The likelihood of the global science community developing an effective Covid-19 vaccine over the next year is a matter of greater uncertainty than much of the public debate suggests. None of us find the concept of probability easy to handle and expectations are high. How and where the vaccine can then be manufactured at scale, at reasonable cost and then distributed, are challenges of almost equal proportions.
But even if this all works, the willingness of populations to take the vaccine is becoming an issue of real concern. In 2019, the World Health Organization (WHO) labelled ‘vaccine hesitancy’ as one of the greatest threats to health globally. Fear of vaccinations is nothing new and began with the rollout of the smallpox virus in the nineteenth century. An anti-vaccination march was held in Leicester in 1885, where around 100,000 protestors gathered to oppose enforcement action taken against 5,000 citizens who were refusing to be vaccinated. The controversy of the MMR/autism link – falsely propagated by Andrew Wakefield – was in line with a long tradition.
Vaccinations have always met cultural or religious barriers, often combined with suspicion of the commercial interests of those administering them, mistrust of government, or fear of Western intrusion into communities. The majority of us support vaccinations and understand perhaps just enough of the science. But a minority of those who refuse to take part can greatly reduce a vaccine’s impact.
Public attitudes regarding the coronavirus vaccine are unlikely to be much different, but the consequences could be worse. The internet has, unsurprisingly, greatly amplified these narratives. According to a recent YouGov poll, one in five British adults have reported themselves likely to turn down a coronavirus vaccine. The research also showed that those seeking information from social media, rather than traditional channels, are most likely to be hostile to the idea of a vaccine. Only 40 per cent of respondents said that they would ‘definitely’ have the vaccine administered if one were available. There is a risk that the issue becomes politicised and the anti-vaccination movement becomes conflagrated with broader anti-government opposition.
The battle to shape public opinion on the Covid-19 vaccine will clearly be won or lost online, particularly as search engines and social media have become central platforms through which the public sources information and establishes a stance on the issue. Arguments will not convince the truly committed. But shifting the opinions and instincts of the wider community will be critical.
The anti-vax groups, whether known or anonymous, have become increasingly organised and technologically capable. Against a medical profession often stuck in “old media”, they employ cutting-edge digital communications techniques. They respond to medical facts with false science and emotion, playing to suspicions of the medical profession and deploying free-thinking and anti-science tropes. They are skilful exploiters of Twitter activity to reinforce the credibility of their assertions. Their techniques include the mass creation of fake social media accounts, which make up a significant share of the content regarding vaccines that are found on Twitter and other social media platforms. The majority of posts regarding vaccinations on Pinterest are linked to the anti-vax movement, in spite of Pinterest’s ground-breaking policy to stop showing results for searches related to vaccines as a way to prevent people from encountering harmful health misinformation. Facebook hosts a number of sites that all help drive the argument.
There is no easy policy solution to tackling this issue. For many, these are issues tied up by identity, belief, and community – which state-sponsored campaigns might not be able to influence. The balance between freedom of speech and clear malign use of social media around anti-vaccination sentiment is a fine one. The law is not always designed to respond to harms and dangers such as this. Furthermore, although the major social media platforms have begun to take a firmer stance against this kind of content online, in reality their processes are often slow and ineffective at dealing with the size and complexity of the networks that are sharing anti-vaccination messaging.
In parallel, alternative narratives need to be developed. There are limitations on what government spokespeople can do in this arena to be authoritative. The pharmaceutical industry is similarly disadvantaged, but can both support and finance community initiatives. Social media campaigns need to be community-based, using influencers with clear narratives who emphasise the benefits of vaccination and their safety. This potential network of vaccine advocates needs to be built up and supported. In the same way that search engines and social media have become the central platforms for propagating anti-vaccination mythologies, they can also help to counter it.