00:13:21,750 --> 00:13:24,601 "My mother doesn't believe in vaccines. 258 00:13:24,625 --> 00:13:27,268 She's really worried they cause autism. 259 00:13:27,292 --> 00:13:29,934 In fact, she strongly believes that. 260 00:13:29,958 --> 00:13:31,726 But I'm 18. 261 00:13:31,750 --> 00:13:33,601 I'm a senior in high school. 262 00:13:33,625 --> 00:13:36,143 I can drive a car, I can vote 263 00:13:36,167 --> 00:13:38,601 and I could go get my own vaccine. 264 00:13:38,625 --> 00:13:40,542 Can someone tell me where to get it?" 265 00:13:41,417 --> 00:13:43,976 That post went viral. 266 00:13:44,000 --> 00:13:47,875 It started to get a whole younger movement going. 267 00:13:49,333 --> 00:13:52,184 I saw Ethan speak at a conference, 268 00:13:52,208 --> 00:13:56,393 the Global Vaccine Summit at the EU last fall. 269 00:13:56,417 --> 00:13:58,393 He spoke eloquently, 270 00:13:58,417 --> 00:13:59,893 and I was impressed, 271 00:13:59,917 --> 00:14:01,958 in front of a whole forum. 272 00:14:02,792 --> 00:14:04,726 He told his personal story, 273 00:14:04,750 --> 00:14:06,309 and then he said to the group, 274 00:14:06,333 --> 00:14:09,893 he said, "You know, everybody talks about misinformation, 275 00:14:09,917 --> 00:14:14,018 but I want to tell you about a different kind of misinformation, 276 00:14:14,042 --> 00:14:19,351 and that's misinformation that says that people like my mother, 277 00:14:19,375 --> 00:14:21,184 who is a loving mother, 278 00:14:21,208 --> 00:14:26,059 is a bad person because she doesn't give me vaccines. 279 00:14:26,083 --> 00:14:30,976 Well, I want to tell all of you that she didn't give me a vaccine 280 00:14:31,000 --> 00:14:33,059 because she loves me 281 00:14:33,083 --> 00:14:37,934 and because she believed that that was the best thing for me. 282 00:14:37,958 --> 00:14:39,393 I think differently 283 00:14:39,417 --> 00:14:42,143 and I will never change her mind, 284 00:14:42,167 --> 00:14:44,083 but she's not a bad person." 285 00:14:45,292 --> 00:14:48,476 That was the message from a teenager. 286 00:14:48,500 --> 00:14:52,000 Empathy, kindness and understanding. 287 00:14:53,000 --> 00:14:56,518 We have an abundance of scientific information 288 00:14:56,542 --> 00:14:59,476 to debunk false rumors. 289 00:14:59,500 --> 00:15:01,601 That's not our problem. 290 00:15:01,625 --> 00:15:04,059 We have a relationship problem, 291 00:15:04,083 --> 00:15:06,434 not a misinformation problem. 292 00:15:06,458 --> 00:15:09,184 Misinformation is the symptom, 293 00:15:09,208 --> 00:15:10,726 not the cause. 294 00:15:10,750 --> 00:15:12,809 If people trust, 295 00:15:12,833 --> 00:15:17,393 they'll put up with a little risk to avert a much bigger one. 296 00:15:17,417 --> 00:15:20,976 The one thing that I want and I hope for 297 00:15:21,000 --> 00:15:24,684 is that we as a medical and health community 298 00:15:24,708 --> 00:15:28,851 have the moral courage and humility 299 00:15:28,875 --> 00:15:31,226 to productively engage, 300 00:15:31,250 --> 00:15:32,559 like Ethan, 301 00:15:32,583 --> 00:15:35,768 with those who disagree with us. 302 00:15:35,792 --> 00:15:37,101 I hope so. 303 00:15:37,125 --> 00:15:38,393 Thank you. 304 00:15:38,417 --> 00:15:40,333 (Applause and cheers)