A battle for hearts and minds

There is much talk of the COVID-19 vaccines being rolled out, with the United Kingdom becoming the first Western nation to approve one of the vaccines for general use. The usual reaction is excitement — a hope for the return to normalcy — and trepidation. There will always be legitimate concerns for any new drug, particularly for one which was developed in less than a year and for which it has not yet been possible to pursue long-term studies. Still, the World Health Organization, scientists, and developers have taken pains to assure us that the development was accelerated, but not reckless, and that no steps were skipped to assure safety and efficacy. These concerns are exacerbated by a distrust about how our country has handled the pandemic so far, with gross mismanagement of COVID-19 responses; conflicting health information spread by public officials; botched, misrepresented data; a clear prioritization of high-profile individuals when it comes to testing, quarantine protocols, and hospitalizations; and a crippled health system that was already groaning under the weight of limited resources, brought to its knees by a pandemic that it was never equipped to handle. If citizens are less concerned about the actual vaccines than they are about equitable delivery, about access to health care and recourse in the case of unexpected complications, about logistical problems like the cold chain of vaccine transport, about corruption and misallocation of funds for the vaccine — no one can blame them.

There is also the concern that vaccines can give the public a false sense of security that the pandemic is at an end. Measures to avoid spread will obviously need to be sustained, because not everyone will have access to the vaccines right away, and because the performance of the vaccines, once rolled out, will not always equal their efficacy in controlled studies. Vaccination is at best a new tool against COVID-19.

For health professionals, another worry looms, and that is the anti-vaccine rhetoric that urges people to mistrust other vaccines, too. It is close cousins with the anti-mask sentiment that has continually challenged the global public health response to COVID-19, and with a general, conspiracy-theory-like distrust of evidence-based medicine. As a medical student I had thought that the “antivax” movement thrived only in American suburbs and nonsensical e-mail chains; unfortunately we have seen its impact grow locally, impacting confidence in immunizations, with outbreaks of diseases long thought to be controlled or eradicated, like last year’s polio outbreak. To have hesitations about a new vaccine, as well as the health care system espousing it, is one thing; but to use COVID-19 vaccines as a vehicle to erode confidence in all vaccines, and in evidence-based medicine, is another thing entirely.

Last week, Facebook announced that it would begin to remove false claims about COVID-19 vaccines that have been debunked by public health experts. This is a step up from previous policies: It was only last month that Facebook banned anti-vaccine advertisements, while still allowing social media posts with vaccine misinformation.

A study published in Nature last May described patterns of the spread of vaccine misinformation on Facebook. Among other things, it showed how anti-vaccine Facebook pages and groups are more able to engage “undecided” users compared to pro-vaccine ones. Merely removing ads would not have eliminated the effective sources of anti-vaccine content and recruitment. This activity is so prolific that the article described pro- versus anti-vaccine recruitment as a “battle for the hearts and minds of individuals.”

Facebook, which has been criticized for allowing harmful misinformation and hate speech run on its platform unchecked, has often been called on to maintain stricter standards on content. The latest news is a step in the positive direction (albeit a delayed one), even as Facebook, Twitter, Instagram, and other social media platforms can still continue to be sources of health misinformation. It is challenging enough for scientists to explain the basics of vaccine development and what this can mean for a world turned upside down by the pandemic. There needs to be a better effort from social media platforms to recognize the harm of misinformation and to help those “hearts and minds” have access to better, more substantiated information.

kchuarivera@gmail.com