Image of a child in a blue dress with pigtails receiving a vaccination injection.

Social Media’s Anti-Anti-Vaxxer Fight Ramps Up

According to the World Health Organization (WHO), “vaccine hesitancy,” which is “the reluctance or refusal to vaccinate despite the availability of vaccines” is among the top ten threats to global health in 2019. While there are many complex reasons why people may choose not to vaccinate their children, social media has received a great deal of scrutiny for its role in empowering and financing the movement opposing vaccines. Platforms have taken a wide range of actions in response.

Pinterest, for example, demonstrated an aggressive tactic, banishing results that are associated with certain searches related to vaccines, “regardless of whether those results might have been reputable.“In 2017, the platform altered its “community guidelines” after a 2016 study revealed that 75 percent of vaccine-related posts were negative. The guidelines aim to prevent misinformation and advice that has “immediate and detrimental effects on a pinner’s health and public safety,” and explicitly state that “[t]his includes . . . . anti-vaccination advice.” Now, if a user attempts to search “vaccination,” they’ll see a result stating “Pins about this topic often violate our community guidelines, so we’re currently unable to show search results.” And while users can still pin images related to vaccines, their posts won’t be visible in searches.

The changes began in September and October of 2018. But Pinterest didn’t speak publicly about its search ban until this February, describing it as a temporary but necessary step while working to develop improved strategies to fight vaccine-related misinformation.

Pinterest also uses human reviewers, who judge shared content’s accuracy and determine whether pins (images shared on the site) are in violation of the platform’s health-misinformation guidelines. The reviewers make their determinations by relying on information from WHO, the federal Centers for Disease Control and Prevention (CDC), and the American Academy of Pediatrics (AAP).

Given the high usage rates of Pinterest among parents—2017 data from comScore revealed that 80 percent of mothers and 38 percent of fathers use Pinterest—it’s particularly important for the platform to monitor vaccine-related content’s accuracy.

In a more recent move by large tech company to fight anti-vaxxer content, Amazon removed at least five anti-vaccination documentaries that had been available through Prime Video. But while users are unable to stream these films, people can still purchase most of the DVDs on Amazon.

The removal of these documentaries happened only hours after Democratic U.S. Representative Adam Schiff of California announced publicly that he had sent Jeff Bezos, Amazon’s CEO, a letter regarding his concerns over recommended content and products on Amazon that discourage parents against vaccinating their kids.

The letter discussed the overwhelming consensus in the scientific and medical communities of the safety and efficacy of vaccines and the public health threat posed by failure to vaccinate children. Representative Schiff’s letter also expressed his concern over Amazon’s acceptance of paid advertising containing deliberate vaccine misinformation. Schiff highlighted Amazon’s unique position as the world’s largest online marketplace, and the damaging results of its algorithm’s inability to distinguish reliable information from misleading information and misinformation. In closing, he called on Bezos to address several questions about Amazon’s past, current, and future steps to confront issues surrounding vaccine-related misinformation.

Schiff had previously written to Facebook and Google as well, expressing concern that their algorithms recommended messages discouraging parents from vaccinating their kids.

For Facebook, much concern has been voiced regarding anti-vaxxers spreading misinformation in closed groups, in which members need approval and false information can thereby go unchallenged. On March 7, Facebook stepped up its fight, announcing its planned steps to reduce distribution of vaccine misinformation and to provide authoritative information. Under the new policy, which extends to Instagram as well, Facebook will take action against “vaccine hoaxes,” identified by organizations such as the CDC and WHO. Facebook will decrease the reach of groups providing misinformation, such as by reducing their ranking in search results and excluding them from recommendations. And to address advertisement misinformation, Facebook said it will remove targeting categories advertisers could use to reach almost 900,000 people Facebook considered interested in “vaccine controversies.”

Yet while the anti-vaccine movement has been credited for contributing to an alarming number of recent measles outbreaks—as of February 28, the CDC confirmed 206 cases of measles in 11 states—there is some skepticism as to how much social media actually contributes to parents choosing not to vaccinate their children. According to Brendan Nyhan, professor of public policy at the University of Michigan, “[t]he conversation around vaccines emphasizes social media more than the evidence can support.”

And “strik[ing] a balance between allowing free speech and keeping people safe,” as a Facebook spokesperson put it, isn’t easy. Social media platforms haven’t escaped criticism that their actions target “independent citizens who dare to raise questions online about the safety and efficacy of vaccines.” On the other hand, supporters of enhanced action to reduce the spread of misinformation on social media may claim that Supreme Court precedent supports abridging First Amendment rights to free speech, given the public damage that could result from distributing false information.

And regardless of the magnitude of social media’s role, having parents receive vaccine misinformation from social media or a pseudoscience documentary is very concerning to some children of anti-vaxxers.

An Ohio teen named Ethan Lindenberger, for example, testified before the Senate Committee on Health, Education, Labor and Pensions on March 5 after his Reddit post, titled, “My parents are kind of stupid and don’t believe in vaccines. Now that I’m 18, where do I go to get vaccinated? Can I get vaccinated at my age?” went viral. Now that he’s 18 and legally allowed to decide to get vaccinated, Lindenberger did so, despite his mother’s opposition. According to the teen, Facebook or websites linked on Facebook were really the only sources on which his mother relied for anti-vaccine information.

Notably, Lindenberger stated, “I feel like if my mom didn’t interact with that information, and she wasn’t swayed by those arguments and stories, it could’ve potentially changed everything.” Had she not been persuaded by that information, he said, “[m]y entire family could’ve been vaccinated.”

Rebecca Friedman is a 2018-2019 Petrie-Flom Center Student Fellow. 

 

Rebecca Friedman

Rebecca Friedman

Rebecca Friedman graduated from Harvard Law School in 2019. Prior to becoming a Student Fellow, she participated in the Health Law and Policy Clinic with HLS' Center for Health Law and Policy Innovation. At the time she completed her Fellowship, Rebecca planned to work at Charlotte Center for Legal Advocacy in Charlotte, North Carolina as an Equal Justice Works Fellow sponsored by Kilpatrick, Townsend & Stockton LLP. There, Rebecca will provide direct representation to Medicaid beneficiaries experiencing legal challenges as North Carolina transforms its Medicaid system to managed care, and will work to ensure that Medicaid beneficiaries facing legal issues as a result of social determinants of health receive appropriate support. As a Petrie Flom Center Student Fellow, Rebecca studied the potential for Medicaid to cover doula services and analyzed how racial and socioeconomic disparities in prenatal care and childbirth could be mitigated as a result. The current title of Rebecca’s paper is “The Feasibility and Potential Impact of Broader Medicaid Coverage of Doula Services on Racial and Socioeconomic Disparities in Birth Outcomes.”

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