The other night, midway through watching a clip from “Plandemic” — a documentary that went viral on social media last week, spreading baseless lies and debunked nonsense about the coronavirus to millions of Americans overnight — I had a terrifying thought:
What if we get a Covid-19 vaccine and half the country refuses to take it?
It occurred to me that all the misinformation we’ve seen so far — the false rumors that 5G cellphone towers fuel the coronavirus, that drinking bleach or injecting UV rays can cure it, that Dr. Anthony Fauci is part of an anti-Trump conspiracy — may be just the warm-up act for a much bigger information war when an effective vaccine becomes available to the public. This war could pit public health officials and politicians against an anti-vaccination movement that floods social media with misinformation, conspiracy theories and propaganda aimed at convincing people that the vaccine is a menace rather than a lifesaving, economy-rescuing miracle.
Scariest of all? It could actually work.
I’ve been following the anti-vaccine community on and off for years, watching its members operate in private Facebook groups and Instagram accounts, and have found that they are much more organized and strategic than many of their critics believe. They are savvy media manipulators, effective communicators and experienced at exploiting the weaknesses of social media platforms. (Just one example: Shortly after Facebook and YouTube began taking down copies of “Plandemic” for violating their rules, I saw people in anti-vaccine groups editing it in subtle ways to evade the platforms’ automated enforcement software and reposting it.)
In short, the anti-vaxxers have been practicing for this. And I’m worried that they will be unusually effective in sowing doubts about a Covid-19 vaccine for several reasons.
First, because of the pandemic’s urgency, any promising Covid-19 vaccine is likely to be fast-tracked through the testing and approval process. It may not go through years of clinical trials and careful studies of possible long-term side effects, the way other drugs do. That could create an opening for anti-vaccine activists to claim that it is untested and dangerous, and to spin reasonable concerns about the vaccine into widespread, unfounded fears about its safety.
Second, if a vaccine does emerge, there is a good chance that leading health organizations like the Bill and Melinda Gates Foundation or the World Health Organization will have a hand in producing or distributing it. If that’s the case, anti-vaccine activists, who have been crusading against these groups for years, will have plenty of material stockpiled to try to discredit them. They are already taking aim at Mr. Gates with baseless conspiracy theories claiming that he created and is trying to profit from the virus. These theories will be amplified, and the attempts to discredit leading virus research efforts will intensify as the vaccine nears.
Third, if and when a Covid-19 vaccine is approved for widespread use, people may be required to take it before being allowed to fly on certain airlines, attend certain schools or enter certain businesses. That’s a good idea, public health-wise, but it would play into some of the worst fears of the anti-vaccine movement.
Mandatory vaccination has been an especially potent talking point for anti-vaccine activists, some of whom have rebranded themselves “pro-choice” when it comes to vaccines. And years of battling states and school districts over mandatory vaccine policies have given them a playbook for creating a tangle of legal roadblocks and damaging publicity campaigns.
I wanted to understand if my fears about a vaccine-related information war were valid, so I reached out to Neil Johnson and Rhys Leahy, two researchers at George Washington University. On Wednesday, their study of the online anti-vaccine movement was published in the science journal Nature.
The study, which mapped the vaccine conversation on Facebook during the 2019 measles outbreak, found that there were nearly three times as many active anti-vaccination communities as pro-vaccination communities. In addition, they found that while pro-vaccine pages tended to have more followers, anti-vaccine pages were faster-growing.
“We expected to find a strong core of ‘vanilla’ science — people saying that vaccines are good for you — but that’s not what we found at all,” Mr. Johnson told me. “We found a real struggle online, where the public health establishment and its supporters are almost fighting in the wrong place.”
The researchers found that Facebook pages pushing accurate pro-vaccine information were mostly clustered in an insular group, while the anti-vaccine pages treated vaccine resistance as a kind of political campaign, and used different messages to reach different types of undecided “voters.” A page promoting holistic health remedies might start seeding doubts about vaccines among liberal yoga moms, while a page promoting resistance to government-mandated vaccines might appeal to conservatives and libertarians.
“Public health advocacy groups tend to be monolithic, sending one message” that vaccines are safe and effective, Ms. Leahy said. “The anti-vax movement is really diverse.”
There is some reason for hope. Recent surveys have suggested that most Americans would take a Covid-19 vaccine if one were available today. Even politicians who have expressed skepticism about vaccines in the past, including President Trump, are rooting for one that can prevent the disease. And some public health experts I spoke to said public pressure to end the pandemic and return to normal life might overpower anti-vaccine activism.
“People are seeing the toll of Covid-19 all around,” said Kasisomayajula Viswanath, a professor of health communication at the Harvard School of Public Health. “My guess is that if there is a successful vaccine, especially in the absence of treatment, people may discount the anti-vaccine groups.”
But public acceptance of a Covid-19 vaccine is far from a sure thing. And seeing platforms like Facebook and YouTube struggle to contain the spread of videos like “Plandemic” makes me worry that when the time comes to persuade billions of people to take a critical coronavirus vaccine, our public health officials and social media companies will be outgunned by a well-oiled anti-vaccine movement that has already polluted the air with misinformation and conspiracy theories.
We can prevent that, but only if we start laying the groundwork before it’s too late. Organizations like the Centers for Disease Control and Prevention and the W.H.O. need to understand the dynamics of online anti-vaccination communities and start waging a hearts-and-minds campaign to restore faith in the medical establishment while a vaccine is being developed. Social media companies need to take the threat of vaccine-related misinformation seriously and devote tremendous resources to stopping its spread. And those of us who believe in vaccines need to realize that we may not be in the majority for long and do everything we can to reach the people in our lives who might be susceptible to anti-vaccine propaganda.
To recover from this pandemic, we need to mobilize a pro-vaccine movement that is as devoted, as internet-savvy and as compelling as the anti-vaccine movement is for its adherents. We need to do it quickly, with all the creativity and urgency of the scientists who are developing the vaccine itself. Millions of lives and trillions of dollars in economic activity may depend not just on producing a vaccine, but on persuading people to accept it.