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| Get Ready for a Vaccine Information War | Get Ready for a Vaccine Information War |
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| 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: | 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? | 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. | 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. | 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.) | 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. | 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. | 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. | 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. | 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. | 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. | 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. | 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.” | “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. | 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.” | “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. | 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. |
| Updated June 5, 2020 | Updated June 5, 2020 |
| So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement. | |
| A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study. | A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study. |
| The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April. | The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April. |
| Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission. | Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission. |
| Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home. | Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home. |
| States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people. | States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people. |
| Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks. | Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks. |
| Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days. | Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days. |
| If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.) | If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.) |
| Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications. | Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications. |
| The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing. | The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing. |
| If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others. | If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others. |
| If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested. | If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested. |
| “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.” | “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. | 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. | 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. | 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. |