Human challenge studies in the study of infectious diseases
What can deliberately infecting healthy people tell us about infectious diseases? How is this useful for developing treatments, and how do we manage the risks?
There have been large volumes of inaccurate information about COVID-19 circulating since the beginning of the pandemic, including misinformation about vaccinations against the infection. This article looks at the types and sources of COVID-19 vaccine misinformation and its public health impact. It also looks at the different approaches being used to fight COVID-19 vaccine misinformation, such as social media content moderation and guidance for the public.
DOI: https://doi.org/10.58248/RR66
Vaccine misinformation may arise from true information that has been reconfigured or taken out of context, or may be entirely fabricated conspiracy theories about the vaccine and the pandemic more widely. Widespread misinformation about COVID-19 vaccines has included false or unsubstantiated claims about their safety, efficacy, ingredients, side effects and purpose. Examples include:
Misinformation may also be religiously targeted. For example, there have been false claims that the vaccine contains pork, or ingredients that are non-halal.
Some people have spread false and misleading information about the vaccine for fraudulent purposes. For example, criminals have sought to exploit the vaccine rollout by carrying out financial scams via text messages and phone calls. The messages or calls ask the recipient to click on a link or button on their phone where they are prompted to submit personal information and/or financial details. In January, Action Fraud stated that it had received a rise in the number of reports relating to vaccine scams and warned the public to stay vigilant.
Misinformation about COVID-19 vaccines is passed on in different ways, including through conversations with friends and family. However, the main source of vaccine misinformation is social media. Social media often amplifies misinformation and allows it to spread quickly to a large number of people, with studies showing that misinformation spreads much faster than factual information online.
The rapid spread of misinformation online is potentially fuelled by the algorithms that underpin social media platforms, which display content that is likely to receive a high amount of engagement. Social media algorithms also tailor the content that a user sees to display information that aligns with their existing beliefs and values, creating what is known as ‘echo chambers’. Echo chambers can cause certain beliefs to be amplified because users don’t get shown information or opinions from an alternative perspective that may challenge their attitudes.
Estimates suggest that the number of social media accounts posting misinformation about vaccines, and the number of users following these accounts, has increased over the course of the pandemic. Research by the Center for Countering Digital Hate published in November 2020 suggested that the number of followers of the largest anti-vaccination social media accounts has increased by 25% since 2019. It also estimated that there are 5.4 million UK-based followers of anti-vaccine Twitter accounts.
An Ofcom survey of around 2000 respondents carried out between 12 and 14 March 2021 found that 28% of respondents had come across information about COVID-19 that could be considered false or misleading. Of those who had encountered such information, respondents from minority ethnic backgrounds were around twice as likely to say that the claim made them think twice about the issue (43%), compared with White respondents (24%). The survey found that, of those people who are getting news and information about coronavirus, within the preceding week:
While most people do not perceive misinformation about COVID-19 vaccines to be reliable, some research suggests that a significant minority do. A November 2020 study by King’s College London surveyed 2244 people aged 16–75 years on where they had encountered vaccine misinformation and anti-vaccination messaging online and their attitudes towards it. It found that:
Research has found that there are a number of factors associated with susceptibility to COVID-19 misinformation (including vaccine misinformation). A key factor is where people obtain their information about the virus, with research showing that people who get information about the virus on social media are more likely to think that misinformation is reliable. For example, the King’s College survey found that proportion of people who believed the real purpose of a mass vaccination programme against coronavirus is to track and control the population was 39% for those who used YouTube as a key source of COVID-19 information and 28% for those who used Facebook (compared with 14% across the whole sample). Other research has shown that performing worse in numeracy tasks and having a lower level of trust in scientists, the Government and pharmaceutical industry are also associated with a higher susceptibility to vaccine misinformation. Research has found that being older is typically associated with a higher susceptibility to misinformation more generally. However, some recent studies looking specifically at COVID-19 misinformation have identified correlations inconsistent with prior research, finding that younger people are more likely to find false statements about the virus reliable.
The main public health concern around vaccine misinformation is the risk of it leading to a reduction in vaccine uptake. In 2019, prior to the COVID-19 pandemic, the World Health Organization listed vaccine hesitancy as one of the top 10 threats to global public health.
It difficult to assess the extent to which misinformation alone affects people’s willingness to receive a COVID-19 vaccine as barriers to vaccine uptake are not well-understood, and there is currently limited research into the role of vaccine misinformation as a causative factor in vaccine hesitancy. However, some recent research indicates that exposure to misinformation about COVID-19 vaccines may lower an individual’s intent to get vaccinated against the disease. A September 2020 survey of 4000 UK respondents led by the London School of Hygiene and Tropical Medicine and Imperial College London found that the proportion of respondents who said they would ‘definitely’ take a COVID-19 vaccine fell by 6.2% after participants had been exposed to misinformation about the vaccine, relative to a control group who were shown factual information. The study also found that ‘scientific sounding’ misinformation, such as misinformation that used scientific imagery or links to articles, was more strongly associated with a decrease in vaccination intent.
Studies also show that people who are susceptible to COVID-19 misinformation are less likely to recommend getting vaccinated to friends and family and less likely to comply with government public health guidance, such as guidance on social contact.
Public health authorities, the UK Government, social media companies and other organisations have attempted to address the spread of vaccine misinformation through various strategies, including moderation of vaccine misinformation on social media platforms, ensuring the public have access to accurate and reliable information, and providing education and guidance to people on how to address misinformation.
While studies do not show strong links between susceptibility to misinformation and ethnicity in the UK, some practitioners and other groups have raised concerns about the spread and impact of COVID-19 vaccine misinformation among certain minority ethnic groups. These concerns stem from research that shows historically lower levels of vaccine confidence and uptake among these groups. Some recent evidence from the UK’s vaccine rollout suggests that this trend has continued to be the case for the COVID-19 vaccine. Data from the OpenSAFELY platform (which includes data from 40% of GP practices in England, from over 24 million patients) found that, up to 7 April 2021, 96% of White people aged over 60 had received a vaccination, compared with 77% of people from a Pakistani background, 76% from a Chinese background and 69% of Black people within the same age group. A 2021 survey of 172,099 adults in England on attitudes to the vaccine also found that confidence in COVID-19 vaccines was highest in those of White ethnicity (92.6% said they had accepted or would accept the vaccine) and lowest in those of Black ethnicity (72.5%).
Some of the initiatives to tackle vaccine misinformation and encourage vaccine uptake are aimed at specific minority ethnic groups and experts have emphasised the importance of ensuring factual information about COVID-19 vaccines is available in multiple different languages.
Social media companies have taken various steps to tackle misinformation on their platforms during the COVID-19 pandemic, including removing or demoting misinformation, directing users to information from official sources, and banning certain adverts. Some of the broad approaches to content moderation that digital platforms have taken to address misinformation during the pandemic are discussed in POST’s previous rapid response on COVID-19 and misinformation.
More recently, some social media companies have taken specific action to counter vaccine misinformation, for example:
Experts have emphasised that tackling misinformation about the COVID-19 vaccine requires providing people with access to up-to-date and accurate information. Many organisations have produced information and guidance for the public on COVID-19 vaccinations, including the NHS and World Health Organization. There are also several fact-checking organisations that are checking claims made about COVID-19, including about COVID-19 vaccines. Some resources are targeted at minority ethnic groups and are available in multiple different languages. For example, the British Islamic Medical Association has an online COVID-19 Vaccine Hub containing myth-busting resources in various languages and specific vaccine advice for the Muslim community.
Stakeholders have also emphasised the importance of ensuring people have the knowledge and tools to identify and challenge misinformation. Various organisations have produced resources to improve how people communicate about COVID-19 vaccines and give people tools to address vaccine misinformation if they encounter it. For example, a team led by academics at the University of Bristol has created an online vaccine communication handbook that includes information about the COVID-19 vaccines and strategies for how to debunk vaccine misinformation. Similarly, UNICEF and partners have produced a vaccine misinformation management field guide.
The Government has acknowledged the public health risks of vaccine misinformation and has launched several initiatives to tackle it.
At the end of 2020, the Government agreed a package of measures with social media platforms to prevent the spread of vaccine misinformation. This included a commitment from Facebook, Twitter and Google to the principle that no company should profit from or promote COVID-19 anti-vaccine content. Platforms also agreed to respond quickly to misinformation content flagged to them by the Government and to work with UK public health authorities to help spread official messages about vaccine safety.
In its February 2021 COVID-19 vaccine uptake plan, the Government stated that it was working with the NHS to develop products and messaging to tackle vaccine misinformation. This includes messaging targeted at minority ethnic groups and hard to reach audiences. In January, it also committed £23.75 million of funding to help local councils and voluntary groups expand and tailor their communications about COVID-19 vaccines. Local councils that received funding as part of this initiative have implemented a variety of different programmes to help members of the public access accurate information, including running telephone help lines and workplace training courses. The Government also said that it is working to protect the public from fraud and misinformation from criminals seeking to carry out vaccine-related scams.
In March 2021, the UK Government launched a social media campaign to tackle vaccine misinformation sharing among minority ethnic communities. The campaign involved the creation and distribution of a series of social media posts featuring community figures (such as faith leaders, clinicians and community leaders) with tips on how to identify misinformation and find accurate information about COVID-19 vaccines.
In 2019, the Government put forward plans to address misinformation in its Online Harms White Paper. The White Paper outlined proposals to establish a duty of care for internet companies that will make clear companies’ responsibilities around online harms. Following consultation on the White Paper, the Government confirmed that the duty of care would be introduced through an Online Safety Bill, which it will introduce in 2021. It also confirmed that Ofcom will be the online harms regulator. For more information, see the Library Paper Regulating online harms (CBP 8743, January 2021).
Photo by Robin Worrall on Unsplash
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