At the beginning of 2020, the Covid-19 pandemic generated by the pathogen commonly known as coronavirus sent rumour mills into a frenzy. The World Health Organization (WHO) described it as a massive infodemic, capable of drowning out reliable health guidance in an over-abundance of opinion.
And yet, health misinformation is not a peculiarity of the 2020s. From rumours in Nigeria in the early 2000s that polio vaccinations were a conspiracy, to allegations that the 2015 Zika crisis in the Americas and Asia-Pacific was man made, there is a long history of health misinformation. This briefing reviews some of the key episodes and possible solutions.
To understand how health misinformation travels, it helps to distinguish three building blocks.
•Crises refer to moments of radical disruption and information overload. When the simplest everyday routines are thrust into uncertainty, as it happened with the coronavirus pandemic, most members of the public tend to seek out more information. However, psychological uncertainty also makes it harder to process complexity, and more difficult to distinguish correct information from the noise. The Covid-19, Zika, and Ebola outbreaks, are three examples of crises we review.
•Conspiracies are a type of anti-establishment narrative. Pushed by interest groups in some cases, they are most notable for the ways in which they spread from strong believers to members of the general public, undermining official advice, and advocating potentially life-threatening alternatives. Here we focus on the anti-vaccination movement.
•Everyday misinformation is inherent in the homegrown remedies, beauty hacks or norms which recommend unproven and sometimes harmful treatments.
We all have a part to play in the health misinformation we believe, and share.
•When it comes to belief, we tend to fall for claims which are repeated, easy to process, and in alignment with our world views.
•We share things that are high in emotion, and health crises are a particularly emotive time.
•We struggle to notice false posts when we are distracted – which makes social media particularly tricky to navigate.
But in every case, something can be done: with truth, trust, and tactics.
•Misinformation crises can be tackled with clear, concise advice, delivered promptly by trusted sources.
•Anti-vaccination conspiracies are extremely complex to counter. Even though, in theory, all we need is the right information, there is a lot of variance in the format of a debunk, and still a lot we don’t know about how debunks affect beliefs and behaviours in time. Several experiments found that belief in false claims such as the MMR/autism link, which question the safety of vaccines, could be corrected in the short term. But the only two studies which tracked participants’ beliefs in time, one week after seeing the correction, found that they could actually get worse. It is also unclear whether corrections diminish unfounded but popular concerns in vaccines’ side effects, and whether they improve behaviours. Most studies we reviewed found that seeing a correction had no effect on participants’ intention to vaccinate, and in a couple of cases even backfired, making audiences who were already sceptical even less likely to vaccinate. This is still an emerging field, and further replication studies are needed to establish the robustness of these findings. If there is one main thing fact checkers can do in the meantime however, it is to prevent such information from spreading. Though it is unlikely to change the views of existing believers, marking an anti-vaccination post as false via Facebook’s Third Party Fact Checking initiative, for instance, plays a role in reducing the likelihood of it influencing new audiences.
•Finally, when it comes to everyday misinformation, there is potential in long-term interventions. Tailored to reach target audiences, and developed in partnership with local stakeholders who can ensure that truth commands trust, long-term interventions can reduce harmful everyday behaviours such as smoking, and improve health-seeking behaviours.
This briefing marks the beginning, not the end, of a practitioners-focused guide to tackling health misinformation. We recognise the diversity of interventions and global audiences, and we acknowledge the fact that topics like anti-vaccination have received years of attention from academics and health organisations. This briefing is not intended to act as an exhaustive summary of this work. What we set out to do rather, is provide fact checkers with an introductory toolkit in how to tackle health misinformation, and highlight the important role that social dynamics play in this.