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← Why rumors about vaccines spread -- and how to rebuild trust

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Showing Revision 8 created 08/20/2020 by Erin Gregory.

  1. I study rumors.
  2. Not tabloid gossip
  3. or the kind of rumors
    that are making stock markets crash --
  4. or soar --
  5. but the kind of rumors
    that affect your health ...
  6. and the world's health.
  7. Like eating a lot of garlic
  8. or drinking a lot of water
  9. is going to help
    protect us from coronavirus --
  10. if only.
  11. Rumors have a bad reputation.
  12. They're seen as not fact,
  13. wrong,
  14. or "just a rumor."
  15. But I've studied rumors for years,
  16. and one thing I've learned
    is that they all have a story,
  17. and often, an important story.
  18. One of the most moving or alarming
    rumor episodes that I investigated

  19. was in northern Nigeria.
  20. I was working with UNICEF's
    Global Immunization programme.
  21. And it wasn't the rumors themselves
    that I found so alarming;
  22. it was the global impact of those rumors.
  23. The rumors were suspecting
  24. that the polio vaccine
    was actually a contraceptive.
  25. It was controlling populations --
  26. or maybe it caused AIDS.
  27. No, no, maybe it's the CIA
    spying on them or counting them.
  28. I mean, why else would they have people
    knocking on their door again and again
  29. with the same polio vaccine?
  30. When children were dying of measles,
  31. no one was coming with measles vaccines.
  32. This wasn't about getting the facts right.

  33. This was about trust.
  34. It was about broken trust.
  35. Why so much distrust?
  36. It wasn't the mothers who were
    particularly distrusting, actually.
  37. It was the local leaders,
  38. the religious leaders,
  39. the local political leaders.
  40. It was the governor of the state of Kano
  41. who decided to boycott
  42. the entire polio eradication
    effort in that state ...
  43. for 11 months.
  44. Why such distrust?

  45. Well, it was 2003.
  46. It was two years after 9/11.
  47. And they were convinced that the West,
  48. and particularly the United States,
  49. was at war with Muslims.
  50. And they knew that the West,
  51. and particularly the United States,
  52. was a huge supporter --
  53. and funder --
  54. of the global polio
    eradication initiative.
  55. They had their reasoning.
  56. That lack of trust,
  57. that "just a rumor or two"
  58. cost the polio eradication program
    500 million dollars
  59. to reset the clock,
  60. to regain the progress lost
    during those 11 months
  61. and beyond.
  62. The Nigerian strain of the polio virus
    traveled to over 20 countries,
  63. as far as Indonesia.
  64. The cost of a rumor.
  65. The Nigeria episode was one
    of many episodes that I investigated

  66. when I was with UNICEF
  67. and earned the title of the "director
    of UNICEF's fire department."
  68. (Laughs)

  69. We -- at that point I realized
    I never really had enough time.

  70. I was too busy putting out the fires
    and not enough time to understand
  71. what was driving
    not just the individual episodes,
  72. but why was there an epidemic
    of these happening around the world.
  73. I left UNICEF and went back to research --

  74. applied research --
  75. and I set up in 2010 what I called
    the Vaccine Confidence Project
  76. at the London School of Hygiene
    and Tropical Medicine.
  77. I convened anthropologists,
    epidemiologists,
  78. psychologists,
  79. digital media specialists
  80. and mathematical modelers.
  81. We set ourselves the task
  82. to investigate historic episodes of rumors
  83. and their impacts,
  84. from trying to figure out
    what were the early signals,
  85. what were the amplifying factors
  86. and the impacts,
  87. how did they get traction,
  88. so we could start to understand
    what we should be looking for,
  89. how we could help governments
  90. and immunization programs
    be more alert and responsive
  91. to early signals of problems.
  92. It was an early warning system.
  93. In 2015, we developed
    a vaccine confidence index.

  94. It's a survey trying to investigate
    to what extent do people agree
  95. or disagree that vaccines are important,
  96. they're safe, they're effective --
  97. they work --
  98. and somehow they're compatible
    with my religious beliefs.
  99. We've run this with over hundreds
    of thousands of people around the world,
  100. trying to get our finger on the pulse
    of confidence and trust,
  101. but also, more importantly, looking
    at when that trust goes up or down,
  102. because we want to see
    when it starts to decline,
  103. that's the time to jump in,
  104. to get there before there's a crisis
    like the Nigerian one.
  105. We also set up 24-7 media and social media
    monitoring around the world --
  106. multilanguage --
  107. listening for what's going on
    in vaccine conversations,
  108. trying to pick up early concerns
    or changes in sentiment
  109. that we should be paying attention to.
  110. We've created an ecosystem
    of different types of information

  111. to try to understand:
  112. what are the public thinking
    and how can we engage?
  113. We look for early signals.
  114. When we find one,
  115. we have a global network of collaborators
    in a number of countries
  116. who have more local
    intelligence in that setting
  117. to try to understand --
  118. is this signal misinformation,
  119. or is something brewing
    that we should know about?
  120. In London, we have a bigger picture.

  121. We watch the swarms of rumors,
    not just traveling locally
  122. but jumping countries.
  123. We've seen them jump
    from Japan over to Colombia,
  124. through Europe and around.
  125. They move.
  126. We live in a hyperconnected environment.
  127. One of the things
    that we found fascinating,

  128. and we've learned
    a lot in the last 10 years --
  129. this is our 10th anniversary,
  130. this didn't start yesterday,
    this rumor problem --
  131. and one of the things we've learned
  132. is in our global monitoring,
  133. that Europe is the most
    skeptical region in the world.
  134. France won the prize, actually.
  135. (Laughter)

  136. By far.

  137. And actually some of those rumors
    have traveled to other parts of the world.
  138. But we were trying to understand Europe.
  139. Hmm. Why Europe?
  140. I thought the US was really --
  141. had some of the most skepticism,
  142. but boy, I was wrong.
  143. And a political scientist,
    a colleague we work with,

  144. Jon Kennedy,
  145. he took our data
    from 28 European countries
  146. and he looked at it
  147. and correlated it
    with political opinion polling.
  148. And what did he find?
  149. He found that people who are most likely
    to vote for a populist party
  150. also were the ones most likely
    to strongly disagree
  151. that vaccines were important,
    safe or effective.
  152. What did we learn?
  153. Vaccines cannot escape
    the political and social turbulence
  154. that surrounds it.
  155. Scientists were unprepared
    for this tsunami of doubt
  156. and questions and distrust.
  157. What -- why are vaccines
    so ripe for resistance?

  158. Well, we identified a number of things,
  159. but one:
  160. they're highly mediated by government
  161. that requires, regulates
    and sometimes recommends vaccines --
  162. or often recommends
    and sometimes requires.
  163. Big business makes vaccines,
  164. and neither institution,
    government or big business,
  165. are high in the trust ranks these days.
  166. And then there's scientists
    who discover and develop vaccines,
  167. and they're pretty elite
  168. and not accessible to the general public,
  169. at least the language they speak.
  170. Third, we're in a hyperconnected
    environment with social media these days,
  171. and people can share
    their unfettered views,
  172. concerns, anxieties and worries
  173. and find a lot of people
    that think the way they do,
  174. and think maybe their worries
    are worth paying attention to.
  175. And finally,
  176. vaccines touch every single
    life on the planet.
  177. What other health intervention,
  178. besides water,
  179. touches every single life?
  180. So if you're looking
    for something to disrupt,
  181. it's a perfect stage.
  182. Perhaps that's one of the reasons
    that we need to pay more attention

  183. and rebuild our trust in issues.
  184. People are asking all kinds of questions.
  185. They're asking,
  186. why are vaccines --
  187. and these are the kinds of things
    we're hearing in our social media --
  188. why can't my child have
    a personalized vaccination schedule?
  189. What's the wisdom of so many vaccines?
  190. What about all those ingredients
    and preservatives?
  191. These are not crazy people,
  192. they're not uneducated;
  193. they're actually worried mothers.
  194. But some of them have come to me
    and said, "We feel ignored,
  195. we feel judged if we ask a question,
  196. and we even feel demonized
  197. that maybe we're part of some
    antivaccine group."
  198. So we have some listening to do.

  199. And maybe that's why last year,
  200. there was research that found
  201. that in six months in 2019,
  202. online --
  203. this was with hundreds --
  204. 100 million different users
    on social media --
  205. although the numbers of individuals
    who expressed in their online groups,
  206. they were positive,
  207. as groups,
  208. the ones who were the most negative
  209. were recruiting
    the conversations in the middle
  210. that were undecided about whether
    they wanted to get vaccines.
  211. The highly negative --
  212. what we might call
    the antivaccine groups --
  213. were recruiting the undecided
  214. at a rate 500 percent faster
  215. than the provaccine groups.
  216. 500 percent faster.
  217. They were more nimble,
    they were responsive
  218. and they were listening.
  219. Most people believe that vaccines are good

  220. and they believe in their importance.
  221. But that belief is under attack.
  222. We need to build in
    more opportunities for conversation.
  223. And there are ways to do it.
  224. It's not easy for some
    health professionals

  225. to have conversations
    where their authority is questioned.
  226. It's uncomfortable.
  227. And they're just too busy
    to listen to all these questions.
  228. But we need to do something about that,
  229. because we're losing
    a lot of concerned parents
  230. that just want a conversation.
  231. We should get volunteers
    trained to sit in waiting rooms,
  232. to be on hotlines,
  233. to have online chat forums,
  234. to have chat boxes.
  235. In younger kids,
    with younger kids in school,
  236. teach them about immune systems
  237. and teach them that actually,
  238. you know that vaccine
    your little brother got?
  239. Well, it just inspired
    your natural immune system.
  240. It's a great thing and this is why.
  241. We need to build that confidence;
  242. we need to listen.
  243. Despite all this questioning --

  244. and there's a lot of it --
  245. I hear probably more
    than a lot of people --
  246. I am an optimist.
  247. And my optimism
    is with a younger generation.
  248. The younger generation
    who actually now are becoming very aware
  249. of the risks of social media,
  250. the false news,
  251. the false identities,
  252. and they're starting to embrace science.
  253. And some of them are a group of children
    whose mothers refused to vaccinate them.
  254. Last spring of 2019,

  255. 18-year-old Ethan Lindenberger
  256. went on Reddit and put out a post.
  257. "My mother doesn't believe in vaccines.
  258. She's really worried they cause autism.
  259. In fact, she strongly believes that.
  260. But I'm 18.
  261. I'm a senior in high school.
  262. I can drive a car, I can vote
  263. and I could go get my own vaccine.
  264. Can someone tell me where to get it?"
  265. That post went viral.
  266. It started to get
    a whole younger movement going.
  267. I saw Ethan speak at a conference,

  268. the Global Vaccine Summit
    at the EU last fall.
  269. He spoke eloquently,
  270. and I was impressed,
  271. in front of a whole forum.
  272. He told his personal story,
  273. and then he said to the group,
  274. he said, "You know, everybody
    talks about misinformation,
  275. but I want to tell you about
    a different kind of misinformation,
  276. and that's misinformation
    that says that people like my mother,
  277. who is a loving mother,
  278. is a bad person because
    she doesn't give me vaccines.
  279. Well, I want to tell all of you
    that she didn't give me a vaccine,
  280. because she loves me
  281. and because she believed
    that that was the best thing for me.
  282. I think differently
  283. and I will never change her mind,
  284. but she's not a bad person."
  285. That was the message from a teenager.
  286. Empathy, kindness and understanding.
  287. We have an abundance
    of scientific information

  288. to debunk false rumors.
  289. That's not our problem.
  290. We have a relationship problem,
  291. not a misinformation problem.
  292. Misinformation is the symptom,
  293. not the cause.
  294. If people trust,
  295. they'll put up with a little risk
    to avert a much bigger one.
  296. The one thing that I want and I hope for

  297. is that we as a medical
    and health community
  298. have the moral courage and humility
  299. to productively engage,
  300. like Ethan,
  301. with those who disagree with us.
  302. I hope so.
  303. Thank you.

  304. (Applause and cheers)