According to recent reports from international health experts, Europe is currently experiencing a 20-year high in measles cases, including in many countries where it had been mostly eradicated. Within the European Union, Greece has been hit the worst. The primary reason, according to the World Health Organization (WHO), is “vaccine hesitancy.” This is listed as one of the WHO’s top 10 global health threats for 2019. According to the WHO, “vaccine hesitancy” is defined as the reluctance or refusal to vaccinate despite the availability of vaccines.
The causes of vaccine hesitancy are multifaceted, but a major factor is the influence of news media and social media, in particular the role of bots and trolls in spreading disinformation about vaccines.
According to the recent study “Weaponized Health Communication: Twitter Bots and Russian Trolls Amplify the Vaccine Debate,” carried out by researchers from the George Washington University, the University of Maryland and Johns Hopkins and which was published in the American Journal of Public Health, the same bots and trolls that were linked to Russia’s Internet Research Agency which spread discord in the 2016 US elections are now feeding disinformation and contributing to the current measles crisis in Greece and the rest of Europe. This same study says that 93 percent of the vaccine narrative on Twitter originates from or is amplified by Russian trolls and/or bots.
The goal of this disinformation campaign is to flood the discourse with anti-vaccine propaganda, creating a sense of “false equivalence” in the “anti-vax vs pro-vax” discourse. The bots assist by repeating and spreading the same narrative on various social media platforms in the languages of the countries they are targeting.
In 2018, Ukraine saw the biggest surge in measles outbreaks of all European countries, with a 634 percent increase in cases. From 2017 to 2018 an astonishing 53,000 cases were reported in Ukraine. In 2018, Ukraine’s minister of health attributed the rapid rise of measles cases to the ongoing war, substandard vaccines imported from Russia, and Russian anti-vaccination propaganda on social media and in the mainstream media.
At the same time, a newly published study from Queen Mary University of London found a positive association between the percentage of people in a country who voted for populist parties and the percentage who are skeptical of vaccinations. Also, populist parties in Europe are seen taking positions which also feed into vaccine hesitancy.
Greece’s left-wing SYRIZA government has proposed that parents should be able to opt out of vaccinating their children. Furthermore, since the beginning of 2019 there have been three posts by suspected trolls in Greece falsely stating the US Centers for Disease Control and Prevention (CDC) “admitted” that vaccines cause autism. These posts were subsequently spread and amplified by suspected Russian bots. Currently, with 196 cases per million residents, Greece has the highest per capita number of reported measles cases within the EU.
Concerned parents searching online for information about vaccines struggle to sort out truth from disinformation. One anthropological study at McMaster University in Canada found that 71 percent of the top 10 Google search results using the keyword “vaccination” were anti-vaccination sites. Anna Kata, the study’s author, calls the internet a “postmodern Pandora’s box” in which scientific truth is rejected and misinformation is conflated with information.
So, what can be done to address the disinformation challenge which is feeding the measles surge in Greece?
Firstly, public health information campaigns combined with increased transparency about vaccines, more flexible vaccine schedules, and better risk-benefit data can serve to better inform those parents who may not be resistant but may be ambivalent about vaccinating their children.
Some experts suggest mandatory vaccine schedules as an effective approach, but these can lead to even greater resistance among the most skeptical parents. Conversely, mandatory vaccinations do signal a broad societal consensus that vaccines are an important aspect of public health. Just last week Italy enacted a new law making a full schedule of vaccinations mandatory and banning young children from schools unless they have been vaccinated.
Finally, the early identification and elimination of trolls and bots, before their influence spreads too far, is an important step in countering a disinformation campaign. To do so requires a detection system that is not simply automated but also augmented by human judgment to ensure adequate safeguards and provide feedback to better improve detection accuracy.
Christopher Kremidas-Courtney is a senior consultant at Strategy International.