As the COVID-19 vaccination programme progresses in Northern Ireland and the rest of the United Kingdom, this article considers the causes and consequences of misinformation surrounding vaccines, and highlights possible ways to tackle it.
Information, misinformation and disinformation
With the increasingly widespread use and availability of the Internet, information is seemingly at the fingertips of a growing number of people all over the world. But is that really the case? The Merriam-Webster dictionary defines information as ‘knowledge obtained from investigation, study, or instruction; intelligence, news; facts, data’. Conversely, misinformation is defined as ‘incorrect or misleading information’, while disinformation is ‘false information deliberately and often covertly spread (as by the planting of rumours) in order to influence public opinion or obscure the truth’. Unfortunately, all three of them are accessible online, so it is ultimately down to each individual to tell them apart. The inability to distinguish between them can have clear negative consequences in people’s lives.
The role of social media in the spread of false information
As of late 2020, there is a reported total of roughly 2.8 billion monthly active Facebook users worldwide, 192 million daily active Twitter users, and 689 million monthly active TikTok users, to name but a few social media applications. On top of the high number of users, social media feeds are tailored to each individual based on previous interactions with the application, which can create ‘information silos and echo chamber effects’, decreasing the chances of an individual encountering differing viewpoints. The potential for the spread of false news through social media is therefore considerable. The current COVID-19 pandemic has been no exception to that.
In June 2020, BBC news reported that social media firms were failing to act on false news relating to COVID-19, with hundreds of posts spreading misinformation (from 5G conspiracy theories to false cures) being left online. Facebook has since released a statement claiming to be taking action to share and promote authoritative information about COVID-19 vaccines, as well as combating misinformation by removing false claims on the topic. The consequences of this are yet to be assessed.
Herd immunity through vaccination is key to the long-term control of the pandemic
The ongoing SARS-CoV-2 pandemic has caused roughly 112 million clinically confirmed cases of COVID-19 and been linked to 2.5 million deaths worldwide (as of 26th February 2021). The long-term control of the pandemic can only be achieved through herd immunity. Herd immunity is defined by the World Health Organisation (WHO) as ‘the indirect protection from an infectious disease that happens when a population is immune either through vaccination or immunity developed through previous infection’. It is a way of indirectly protecting those who can’t be vaccinated, such as very young babies or people with certain diseases.
While building herd immunity through natural infection may be theoretically possible, attempting to reach it by exposing people to the virus is ‘‘scientifically and ethically problematic“, according to the Director-General of World Health Organisation (WHO), Dr Tedros Adhanom Ghebreyesus. Therefore, herd immunity should be achieved, as it has been for many other infectious diseases, by protecting people through vaccination. Being vaccinated is thus beneficial in two ways: to protect each individual, and those around them.
Vaccine hesitancy and resistance
The spread of false information on COVID-19 is of particular concern to healthcare and public health experts. The Director-General of WHO has warned of the potential dangers of misinformation as a source of otherwise avoidable harm. He has also stressed the necessity to fight the current “infodemic”, alongside the COVID-19 epidemic, a sentiment which is echoed by Dr Nikki Kanani, GP and medical director of primary care for NHS England and NHS Improvement. One of the most worrying consequences of misinformation surrounding COVID-19 is arguably vaccine hesitancy and resistance.
A recent study looked to identify and understand COVID-19 vaccine acceptance, hesitancy and resistance in the Republic of Ireland and in the United Kingdom. Researchers found vaccine hesitant or resistant respondents in both populations to show lower levels of trust in scientists/healthcare practitioners. Additionally, vaccine resistant individuals were found to: be less likely to obtain information regarding the pandemic from traditional and authoritative sources such as newspapers and television broadcasts; show higher levels of mistrust in information disseminated through those sources, healthcare practitioners, and government agencies; and consume more information from social media. This highlights the need to both ensure the accuracy of the information disseminated through less conventional media and to regain the trust in experts in a segment of the population.
It is also important to note that Northern Ireland was found, in the same study, to have the lowest rate of vaccine acceptance out of both the devolved nations of the UK and the Republic of Ireland, at only 51%. Consequently, it may be necessary to put in place targeted campaigns to promote vaccine acceptance.
Possible ways forward
A number of strategies could be employed to tackle social media-driven misinformation, with two key possibilities being pointed out by Guy Berger, the Director for Policies and Strategies regarding Communication and Information at UNESCO (United Nations Educational, Scientific and Cultural Organization).
Firstly, it is crucial to meet the public’s demand for information by increasing the supply of accurate information from official sources and the news media. As Dr Claire Wardle, a misinformation expert at Harvard University, puts it, “The best way to fight misinformation is to swamp the landscape with accurate information that is easy to digest, is engaging and easy to share on mobile. It should also answer people’s questions and ultimately fears. It’s the vacuums that are creating space for rumours to run wild”. The WHO has recently launched a Mythbusters section on their website, where they debunk some of the most commonly heard myths related to COVID-19 and vaccines.
Secondly, it is important to make people aware of the need to be critical of the information they’re presented with, particularly online and through social media. With that in mind, UNESCO is using the hashtags #ThinkBeforeSharing, #ThinkBeforeClicking, and #ShareKnowledge, and the WHO is providing tips to stop the spread of misinformation, in order to “flatten the infodemic curve”.
However, as described in the previous section, some individuals, such as those hesitant or resistant to a COVID-19 vaccine, may show a high level of distrust in authoritative sources like the government, scientists and healthcare professionals. This means that, while the responsibility for public health messaging should primarily lie with them, it may be necessary to find alternative sources to get the information to everyone. One possibility could include religious and community leaders, which have been shown to play important roles in the implementation of vaccination programmes. Additionally, videos featuring celebrities have recently been used in the UK to promote COVID-19 vaccination in high priority groups and ethnic minority communities.
Other possible strategies have been proposed by a recent study that looked to understand factors influencing the behaviour of social media users when encountering fake news (that is, whether to engage with them or not). These were to be implemented by two main stakeholders: governments, through the development of guidelines and protocols for social media platforms, and the enforcement of regulatory standards; and social media platforms, by developing algorithms to detect fake news, and cultivating a shared online standard of conduct regarding the treatment of fake news.
Another study has, however, argued that most of these approaches are actually likely to fail and proposed yet another strategy. According to these researchers, fact-checks, for instance, are unlikely to be effective on their own, as they tend to spread more slowly than misinformation, and individuals may continue to believe in misinformation even after it has been debunked (‘continued influence effect’). Additionally, media literacy initiatives can be slow and expensive to develop. They suggest, instead, a method called ‘pre-bunking’, that is, ‘pre-emptive debunking’, whereby individuals are pre-emptively exposed to the techniques and motivations behind misinformation, increasing their ability to identify and disregard misinformation in the future. In fact, an online game called Bad News has been shown to reduce susceptibility to false information for at least three months through ‘pre-bunking’. A new version of the game, Go Viral!, has recently been developed by the same team at the University of Cambridge, in collaboration with media agency DROG and the UK Cabinet Office, to specifically target COVID-19 conspiracies.
Finally, with regards to directly promoting vaccine acceptance, a multitude of approaches are likely to be necessary. For instance, some researchers have suggested focusing on the prosocial benefits of vaccination, as they found willingness to take a vaccine to be closely bound to recognition of its collective importance, while others found vaccine hesitant or resistant individuals to show lower levels of altruism and hence proposed an emphasis on the personal benefits of vaccination. The WHO has also put forward a number of steps to address vaccine uptake and hesitancy, which include understanding the drivers of immunisation uptake, and improving and sustaining uptake by tailoring immunisation programmes, addressing missed opportunities for vaccination and vaccine hesitancy, supporting health workers, and engaging with communities.
As the current COVID-19 pandemic has highlighted, the role of social media in the spread of misinformation can have serious public health consequences. Mass vaccination remains the most likely successful strategy to achieve long-term control of the pandemic. A joint effort by governments, health organisations and social media platforms, employing a multitude of approaches, may be necessary to tackle misinformation regarding vaccines, in order to improve vaccine uptake.