0:00:01.625,0:00:03.893
I study rumors.

0:00:03.917,0:00:05.309
Not tabloid gossip

0:00:05.333,0:00:08.851
or the kind of rumors[br]that are making stock markets crash --

0:00:08.875,0:00:10.434
or soar --

0:00:10.458,0:00:13.351
but the kind of rumors[br]that affect your health ...

0:00:13.375,0:00:15.143
and the world's health.

0:00:15.167,0:00:17.643
Like eating a lot of garlic

0:00:17.667,0:00:18.976
or drinking a lot of water

0:00:19.000,0:00:21.976
is going to help[br]protect us from coronavirus --

0:00:22.000,0:00:23.458
if only.

0:00:24.167,0:00:26.768
Rumors have a bad reputation.

0:00:26.792,0:00:28.684
They're seen as not fact,

0:00:28.708,0:00:30.476
wrong,

0:00:30.500,0:00:32.083
or "just a rumor."

0:00:33.125,0:00:35.601
But I've studied rumors for years,

0:00:35.625,0:00:39.434
and one thing I've learned[br]is that they all have a story,

0:00:39.458,0:00:41.976
and often, an important story.

0:00:42.000,0:00:48.143
One of the most moving or alarming[br]rumor episodes that I investigated

0:00:48.167,0:00:50.559
was in northern Nigeria.

0:00:50.583,0:00:54.208
I was working with UNICEF's[br]Global Immunization programme.

0:00:54.792,0:00:58.851
And it wasn't the rumors themselves[br]that I found so alarming;

0:00:58.875,0:01:02.000
it was the global impact of those rumors.

0:01:02.917,0:01:04.726
The rumors were suspecting

0:01:04.750,0:01:09.226
that the polio vaccine[br]was actually a contraceptive.

0:01:09.250,0:01:12.143
It was controlling populations --

0:01:12.167,0:01:15.333
or maybe it caused AIDS.

0:01:16.042,0:01:20.351
No, no, maybe it's the CIA[br]spying on them or counting them.

0:01:20.375,0:01:26.268
I mean, why else would they have people[br]knocking on their door again and again

0:01:26.292,0:01:29.434
with the same polio vaccine?

0:01:29.458,0:01:32.434
When children were dying of measles,

0:01:32.458,0:01:35.167
no one was coming with measles vaccines.

0:01:37.667,0:01:40.768
This wasn't about getting the facts right.

0:01:40.792,0:01:42.893
This was about trust.

0:01:42.917,0:01:45.309
It was about broken trust.

0:01:45.333,0:01:47.768
Why so much distrust?

0:01:47.792,0:01:51.684
It wasn't the mothers who were[br]particularly distrusting, actually.

0:01:51.708,0:01:53.601
It was the local leaders,

0:01:53.625,0:01:55.226
the religious leaders,

0:01:55.250,0:01:57.184
the local political leaders.

0:01:57.208,0:02:00.393
It was the governor of the state of Kano

0:02:00.417,0:02:02.226
who decided to boycott

0:02:02.250,0:02:06.934
the entire polio eradication[br]effort in that state ...

0:02:06.958,0:02:09.976
for 11 months.

0:02:10.000,0:02:12.434
Why such distrust?

0:02:12.458,0:02:14.934
Well, it was 2003.

0:02:14.958,0:02:18.476
It was two years after 9/11.

0:02:18.500,0:02:21.809
And they were convinced that the West,

0:02:21.833,0:02:24.018
and particularly the United States,

0:02:24.042,0:02:26.143
was at war with Muslims.

0:02:26.167,0:02:28.476
And they knew that the West,

0:02:28.500,0:02:30.809
and particularly the United States,

0:02:30.833,0:02:32.434
was a huge supporter --

0:02:32.458,0:02:33.851
and funder --

0:02:33.875,0:02:36.934
of the global polio[br]eradication initiative.

0:02:36.958,0:02:38.458
They had their reasoning.

0:02:39.667,0:02:42.518
That lack of trust,

0:02:42.542,0:02:46.018
that "just a rumor or two"

0:02:46.042,0:02:52.184
cost the polio eradication program[br]500 million dollars

0:02:52.208,0:02:53.851
to reset the clock,

0:02:53.875,0:02:57.976
to regain the progress lost[br]during those 11 months

0:02:58.000,0:02:59.393
and beyond.

0:02:59.417,0:03:05.518
The Nigerian strain of the polio virus[br]traveled to over 20 countries,

0:03:05.542,0:03:07.417
as far as Indonesia.

0:03:08.667,0:03:10.625
The cost of a rumor.

0:03:11.708,0:03:15.976
The Nigeria episode was one[br]of many episodes that I investigated

0:03:16.000,0:03:17.351
when I was with UNICEF

0:03:17.375,0:03:21.792
and earned the title of the "director[br]of UNICEF's fire department."

0:03:22.792,0:03:23.851
(Laughs)

0:03:23.875,0:03:28.143
We -- at that point I realized[br]I never really had enough time.

0:03:28.167,0:03:32.309
I was too busy putting out the fires[br]and not enough time to understand

0:03:32.333,0:03:36.351
what was driving[br]not just the individual episodes,

0:03:36.375,0:03:41.101
but why was there an epidemic[br]of these happening around the world.

0:03:41.125,0:03:44.893
I left UNICEF and went back to research --

0:03:44.917,0:03:47.018
applied research --

0:03:47.042,0:03:53.976
and I set up in 2010 what I called[br]the Vaccine Confidence Project

0:03:54.000,0:03:58.101
at the London School of Hygiene[br]and Tropical Medicine.

0:03:58.125,0:04:01.268
I convened anthropologists,[br]epidemiologists,

0:04:01.292,0:04:02.934
psychologists,

0:04:02.958,0:04:05.976
digital media specialists

0:04:06.000,0:04:08.351
and mathematical modelers.

0:04:08.375,0:04:10.726
We set ourselves the task

0:04:10.750,0:04:15.184
to investigate historic episodes of rumors

0:04:15.208,0:04:17.018
and their impacts,

0:04:17.042,0:04:20.976
from trying to figure out[br]what were the early signals,

0:04:21.000,0:04:22.976
what were the amplifying factors

0:04:23.000,0:04:24.601
and the impacts,

0:04:24.625,0:04:26.434
how did they get traction,

0:04:26.458,0:04:30.351
so we could start to understand[br]what we should be looking for,

0:04:30.375,0:04:31.934
how we could help governments

0:04:31.958,0:04:36.976
and immunization programs[br]be more alert and responsive

0:04:37.000,0:04:39.976
to early signals of problems.

0:04:40.000,0:04:42.601
It was an early warning system.

0:04:42.625,0:04:47.309
In 2015, we developed[br]a vaccine confidence index.

0:04:47.333,0:04:53.559
It's a survey trying to investigate[br]to what extent do people agree

0:04:53.583,0:04:56.684
or disagree that vaccines are important,

0:04:56.708,0:04:59.018
they're safe, they're effective --

0:04:59.042,0:05:00.351
they work --

0:05:00.375,0:05:03.768
and somehow they're compatible[br]with my religious beliefs.

0:05:03.792,0:05:08.393
We've run this with over hundreds[br]of thousands of people around the world,

0:05:08.417,0:05:13.643
trying to get our finger on the pulse[br]of confidence and trust,

0:05:13.667,0:05:19.768
but also, more importantly, looking[br]at when that trust goes up or down,

0:05:19.792,0:05:23.351
because we want to see[br]when it starts to decline,

0:05:23.375,0:05:25.726
that's the time to jump in,

0:05:25.750,0:05:30.458
to get there before there's a crisis[br]like the Nigerian one.

0:05:31.500,0:05:36.726
We also set up 24-7 media and social media[br]monitoring around the world --

0:05:36.750,0:05:38.393
multilanguage --

0:05:38.417,0:05:42.768
listening for what's going on[br]in vaccine conversations,

0:05:42.792,0:05:46.684
trying to pick up early concerns[br]or changes in sentiment

0:05:46.708,0:05:49.143
that we should be paying attention to.

0:05:49.167,0:05:54.059
We've created an ecosystem[br]of different types of information

0:05:54.083,0:05:55.893
to try to understand:

0:05:55.917,0:06:00.226
what are the public thinking[br]and how can we engage?

0:06:00.250,0:06:01.601
We look for early signals.

0:06:01.625,0:06:02.976
When we find one,

0:06:03.000,0:06:06.809
we have a global network of collaborators[br]in a number of countries

0:06:06.833,0:06:09.684
who have more local[br]intelligence in that setting

0:06:09.708,0:06:11.476
to try to understand --

0:06:11.500,0:06:13.601
is this signal misinformation,

0:06:13.625,0:06:16.542
or is something brewing[br]that we should know about?

0:06:17.417,0:06:19.268
In London, we have a bigger picture.

0:06:19.292,0:06:23.518
We watch the swarms of rumors,[br]not just traveling locally

0:06:23.542,0:06:25.309
but jumping countries.

0:06:25.333,0:06:29.101
We've seen them jump[br]from Japan over to Colombia,

0:06:29.125,0:06:31.143
through Europe and around.

0:06:31.167,0:06:32.434
They move.

0:06:32.458,0:06:35.934
We live in a hyperconnected environment.

0:06:35.958,0:06:38.893
One of the things[br]that we found fascinating,

0:06:38.917,0:06:41.226
and we've learned[br]a lot in the last 10 years --

0:06:41.250,0:06:43.643
this is our 10th anniversary,

0:06:43.667,0:06:46.643
this didn't start yesterday,[br]this rumor problem --

0:06:46.667,0:06:48.476
and one of the things we've learned

0:06:48.500,0:06:50.893
is in our global monitoring,

0:06:50.917,0:06:55.268
that Europe is the most[br]skeptical region in the world.

0:06:55.292,0:06:57.476
France won the prize, actually.

0:06:57.500,0:06:58.559
(Laughter)

0:06:58.583,0:06:59.976
By far.

0:07:00.000,0:07:04.250
And actually some of those rumors[br]have traveled to other parts of the world.

0:07:05.083,0:07:07.101
But we were trying to understand Europe.

0:07:07.125,0:07:08.643
Hmm. Why Europe?

0:07:08.667,0:07:11.059
I thought the US was really --

0:07:11.083,0:07:12.893
had some of the most skepticism,

0:07:12.917,0:07:15.351
but boy, I was wrong.

0:07:15.375,0:07:18.434
And a political scientist,[br]a colleague we work with,

0:07:18.458,0:07:20.059
Jon Kennedy,

0:07:20.083,0:07:24.226
he took our data[br]from 28 European countries

0:07:24.250,0:07:25.518
and he looked at it

0:07:25.542,0:07:28.458
and correlated it[br]with political opinion polling.

0:07:29.167,0:07:30.934
And what did he find?

0:07:30.958,0:07:37.101
He found that people who are most likely[br]to vote for a populist party

0:07:37.125,0:07:40.684
also were the ones most likely[br]to strongly disagree

0:07:40.708,0:07:44.268
that vaccines were important,[br]safe or effective.

0:07:44.292,0:07:45.934
What did we learn?

0:07:45.958,0:07:51.059
Vaccines cannot escape[br]the political and social turbulence

0:07:51.083,0:07:52.518
that surrounds it.

0:07:52.542,0:07:57.934
Scientists were unprepared[br]for this tsunami of doubt

0:07:57.958,0:08:00.684
and questions and distrust.

0:08:00.708,0:08:06.101
What -- why are vaccines[br]so ripe for resistance?

0:08:06.125,0:08:08.101
Well, we identified a number of things,

0:08:08.125,0:08:09.393
but one:

0:08:09.417,0:08:11.893
they're highly mediated by government

0:08:11.917,0:08:17.809
that requires, regulates[br]and sometimes recommends vaccines --

0:08:17.833,0:08:21.000
or often recommends[br]and sometimes requires.

0:08:22.042,0:08:24.434
Big business makes vaccines,

0:08:24.458,0:08:27.809
and neither institution,[br]government or big business,

0:08:27.833,0:08:30.976
are high in the trust ranks these days.

0:08:31.000,0:08:34.934
And then there's scientists[br]who discover and develop vaccines,

0:08:34.958,0:08:36.643
and they're pretty elite

0:08:36.667,0:08:39.351
and not accessible to the general public,

0:08:39.375,0:08:41.583
at least the language they speak.

0:08:42.583,0:08:48.184
Third, we're in a hyperconnected[br]environment with social media these days,

0:08:48.208,0:08:50.976
and people can share[br]their unfettered views,

0:08:51.000,0:08:55.143
concerns, anxieties and worries

0:08:55.167,0:08:58.518
and find a lot of people[br]that think the way they do,

0:08:58.542,0:09:04.851
and think maybe their worries[br]are worth paying attention to.

0:09:04.875,0:09:06.184
And finally,

0:09:06.208,0:09:11.018
vaccines touch every single[br]life on the planet.

0:09:11.042,0:09:13.434
What other health intervention,

0:09:13.458,0:09:15.684
besides water,

0:09:15.708,0:09:18.851
touches every single life?

0:09:18.875,0:09:21.893
So if you're looking[br]for something to disrupt,

0:09:21.917,0:09:23.667
it's a perfect stage.

0:09:24.708,0:09:29.393
Perhaps that's one of the reasons[br]that we need to pay more attention

0:09:29.417,0:09:32.976
and rebuild our trust in issues.

0:09:33.000,0:09:36.434
People are asking all kinds of questions.

0:09:36.458,0:09:38.059
They're asking,

0:09:38.083,0:09:39.976
why are vaccines --

0:09:40.000,0:09:44.018
and these are the kinds of things[br]we're hearing in our social media --

0:09:44.042,0:09:50.018
why can't my child have[br]a personalized vaccination schedule?

0:09:50.042,0:09:52.792
What's the wisdom of so many vaccines?

0:09:53.917,0:09:57.643
What about all those ingredients[br]and preservatives?

0:09:57.667,0:09:59.809
These are not crazy people,

0:09:59.833,0:10:02.101
they're not uneducated;

0:10:02.125,0:10:04.167
they're actually worried mothers.

0:10:05.208,0:10:10.434
But some of them have come to me[br]and said, "We feel ignored,

0:10:10.458,0:10:13.601
we feel judged if we ask a question,

0:10:13.625,0:10:15.434
and we even feel demonized

0:10:15.458,0:10:18.750
that maybe we're part of some[br]antivaccine group."

0:10:19.792,0:10:22.518
So we have some listening to do.

0:10:22.542,0:10:25.018
And maybe that's why last year,

0:10:25.042,0:10:27.101
there was research that found

0:10:27.125,0:10:31.042
that in six months in 2019,

0:10:33.333,0:10:34.643
online --

0:10:34.667,0:10:35.976
this was with hundreds --

0:10:36.000,0:10:40.101
100 million different users[br]on social media --

0:10:40.125,0:10:45.851
although the numbers of individuals[br]who expressed in their online groups,

0:10:45.875,0:10:47.393
they were positive,

0:10:47.417,0:10:48.851
as groups,

0:10:48.875,0:10:51.351
the ones who were the most negative

0:10:51.375,0:10:55.143
were recruiting[br]the conversations in the middle

0:10:55.167,0:10:59.518
that were undecided about whether[br]they wanted to get vaccines.

0:10:59.542,0:11:00.934
The highly negative --

0:11:00.958,0:11:03.559
what we might call[br]the antivaccine groups --

0:11:03.583,0:11:06.476
were recruiting the undecided

0:11:06.500,0:11:11.226
at a rate 500 percent faster

0:11:11.250,0:11:13.893
than the provaccine groups.

0:11:13.917,0:11:16.518
500 percent faster.

0:11:16.542,0:11:18.976
They were more nimble,[br]they were responsive

0:11:19.000,0:11:20.684
and they were listening.

0:11:20.708,0:11:24.101
Most people believe that vaccines are good

0:11:24.125,0:11:26.434
and they believe in their importance.

0:11:26.458,0:11:29.309
But that belief is under attack.

0:11:29.333,0:11:33.809
We need to build in[br]more opportunities for conversation.

0:11:33.833,0:11:35.518
And there are ways to do it.

0:11:35.542,0:11:38.351
It's not easy for some[br]health professionals

0:11:38.375,0:11:42.268
to have conversations[br]where their authority is questioned.

0:11:42.292,0:11:44.143
It's uncomfortable.

0:11:44.167,0:11:48.143
And they're just too busy[br]to listen to all these questions.

0:11:48.167,0:11:50.226
But we need to do something about that,

0:11:50.250,0:11:54.184
because we're losing[br]a lot of concerned parents

0:11:54.208,0:11:57.184
that just want a conversation.

0:11:57.208,0:12:01.559
We should get volunteers[br]trained to sit in waiting rooms,

0:12:01.583,0:12:03.518
to be on hotlines,

0:12:03.542,0:12:05.934
to have online chat forums,

0:12:05.958,0:12:08.059
to have chat boxes.

0:12:08.083,0:12:11.309
In younger kids,[br]with younger kids in school,

0:12:11.333,0:12:13.726
teach them about immune systems

0:12:13.750,0:12:15.476
and teach them that actually,

0:12:15.500,0:12:17.976
you know that vaccine[br]your little brother got?

0:12:18.000,0:12:23.351
Well, it just inspired[br]your natural immune system.

0:12:23.375,0:12:25.917
It's a great thing and this is why.

0:12:27.333,0:12:29.143
We need to build that confidence;

0:12:29.167,0:12:30.625
we need to listen.

0:12:32.417,0:12:35.143
Despite all this questioning --

0:12:35.167,0:12:36.518
and there's a lot of it --

0:12:36.542,0:12:39.833
I hear probably more[br]than a lot of people --

0:12:40.792,0:12:42.309
I am an optimist.

0:12:42.333,0:12:46.893
And my optimism[br]is with a younger generation.

0:12:46.917,0:12:52.601
The younger generation[br]who actually now are becoming very aware

0:12:52.625,0:12:54.934
of the risks of social media,

0:12:54.958,0:12:56.726
the false news,

0:12:56.750,0:12:58.500
the false identities,

0:12:59.708,0:13:02.601
and they're starting to embrace science.

0:13:02.625,0:13:08.208
And some of them are a group of children[br]whose mothers refused to vaccinate them.

0:13:09.750,0:13:13.226
Last spring of 2019,

0:13:13.250,0:13:16.768
18-year-old Ethan Lindenberger

0:13:16.792,0:13:20.000
went on Reddit and put out a post.

0:13:21.750,0:13:24.601
"My mother doesn't believe in vaccines.

0:13:24.625,0:13:27.268
She's really worried they cause autism.

0:13:27.292,0:13:29.934
In fact, she strongly believes that.

0:13:29.958,0:13:31.726
But I'm 18.

0:13:31.750,0:13:33.601
I'm a senior in high school.

0:13:33.625,0:13:36.143
I can drive a car, I can vote

0:13:36.167,0:13:38.601
and I could go get my own vaccine.

0:13:38.625,0:13:40.542
Can someone tell me where to get it?"

0:13:41.417,0:13:43.976
That post went viral.

0:13:44.000,0:13:47.875
It started to get[br]a whole younger movement going.

0:13:49.333,0:13:52.184
I saw Ethan speak at a conference,

0:13:52.208,0:13:56.393
the Global Vaccine Summit[br]at the EU last fall.

0:13:56.417,0:13:58.393
He spoke eloquently,

0:13:58.417,0:13:59.893
and I was impressed,

0:13:59.917,0:14:01.958
in front of a whole forum.

0:14:02.792,0:14:04.726
He told his personal story,

0:14:04.750,0:14:06.309
and then he said to the group,

0:14:06.333,0:14:09.893
he said, "You know, everybody[br]talks about misinformation,

0:14:09.917,0:14:14.018
but I want to tell you about[br]a different kind of misinformation,

0:14:14.042,0:14:19.351
and that's misinformation[br]that says that people like my mother,

0:14:19.375,0:14:21.184
who is a loving mother,

0:14:21.208,0:14:26.059
is a bad person because[br]she doesn't give me vaccines.

0:14:26.083,0:14:30.976
Well, I want to tell all of you[br]that she didn't give me a vaccine,

0:14:31.000,0:14:33.059
because she loves me

0:14:33.083,0:14:37.934
and because she believed[br]that that was the best thing for me.

0:14:37.958,0:14:39.393
I think differently

0:14:39.417,0:14:42.143
and I will never change her mind,

0:14:42.167,0:14:44.083
but she's not a bad person."

0:14:45.292,0:14:48.476
That was the message from a teenager.

0:14:48.500,0:14:52.000
Empathy, kindness and understanding.

0:14:53.000,0:14:56.518
We have an abundance[br]of scientific information

0:14:56.542,0:14:59.476
to debunk false rumors.

0:14:59.500,0:15:01.601
That's not our problem.

0:15:01.625,0:15:04.059
We have a relationship problem,

0:15:04.083,0:15:06.434
not a misinformation problem.

0:15:06.458,0:15:09.184
Misinformation is the symptom,

0:15:09.208,0:15:10.726
not the cause.

0:15:10.750,0:15:12.809
If people trust,

0:15:12.833,0:15:17.393
they'll put up with a little risk[br]to avert a much bigger one.

0:15:17.417,0:15:20.976
The one thing that I want and I hope for

0:15:21.000,0:15:24.684
is that we as a medical[br]and health community

0:15:24.708,0:15:28.851
have the moral courage and humility

0:15:28.875,0:15:31.226
to productively engage,

0:15:31.250,0:15:32.559
like Ethan,

0:15:32.583,0:15:35.768
with those who disagree with us.

0:15:35.792,0:15:37.101
I hope so.

0:15:37.125,0:15:38.393
Thank you.

0:15:38.417,0:15:40.333
(Applause and cheers)