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How to address the persistence of misinformation about vaccines online

Today an interesting study exploring the link between exposure to negative information regarding vaccination on Twitter and expression of a negative opinion regarding vaccination has been published by a team from Macquarie University and the University of Sydney. In this post, lead authors Adam Dunn and Julie Leask look at how to approach the issue of misinformation online.

Adam Dunn and Julie Leask write:

The recently proposed ‘no jab, no play and no pay’  policy was focused on influencing the approximately 2% of Australian parents registered as refusing vaccinations for a variety of non-medical reasons. While this proportion has grown in the last decade, there are other percentages that are of much greater concern.

In Australia, half of parents have concerns  about the safety of vaccines, and surveys from Australia, US, and Canada indicate that between 20% and 33% of adults believe that vaccines can cause autism. Even though the link has been thoroughly and repeatedly debunked in the 17 years since it first appeared, this kind of persistent misinformation does influence vaccine hesitancy and refusal.  With online social networks becoming the norm for information sharing within communities, misinformation can be amplified in hours not months or years.

Step 1: Measure the size of the problem

In our research we combine data mining and social science to better understand misinformation. We use Twitter as a kind of social laboratory to examine how people share opinions about the human papillomavirus (HPV) vaccine. Since October 2013 we have collected over two hundred thousand tweets, and mapped out the network of social connections among all the users who tweeted about the vaccines.

Today we published a new study in the Journal of Medical Internet Research, looking at 83,551 tweets about HPV vaccines posted within a six month period. Just over 24% of those were negative – rejecting the safety or value of the vaccines. Examples include stories about young girls who suffered from serious medical conditions after receiving the vaccine, claims that a lead developer believes that the vaccine will not prevent cancer, and a whole range of causation-correlation confusion and data manipulation.

The main result of our study was to confirm the presence of a strong echo chamber effect for HPV vaccines. Users who were more often exposed to negative opinions were then much more likely to post negative opinions. These users also tended to inhabit sections of the Twitter ecosystem that were largely isolated from scientists, clinical evidence, and public health organisations. The implications can be described more simply: for the vast majority of us, the social connections we choose largely dictate the information we see as well as the opinions we express.

A network view of more than 30,000 Twitter users who posted tweets about HPV vaccines in a six month period, connected to who they follow, sized according to how many followers they have in this network, and coloured according to whether they were more often exposed to anti-vaccine opinions (orange) or not (blue) in the period.

Step 2: Work with communities at risk of misinformed opinions

The results of our study are consistent with the results of a recent study examining what Facebook users see in their timelines, showing that the way we structure our own social networks is the most important factor in limiting exposure to attitude-challenging information. Conflicts that could increase the polarisation in our social networks may further drive a wedge between clinical research and large sections of the broader community. This could increase the level of distrust in public health interventions and make it much harder to recover from any future safety scares that may be gain traction in the media.

Instead, we should engage with the fence sitters – those at risk of becoming the refusers of all or some vaccines, or those who plan to vaccinate but simply want their concerns and questions addressed. And because vaccine rejection is a community phenomenon wound up in social norms, a useful way to do this is to support local advocates so that they can be effective voices for vaccination in a way that speaks the language of those communities.

Step 3: Help people evaluate what they read

By measuring misinformation online, we know that there are a range of different concerns about HPV vaccines. Stories of teenaged girls facing health issues after vaccination are posted on blogs mixed with advertising for gun rights. Homeopathy businesses are connected to conspiracy theorists concerned with the profiteering of pharmaceutical companies. These stories appear to affect people across the political and educational spectrum, so we should be careful not to assume there is a one-size-fits-all solution to addressing vaccine hesitancy.

We need to provide the tools that many of us in science take for granted in our professional lives – the tools needed to recognise false balance in the media, tools to evaluate the credibility of health information online, to reflect on our own personal biases, to separate temporal and causal association, and to support parents’ decision-making in a way that communicates science honestly.

Scientists, governments, science communicators, and journalists should work together to improve the quality of information available online. These include translating research without distortion or exaggeration, and providing access to the full texts of studies being reported. Given the centrality of news organisations in the networks we measure, it is clear that the media need to wield their influence with finesse and care.

Six-word policies that punish people for misinformed opinions create further conflict with a very small proportion of people who are unlikely to change their decisions. The risk associated with this kind of policy is that it could drive a larger wedge between public health practices based in clinical evidence and the kind of science denialism that is prevalent well beyond the 2% who refuse to vaccinate. To help guide parents away from these oubliettes of misinformation, we need to do much more to bridge the divide that separates evidence and public opinion.

 

Adam G. Dunn is a  Senior Research Fellow, Centre for Health Informatics, Australian Institute of Health Innovation Macquarie University

Julie Leask is  Associate Professor, School of Public Health, The University of Sydney

Related Posts

Comments 21

  1. Chris Hartwell says:

    There are plenty of hardline anti-science types that dress themselves up as fence-sitters or “Just Asking Questions” (also known as JAQing off) – being able to identify a genuinely curious person who is sitting on the fence would be useful in targeting education efforts, as practically nothing will change the mind of someone committed to the idea the vaccines are dangerous.

  2. Twinto Dimore says:

    It would help clear the air if the mainstream media published the various class actions dealing with vaccine damage.

    For example

    “the National Vaccine Injury Compensation Program (VICP) has Paid Out Nearly $6 million in Claims to Victims of Controversial HPV (human papillomavirus) Vaccine, including Families of Two Dead”

    And try this for risk management:

    ” U.S. law prevents anyone damaged by vaccines from suing the manufacturer. In 1986, Congress passed a law preventing legal liability to vaccine damages”

    http://healthimpactnews.com/2014/judge-lawsuit-against-mercks-mmr-vaccine-fraud-to-continue/#sthash.yfmZAfzt.dpuf

  3. Many cancers are preventable or largely preventable. For some, including cervical cancer, preventability is well publicized and people change their behavior accordingly. For at least one, namely bowel cancer, which can be prevented by finding and removing pre-cancerous “polyps” during a colonoscopy, preventability is under-reported, with catastrophic results. – https://t.co/qb83PGmLHB

  4. Norman Hanscombe says:

    Something which would help clarify the situation is a STRONG campaign by socially responsible sources such as on this issue at least, Crikey.
    Let the Campaign begin?

  5. David Ayers says:

    Yes we always hear that vaccines are for our own good and that those who reject them are ignorant or plain negligent.

    Try selling the vaccines are safe line to someone who has an autistic child bouncing off the walls. Many parents have their lives and marriages wrecked but caring for an autistic child. If autism is not caused by the thimerosal which is contained in the MMR vaccines, then what is the cause.

    Why is it that over2 million children in the United States have been diagnosed with autism. Autism has been steadily growing in the United States since the introduction of the measles vaccine in 1963. US children now receive over 100 antigens before they reach school age and vaccine promoters want to increase that. This is beyond criminal.

    Explain to me why a growing number of children now have serious neurological problems such as autism, ADHD, learning difficulties , behavioural disorders , immune disorders and allergies. Could it be that vaccines are not enhancing the bodys immune defences, but in fact are highly destructive.

    Perhaps the vaccine companies want to brainwash parents into subjecting their child to Russian roulette to protect their huge market .Perhaps they are lying about the real risks posed by vaccines. Have you ever heard of Dr William Thompson The Whisleblower from the Center For Disease Control in America?.

    In 2014, Dr Thompson who was a senior epidemiologist with the CDC published documents that showed that by 2001, the CDC knew that a child exposed in utero to Thimerosal which is contained in the MMR vaccine is 800% more likely to develop autism. Also the CDC knew that a child that received the MMR vaccine is 300%more likely to degress into autism, yet it failed to publish its findings.

    This is but one example of the many lies that come out of the mouths of ‘experts’ who promote vaccines. I will pose one final question.

    Why is it that those who defend vaccination of children refuse to do a comparison study of health between those children who are vaccinated and those who are not?. There is one simple reason.

    On average unvaccinated children are healthier on every level and if parents realised that, the vaccine program would collapse. That would mean the medical companies miss out on their fithy profit wouldn’t they?

  6. Chris Hartwell says:

    As someone who had ADHD long before I was ever vaccinated David, I can comfortably tell you that it’s a hereditary condition. Autism? Yeah, it’s amazing how we can better diagnose things now isn’t it? OH, and you were of course aware that increasing autism rates also correlates with increasing organic food consumption, yes?

    You’re an example of the committed anti-science type. One of these hateful people that would rather a child dead than autistic.

  7. Chris Hartwell says:

    Twinto, again, you are making conspiratorialist claims – the so-called Vaccine Court has a lower standard of proof than civil cases – possible cause need be shown, nothing more. The liability limitation is because of the number of spurious cases brought by people who like to JAQ off endlessly – like yourself – and the genuine risk to public health a lack of vaccine availability would present.

  8. David Ayers says:

    Are you saying Chris that Dr William Thompson and many others who have revealed the deception of the vaccine industry are liars then?

    I am not a science hater, but I despise people who think they know best and then refuse to examine the damage that vaccines do to children.They dismiss the huge number of children who are adversely affected as mere statistics.

    Vaccines may be justified if we live in squalor and shit but we dont.You still have not explained the growing rate of auto immune and neurological disorders in children over the last few decades? Has that just magically appeared?

    Basically the sickness industry parasites off the whole vaccine paradimn in that it creates customers who are dependent on them for life. It is all about money,not health.

  9. s.applin says:

    Yes David Ayers I agree that those who “Dr William Thompson and many others who have revealed the deception of the vaccine industry” are liars.

    To be specific: they outright lie; they misrepresent; they distort; they quote mine in order to draw a conclusion which is false or deceptive; they take particular conclusions or facts out of context to draw a conclusion which is false or deceptive; they present unqualified people as experts; they confuse correlation with causation, and; so much more dishonesty.

  10. s.applin says:

    My my, aren’t the science deniers out in force today.

  11. s.applin says:

    David, you may or may not be a science hater, but you are certainly in a state of denial about the safety and efficacy of vaccines.

  12. Adam Dunn says:

    David, thanks for your interest in the research. Having been watching quite closely the kinds of information that seem to be recycled ad nauseam by people who passionately reject the safety of vaccines, I’m impressed by how well you have managed to condense several of them into your comment. What I never seem to see when I look at the links to websites that come from people who reject the safety or value of vaccines are examples of peer-reviewed research. I do see a lot of bad blog posts that recycle misinformation from other blog posts, anecdotes, and the misrepresentation of adverse event reports.

    Here is the most recent serious study showing that there is no link between vaccines and autism: http://dx.doi.org/10.1001/jama.2015.3077

    Not all researchers are influenced to support the position of industry. Some of us have even spent years looking at where clinical evidence has failed us in the past, and actively reject over-diagnosis and unnecessary interventions. This is not one of those areas.

  13. Don says:

    this article is full of the usual lies and misinformation.

    it is all about money. lost of it.

  14. Don says:

    *lots

  15. Don says:

    simple scientific question.

    if vaccines worked, why would be people who were vaccinated be so fearful?

    (oh, and why do people who get flu vaccine, get the flu more than those who don’t?)

  16. Keith Thomas says:

    we should engage with the fence sitters — those at risk of becoming the refusers of all or some vaccines, or those who plan to vaccinate but simply want their concerns and questions addressed.
    Has there been any serious consideration given to making these two changes that should dilute the cases of the anti-vaxers:

    1. Jump on people like David Ayres who recycle information from the US that does not apply in Australia. Particularly make it clear that thimerosal is not used in routine childhood vaccines here.

    2. Give Australian parents the option of replacing the MMR vaccine with separate vaccines for measles, mumps and rubella. I can understand why some cautious parents might be concerned about their infants receiving this triple whammy to their child’s immune system when there are alternatives with the same protective outcome. Sure that may cost a little more, but that’s a separate issue and we should not be obstinate. Perhaps, in the interests of greater vaccine coverage, we should wear the extra cost, or split it 50/50 with the parents.

  17. Tim Senior says:

    This is important. As a GP parents come to see me with their children and want to do the best they can to protect them. To give them advice, I can’t just make it up. I can’t just go by what I feel. The only way of answering this question is to look at the scientific evidence, as “Is this vaccine safe?” is a question only reliably answered by actually measuring it. And because I don’t want my patients to be harmed, I will change my mind according to what the evidence says. This is true of many interventions. I don’t prescribe anti-inflammatories anywhere near as I once did, because of the harms, for example. In medicine there is a whole movement around not overinvestigating or overtreating. So, I will happily change practice if anyone can show me the evidence that when you compare a large number of vaccinated children with a large number of unvaccinated children, there are more harms in the vaccinated. All of the evidence in the peer reviewed literature shows the vaccines we currently use to be effective and safe. If you’re doing science (as opposed to polemics) then you’ll also be willing to change your mind based on the evidence, and it would be good to hear what evidence would do that for you. However, you have to have very good reasons for rejecting the current findings. I won’t be changing my current practice based on small studies, in vitro studies, theoretical studies, blogs, newspaper articles or pressure groups. It’s why this study is important. My patients do worry about vaccine safety, and expect me to be able to guide them, based on the evidence, not on the blogs I have read. Like my patients, I feel that their health is way too important for anything less.

  18. Twinto Dimore says:

    @Tim

    Unfortunately these days with scientific studies the first question is: Who paid for it?

    And since the pharmaceutical industry has the most money there is a real problem.

    I am reminded of the tobacco industry that for 2 generations said: there is no scientific proof.

    Later it turned out that the industry had the proof all the time.

    What have we learned from that? Not much.

  19. Stuart Coyle says:

    @David is this the same Dr Thompson who issued a statement last year including this:

    “I want to be absolutely clear that I believe vaccines have saved and continue to save countless lives. I would never suggest that any parent avoid vaccinating children of any race. Vaccines prevent serious diseases, and the risks associated with their administration are vastly outweighed by their individual and societal benefits.”

    I don’t think you can quote him as one of the anti-vaccination supporters.

  20. Chris Hartwell says:

    No Twinto, oil companies have far more. And they can’t hide the research that demonstrates human activity is accelerating the rate of global climate change.

    The tobacco industry had a small number of pet scientists who were at odds with what every other researcher was saying

  21. Healthy Skeptic says:

    “How to address the persistence of misinformation about vaccines online”

    The idea being presented here is that any information that goes againt the Big Pharma push for mandatory vaccination is “misinformation” is itself, misinformation.

    There are good reasons the survey found many people concerned with the safety of vaccines, it is because there are many cases where a vaccination has caused harm. Instead of trying to work out how to prevent people from exercising their right of informed consent, it might help if those advocating mandatory injecting of gawd only knows what, had a closer look at what goes into these things.

    http://www.thelibertybeacon.com/2015/12/21/vaccines-dark-inferno-what-is-not-on-the-vaccine-insert-labels/

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