9:59:59.000,9:59:59.000
I study rumors.

9:59:59.000,9:59:59.000
Not tabloid gossip

9:59:59.000,9:59:59.000
or the kind of rumors that are making[br]stock markets crash --

9:59:59.000,9:59:59.000
or soar,

9:59:59.000,9:59:59.000
but the kind of rumors[br]that effect your health ...

9:59:59.000,9:59:59.000
and the world's health.

9:59:59.000,9:59:59.000
Like eating a lot of garlic

9:59:59.000,9:59:59.000
or drinking a lot of water

9:59:59.000,9:59:59.000
is going to help protect[br]us from coronavirus --

9:59:59.000,9:59:59.000
if only.

9:59:59.000,9:59:59.000
Rumors have a bad reputation.

9:59:59.000,9:59:59.000
There seen as "not fact," wrong[br]or "just a rumor."

9:59:59.000,9:59:59.000
But I've studied rumors for years,

9:59:59.000,9:59:59.000
and one thing I've learned[br]is that they all have a story,

9:59:59.000,9:59:59.000
and often, an important story.

9:59:59.000,9:59:59.000
One of the most moving or alarming[br]rumor episodes that I investigated

9:59:59.000,9:59:59.000
was in Northern Nigeria.

9:59:59.000,9:59:59.000
I was working with UNICEF's global[br]immunization program.

9:59:59.000,9:59:59.000
And it was the rumors themselves[br]that I found so alarming;

9:59:59.000,9:59:59.000
it was the global impact of those rumors.

9:59:59.000,9:59:59.000
The rumors were suspecting

9:59:59.000,9:59:59.000
that the polio vaccine[br]was actually a contraceptive;

9:59:59.000,9:59:59.000
it was controlling populations --

9:59:59.000,9:59:59.000
or maybe it caused AIDS.

9:59:59.000,9:59:59.000
No, no, maybe it's the CIA[br]spying on them or counting them.

9:59:59.000,9:59:59.000
I mean, why else would they have people[br]knocking on their door again and again

9:59:59.000,9:59:59.000
with the same polio vaccine?

9:59:59.000,9:59:59.000
When children were dying of measles,

9:59:59.000,9:59:59.000
no one was coming with measles vaccines.

9:59:59.000,9:59:59.000
This wasn't about getting the facts right.

9:59:59.000,9:59:59.000
This was about trust.

9:59:59.000,9:59:59.000
It was about broken trust.

9:59:59.000,9:59:59.000
Why so much distrust?

9:59:59.000,9:59:59.000
It wasn't the mothers who were[br]particularly distrusting, actually.

9:59:59.000,9:59:59.000
It was the local leaders,

9:59:59.000,9:59:59.000
the religious leaders,

9:59:59.000,9:59:59.000
the local political leaders.

9:59:59.000,9:59:59.000
It was the governor of the state of Kano

9:59:59.000,9:59:59.000
who decided to boycott

9:59:59.000,9:59:59.000
the entire polio eradication[br]effort in that state ...

9:59:59.000,9:59:59.000
for 11 months.

9:59:59.000,9:59:59.000
Why such distrust?

9:59:59.000,9:59:59.000
Well, it was 2003.

9:59:59.000,9:59:59.000
It was two years after 9/11.

9:59:59.000,9:59:59.000
And they were convinced that the West,

9:59:59.000,9:59:59.000
and particularly the United States,

9:59:59.000,9:59:59.000
was at war with Muslims.

9:59:59.000,9:59:59.000
And they knew that the West,

9:59:59.000,9:59:59.000
and particularly the United States,

9:59:59.000,9:59:59.000
was a huge supporter --

9:59:59.000,9:59:59.000
and funder --

9:59:59.000,9:59:59.000
of the global polio[br]eradication initiative.

9:59:59.000,9:59:59.000
They had their reasoning.

9:59:59.000,9:59:59.000
That lack of trust,

9:59:59.000,9:59:59.000
that "just a rumor or two"

9:59:59.000,9:59:59.000
cost the polio eradication program[br]500 million dollars

9:59:59.000,9:59:59.000
to reset the clock,

9:59:59.000,9:59:59.000
to regain the progress lost[br]during those 11 months

9:59:59.000,9:59:59.000
and beyond.

9:59:59.000,9:59:59.000
The Nigerian strain of the polio virus[br]traveled to over 20 countries

9:59:59.000,9:59:59.000
as far as Indonesia.

9:59:59.000,9:59:59.000
The cost of a rumor.

9:59:59.000,9:59:59.000
The Nigeria episode was one[br]of many episodes that I investigated

9:59:59.000,9:59:59.000
when I was with UNICEF

9:59:59.000,9:59:59.000
and earned the title of the director[br]of UNICEF's fire department.

9:59:59.000,9:59:59.000
At that point I realized I never[br]really had enough time.

9:59:59.000,9:59:59.000
I was too busy putting out the fires

9:59:59.000,9:59:59.000
and not enough time to understand

9:59:59.000,9:59:59.000
what was driving not just[br]the individual episodes,

9:59:59.000,9:59:59.000
but why was there an epidemic[br]of these happening around the world.

9:59:59.000,9:59:59.000
I left UNICEF and went[br]back to research --

9:59:59.000,9:59:59.000
applied research --

9:59:59.000,9:59:59.000
and I set up in 2010 what I called[br]the Vaccine Confidence Project

9:59:59.000,9:59:59.000
at the London School of Hygiene[br]and Tropical Medicine.

9:59:59.000,9:59:59.000
I convened antrhopologists,

9:59:59.000,9:59:59.000
epidemiologists,

9:59:59.000,9:59:59.000
psychologists,

9:59:59.000,9:59:59.000
digital media specialists

9:59:59.000,9:59:59.000
and mathematical modelers.

9:59:59.000,9:59:59.000
We set ourselves the task

9:59:59.000,9:59:59.000
to investigate historic[br]episodes of rumors

9:59:59.000,9:59:59.000
and their impacts,

9:59:59.000,9:59:59.000
from trying to figure out[br]what were the early signals,

9:59:59.000,9:59:59.000
what were the amplifying factors

9:59:59.000,9:59:59.000
and the impacts,

9:59:59.000,9:59:59.000
how did they get traction,

9:59:59.000,9:59:59.000
so we could start to understand[br]what we should be looking for,

9:59:59.000,9:59:59.000
how we could help governments

9:59:59.000,9:59:59.000
and immunization programs[br]be more alert and responsive

9:59:59.000,9:59:59.000
to early signals of problems.

9:59:59.000,9:59:59.000
It was an early warning system.

9:59:59.000,9:59:59.000
In 2015 we developed[br]a vaccine confidence index.

9:59:59.000,9:59:59.000
It's a survey trying to investigate[br]to what extent do people agree

9:59:59.000,9:59:59.000
or disagree that vaccines are important,

9:59:59.000,9:59:59.000
they're safe,

9:59:59.000,9:59:59.000
they're effective --

9:59:59.000,9:59:59.000
they work --

9:59:59.000,9:59:59.000
and somehow they're compatible[br]with my religious beliefs.

9:59:59.000,9:59:59.000
We've run this with over hundreds[br]of thousands of people around the world,

9:59:59.000,9:59:59.000
trying to get our finger on the pulse[br]of confidence and trust,

9:59:59.000,9:59:59.000
but also, more importantly, looking[br]at when that trust goes up or down,

9:59:59.000,9:59:59.000
because we want to see[br]when it starts to decline,

9:59:59.000,9:59:59.000
that's the time to jump in,

9:59:59.000,9:59:59.000
to get there before there's a crisis[br]like the Nigerian one.

9:59:59.000,9:59:59.000
We also set up 24/7 media and social media[br]monitoring around the world --

9:59:59.000,9:59:59.000
multilanguage,

9:59:59.000,9:59:59.000
listening for what's going on[br]on vaccine conversations,

9:59:59.000,9:59:59.000
trying to pick up early concerns[br]or changes in sentiment

9:59:59.000,9:59:59.000
that we should be paying attention to.

9:59:59.000,9:59:59.000
We've created an ecosystem[br]of different types of information

9:59:59.000,9:59:59.000
to try to understand[br]what are the public thinking

9:59:59.000,9:59:59.000
and how can we engage?

9:59:59.000,9:59:59.000
We look for early signals.

9:59:59.000,9:59:59.000
When we find one,

9:59:59.000,9:59:59.000
we have global network of collaborators[br]in a number of countries

9:59:59.000,9:59:59.000
who have more local [br]intelligence in that setting,

9:59:59.000,9:59:59.000
to try to understand:

9:59:59.000,9:59:59.000
is this signal misinformation

9:59:59.000,9:59:59.000
or is something brewing[br]that we should know about?

9:59:59.000,9:59:59.000
In London, we have a bigger picture;

9:59:59.000,9:59:59.000
we watch the swarms of rumors[br]not just traveling locally

9:59:59.000,9:59:59.000
but jumping countires.

9:59:59.000,9:59:59.000
We've seen them jump[br]from Japan over to Columbia,

9:59:59.000,9:59:59.000
through Europe and around.

9:59:59.000,9:59:59.000
They move.

9:59:59.000,9:59:59.000
We live in a hyper-connected environment.

9:59:59.000,9:59:59.000
One of the things[br]that we found fascinating,

9:59:59.000,9:59:59.000
and we've learned[br]a lot in the last 10 years --

9:59:59.000,9:59:59.000
this is our 10th anniversary,

9:59:59.000,9:59:59.000
this didn't start yesterday,

9:59:59.000,9:59:59.000
this rumor problem --

9:59:59.000,9:59:59.000
and one of the things we learned

9:59:59.000,9:59:59.000
is in our global monitoring,

9:59:59.000,9:59:59.000
that Europe is the most[br]skeptical region in the world.

9:59:59.000,9:59:59.000
France won the prize actually.

9:59:59.000,9:59:59.000
(Laughter)

9:59:59.000,9:59:59.000
By far.

9:59:59.000,9:59:59.000
And actually some of those rumors[br]have traveled to other parts of the world.

9:59:59.000,9:59:59.000
But we were trying to understand Europe.

9:59:59.000,9:59:59.000
Hm.

9:59:59.000,9:59:59.000
Why Europe?

9:59:59.000,9:59:59.000
I thought the US was really --

9:59:59.000,9:59:59.000
had some of the most skepticism,

9:59:59.000,9:59:59.000
but boy, I was wrong.

9:59:59.000,9:59:59.000
And a political scientist,

9:59:59.000,9:59:59.000
a colleague we work with,

9:59:59.000,9:59:59.000
John Kennedy,

9:59:59.000,9:59:59.000
he took our data from 28[br]European countries

9:59:59.000,9:59:59.000
and he looked at it

9:59:59.000,9:59:59.000
and correlated it[br]with political opinion polling.

9:59:59.000,9:59:59.000
And what did he find?

9:59:59.000,9:59:59.000
He found that people who are most likely[br]to vote for a populous party

9:59:59.000,9:59:59.000
also were the ones the most likely[br]to strongly disagree

9:59:59.000,9:59:59.000
that vaccines were important,[br]safe or effective.

9:59:59.000,9:59:59.000
What did we learn?

9:59:59.000,9:59:59.000
Vaccines cannot escape[br]the politcal and social turbulance

9:59:59.000,9:59:59.000
that surrounds it.

9:59:59.000,9:59:59.000
Scientists were unprepared[br]for this tsunami of doubt

9:59:59.000,9:59:59.000
and questions

9:59:59.000,9:59:59.000
and distrust.

9:59:59.000,9:59:59.000
What --

9:59:59.000,9:59:59.000
why are vaccines so ripe for resistance?

9:59:59.000,9:59:59.000
Well, we identified a number of things,

9:59:59.000,9:59:59.000
but one:

9:59:59.000,9:59:59.000
they're highly mediated by government[br]that require, regulates

9:59:59.000,9:59:59.000
and sometimes recommmends vaccines,

9:59:59.000,9:59:59.000
or often recommends or sometimes requires.

9:59:59.000,9:59:59.000
Big business makes vaccines,

9:59:59.000,9:59:59.000
and neither institution,

9:59:59.000,9:59:59.000
government or big business,

9:59:59.000,9:59:59.000
are high in the trust ranks these days.

9:59:59.000,9:59:59.000
And then there's scientists[br]who discover and develop vaccines,

9:59:59.000,9:59:59.000
and they're pretty elite

9:59:59.000,9:59:59.000
and not accessible to the general public,

9:59:59.000,9:59:59.000
at least the language they speak.

9:59:59.000,9:59:59.000
Third, we're in a hyper-connected[br]environment with social media these days,

9:59:59.000,9:59:59.000
and people can share their unfettered[br]views, concerns, anxieties and worries

9:59:59.000,9:59:59.000
and find a lot of people[br]that think the way they do,

9:59:59.000,9:59:59.000
and think maybe their worries[br]are worth paying attention to.

9:59:59.000,9:59:59.000
And finally,

9:59:59.000,9:59:59.000
vaccines touch every single[br]life on the planet.

9:59:59.000,9:59:59.000
What other health intervention,

9:59:59.000,9:59:59.000
besides water,

9:59:59.000,9:59:59.000
touches every single life?

9:59:59.000,9:59:59.000
So if you're looking[br]for something to disrupt,

9:59:59.000,9:59:59.000
it's a perfect stage.

9:59:59.000,9:59:59.000
Perhaps that's one of the reasons[br]that we need to pay more attention

9:59:59.000,9:59:59.000
and rebuild our trust in issues.

9:59:59.000,9:59:59.000
People are asking all kinds of questions.

9:59:59.000,9:59:59.000
They're asking,

9:59:59.000,9:59:59.000
why are vaccines --

9:59:59.000,9:59:59.000
and these are the kinds of things[br]we're hearing in our social media --

9:59:59.000,9:59:59.000
why can't my child have[br]a personalized vaccination schedule?

9:59:59.000,9:59:59.000
What the wisdom of so many vaccines?

9:59:59.000,9:59:59.000
What about all those ingredients[br]and preservatives?

9:59:59.000,9:59:59.000
These are not crazy people,

9:59:59.000,9:59:59.000
they're not uneducated;

9:59:59.000,9:59:59.000
they're actually worried mothers.

9:59:59.000,9:59:59.000
But some of them have come[br]to me and said we feel ignored,

9:59:59.000,9:59:59.000
we feel judged if we ask a question,

9:59:59.000,9:59:59.000
and we even feel demonized

9:59:59.000,9:59:59.000
that maybe we're part of some[br]antivaccine group.

9:59:59.000,9:59:59.000
So we have some listening to do.

9:59:59.000,9:59:59.000
And maybe that's why last year,

9:59:59.000,9:59:59.000
there was research that found

9:59:59.000,9:59:59.000
that in six months in 2019,

9:59:59.000,9:59:59.000
online --

9:59:59.000,9:59:59.000
this was with hundreds --

9:59:59.000,9:59:59.000
100 million different users[br]on social media --

9:59:59.000,9:59:59.000
although the numbers of individuals[br]who expressed in their online groups

9:59:59.000,9:59:59.000
they were positive,

9:59:59.000,9:59:59.000
as groups,

9:59:59.000,9:59:59.000
the ones who are the most negative

9:59:59.000,9:59:59.000
were recruiting[br]the conversations in the middle

9:59:59.000,9:59:59.000
that were undecided about whether[br]they wanted to get vaccines.

9:59:59.000,9:59:59.000
The highly negative --

9:59:59.000,9:59:59.000
what we might call the antivaccine groups,

9:59:59.000,9:59:59.000
were recruiting the undecided[br]at a rate 500 percent faster

9:59:59.000,9:59:59.000
than the pro-vaccine groups.

9:59:59.000,9:59:59.000
500 percent faster.

9:59:59.000,9:59:59.000
They were more nimble,

9:59:59.000,9:59:59.000
they were responsive

9:59:59.000,9:59:59.000
and they were listening.

9:59:59.000,9:59:59.000
Most people believe that vaccines are good

9:59:59.000,9:59:59.000
and they believe in their importance.

9:59:59.000,9:59:59.000
But that belief is under attack.

9:59:59.000,9:59:59.000
We need to build in more[br]opportunities for conversation.

9:59:59.000,9:59:59.000
And there are ways to do it.

9:59:59.000,9:59:59.000
It's not easy for some[br]health professionals

9:59:59.000,9:59:59.000
to have conversations where[br]their authority is questioned.

9:59:59.000,9:59:59.000
It's uncomfortable.

9:59:59.000,9:59:59.000
And they're just too busy[br]to listen to all these questions.

9:59:59.000,9:59:59.000
But we need to to do something about that

9:59:59.000,9:59:59.000
because we're losing[br]a lot of concerned parents

9:59:59.000,9:59:59.000
that just want a conversation.

9:59:59.000,9:59:59.000
We should get volunteers trained[br]to sit in waiting rooms,

9:59:59.000,9:59:59.000
to be on hotlines,

9:59:59.000,9:59:59.000
to have online chat forums,

9:59:59.000,9:59:59.000
to have chat boxes.

9:59:59.000,9:59:59.000
In younger kids,

9:59:59.000,9:59:59.000
with younger kids in school,

9:59:59.000,9:59:59.000
teach them about immune systems

9:59:59.000,9:59:59.000
and teach them that actually,

9:59:59.000,9:59:59.000
you know that vaccine[br]your little brother got?

9:59:59.000,9:59:59.000
Well, it just inspired[br]your natural immune system.

9:59:59.000,9:59:59.000
It's a great thing and this is why.

9:59:59.000,9:59:59.000
We need to build that confidence;

9:59:59.000,9:59:59.000
we need to listen.

9:59:59.000,9:59:59.000
Despite all this questioning --

9:59:59.000,9:59:59.000
and there's a lot of it --

9:59:59.000,9:59:59.000
I probably hear more[br]than a lot of people --

9:59:59.000,9:59:59.000
I am an optimist.

9:59:59.000,9:59:59.000
And my optimism is with[br]a younger generation.

9:59:59.000,9:59:59.000
The younger generation who actually now[br]are becoming very aware

9:59:59.000,9:59:59.000
of the risks of social media,

9:59:59.000,9:59:59.000
the false news,

9:59:59.000,9:59:59.000
the false identities,

9:59:59.000,9:59:59.000
and they're starting to embrace science.

9:59:59.000,9:59:59.000
And some of them are a group of children[br]whose mothers refused to vaccinate them.

9:59:59.000,9:59:59.000
Last spring of 2019,

9:59:59.000,9:59:59.000
18-year-old Ethan Lindenburg[br]went on Reddit

9:59:59.000,9:59:59.000
and put out a post.

9:59:59.000,9:59:59.000
"My mother doesn't believe in vaccines.

9:59:59.000,9:59:59.000
She's really worried they cause autism.

9:59:59.000,9:59:59.000
In fact, she strong believes that.

9:59:59.000,9:59:59.000
But I'm 18.

9:59:59.000,9:59:59.000
I'm a senior in high school.

9:59:59.000,9:59:59.000
I can drive a car,

9:59:59.000,9:59:59.000
I can vote,

9:59:59.000,9:59:59.000
and I can go get my own vaccine.

9:59:59.000,9:59:59.000
Can someone tell me where to get it?"

9:59:59.000,9:59:59.000
That post went viral.

9:59:59.000,9:59:59.000
It started to get a whole[br]younger movement going.

9:59:59.000,9:59:59.000
I saw Ethan speak at a conference,

9:59:59.000,9:59:59.000
the Global Vaccine Summit[br]at the EU last fall.

9:59:59.000,9:59:59.000
He spoke eloquently,

9:59:59.000,9:59:59.000
and I was impressed

9:59:59.000,9:59:59.000
in front of a whole forum.

9:59:59.000,9:59:59.000
He told his personal story,

9:59:59.000,9:59:59.000
and then he said to the group,

9:59:59.000,9:59:59.000
he said, "You know, everybody[br]talks about misinformation,

9:59:59.000,9:59:59.000
but I want to tell you about[br]a different kind of misinformation,

9:59:59.000,9:59:59.000
and that's misinformation that says[br]that people like my mother,

9:59:59.000,9:59:59.000
who is loving mother,

9:59:59.000,9:59:59.000
is bad person because[br]she doesn't give me vaccines.

9:59:59.000,9:59:59.000
Well, I want to tell all of you[br]that she didn't give me a vaccine

9:59:59.000,9:59:59.000
because she loves me

9:59:59.000,9:59:59.000
and because she believed that that[br]was the best thing for me.

9:59:59.000,9:59:59.000
I think differently

9:59:59.000,9:59:59.000
and I will never change her mind,

9:59:59.000,9:59:59.000
but she's not a bad person."

9:59:59.000,9:59:59.000
That was the message from a teenager.

9:59:59.000,9:59:59.000
Empathy, kindness and understanding.

9:59:59.000,9:59:59.000
We have an abundance[br]of scientific information

9:59:59.000,9:59:59.000
to debunk false rumors.

9:59:59.000,9:59:59.000
That's not our problem.

9:59:59.000,9:59:59.000
We have a relationship problem,

9:59:59.000,9:59:59.000
not a misinformation problem.

9:59:59.000,9:59:59.000
Misiniformation is a symptom,

9:59:59.000,9:59:59.000
not the cause.

9:59:59.000,9:59:59.000
If people trust,

9:59:59.000,9:59:59.000
they'll put up with a little risk[br]to avert a much bigger one.

9:59:59.000,9:59:59.000
The one thing that I want and I hope for

9:59:59.000,9:59:59.000
is that we as a medical[br]and health community

9:59:59.000,9:59:59.000
have the moral courage and humility

9:59:59.000,9:59:59.000
to productively engage,

9:59:59.000,9:59:59.000
like Ethan,

9:59:59.000,9:59:59.000
with those who disagree with us.

9:59:59.000,9:59:59.000
I hope so.

9:59:59.000,9:59:59.000
Thank you.

9:59:59.000,9:59:59.000
(Applause and cheers)