Reporting on common vaccine conspiracies and misinformation

By Tara Haelle

To effectively report on the science behind the effectiveness and safety of vaccines, journalists should understand how false information about them has originated and spread.

That includes a universe of misinformation spread a variety of ways: 

• By well-intentioned people through social media and other platforms 
• By bad actors purposely spreading disinformation for financial and/or political gain
• Via conspiracy theories, which may sometimes start with a kernel of truth, that take root among people looking to have their suspicions confirmed
• From within the media industry’s own bubble, with subtle errors in the framing and context of news coverage that can distort the public’s understanding of the research-based evidence about vaccines.

Those different types of inaccurate information about vaccines can be broken down this way: 

• Misinformation includes statements that are false or misleading, whether intentionally so or not. However, in recent years, “misinformation” itself has become a value-laden term whose connotation can imply condescension, so it may be more useful for journalists to use the terms “misconceptions” or “rumors” or “inaccurate information” when talking about misinformation. 
• Disinformation is inaccurate information intentionally distributed to achieve an end, such as gaining financial benefit or influencing voting patterns. 
• Conspiracy theories are explanations people create for events or situations (real or perceived) that rely on their belief in a secret, powerful, sinister, malicious group of people working behind the scenes to cause harm for their own benefit, such as pharmaceutical companies profiting by making vaccines that cause other health issues that the companies then have medications for. 
• Malinformation is true information that is shared without context or with intentional cherry-picking, thereby becoming misleading, such as information about the risks of myocarditis from COVID vaccines without discussion of the benefits of the vaccines or the cardiac risks from a COVID infection. 

The circulation of any of these forms of inaccurate information can be harmful: It reduces public trust in medical and public health institutions and workers, it can lower vaccine uptake and thereby erode herd immunity and increase the risk of infectious disease outbreaks, and it can adversely influence other health behaviors and outcomes. For example, people who refuse vaccines are more likely to refuse the vitamin K shot for their newborns. Though not a vaccine, this safe and potentially life-saving intervention reduces the risk of vitamin K-deficiency bleeding.

Journalists should also understand that many factors can contribute to how likely someone is to believe false information about vaccines. One of these is the influence of cognitive biases — errors in thinking that arise from patterns of experience. 

• Cognitive biases affect how we perceive and process information and can obscure what’s right in front of us. 
• People’s poor risk assessment arises from familiarity bias (or mere exposure effect).
• The influence of social networks in believing misinformation arises from in-group bias. 
• And other common cognitive biases or logical fallacies that contribute to people’s belief in false information include confirmation bias, survivorship bias, optimism bias, availability bias, omission bias, status quo bias, aversion to ambiguity, and anchoring bias. 

Being familiar with these biases can help in developing reporting strategies. 

Common vaccine misconceptions

When reporting on news and events related to vaccines, it’s helpful to be familiar with the most prevalent and pervasive misconceptions about them. They are outlined here for the sake of journalists’ recognizing them, but research into debunking false claims has suggested that it’s more effective to state the accurate fact (“Vaccines do not cause autism”) or to phrase the “myth” as a question (“Do vaccines cause autism?”) rather than stating the myth itself, which may inadvertently reinforce the false statement through repetition. 

“Vaccines cause autism.” The most common, pervasive misconception about vaccines arose primarily from a now-retracted 1998 case series published in the Lancet that attempted to link the MMR vaccine to developing autism. The claim has been debunked more than any other vaccine-related concern. See here, here, here, here, here, here, and here for resources addressing whether vaccines are associated with autism and vaccine safety. It’s also important to remind audiences that autism is a condition scientists believe to be present or not present at a person’s birth, not developed after birth. Current research suggests the strongest contribution to autism is genetics. While many environmental factors have been explored as possible contributors, no single one has yet been shown to have a clear association with autism development.

“Vaccine ingredients are toxic/harmful.” Nearly every vaccine ingredient has been attacked, and resources such as this, this, this, this, this, and this can familiarize journalists with vaccine ingredients and the reasons they have not been found harmful. But three ingredients are maligned more often than others: 

Thimerosal, a mercury-based preservative, is no longer used in most vaccines, as most have transitioned to single-dose containers that do not require preservatives. It is currently used only in a multi-dose flu vaccine, though trace amounts are present in one tetanus and diphtheria vaccine via the manufacturing process. Learn more about it here, here, here, here, and here. 

Aluminum salts are an adjuvant—a substance designed to enhance the immune response—in multiple vaccines, but infants are exposed to more aluminum in the environment than by all vaccines combined. Learn more here.

Formaldehyde is used in the manufacturing process of some vaccines and may exist in trace amounts in some, but many of our fruits and vegetables contain formaldehyde, and our bodies produce it. See here, and here for more. Other ingredients vaccine critics may question include polysorbate 80, gelatin, and SV40, among others.

“Vaccines are made from aborted babies’ cells.” This is one of those partial misconceptions containing a kernel of truth. Cell lines are used to grow viruses or bacteria for some vaccines, and some of the cell lines used today originated from ones in fetuses aborted in the mid-20th century, though not for the purpose of being used for vaccine development. For faith-based responses to this and other religious concerns about vaccines, see these documents from faith leaders in Protestant Christianity, Catholicism, Islam, and Judaism. 

“Too many vaccines too early in a baby’s life can overwhelm the immune system or harm babies.” The “too many too soon” concern arises from the increase in the number of vaccines on the CDC recommended immunization schedule from approximately three shots against seven diseases in the 1970s to 10 shots against 14 diseases (excluding COVID) today. Yet this increase represents scientific advances—children are protected from more diseases than ever before—and the vaccines themselves have also become safer and resulting in fewer adverse reactions over the years. The number of antigens—the part of a pathogen the immune system recognizes and makes antibodies against—in vaccines is fewer today than it was several decades ago. Further, scientists have tested administration of multiple vaccines at once and over a baby’s first few years and have found the CDC schedule to be safe. Finally, infants encounter far more threats to their immune system every day from their environment than they receive in vaccines during their first few years of life.

“Vaccines are unnatural”/“The body can fight disease on its own.” Vaccines use the exact same natural immune response in the body that a pathogen does, so using a vaccine means taking advantage of the body’s ability to fight disease without experiencing the harms of that disease.

“Natural immunity is better than vaccines.” In most cases, vaccines induce a similar amount of immunity in the body as the pathogen it protects against. In some cases, a natural infection may result in stronger immunity than a vaccine—but at the risk of all the other negative aspects of infection, including risk of hospitalization, long-term consequences (such as loss of limbs from meningitis or conditions like Guillain-Barré syndrome from flu), and death. 

“Vaccines should be 100% safe to be approved.” Unfortunately, it’s not possible for any substance, from water to our food to over-the-counter medications to cancer drugs, to be 100% safe. All interventions involve a trade-off of risks and benefits. Vaccines that receive approval from the FDA have been shown to have extremely low risks and extremely large benefits in overall health. 

“Vaccines are a tool for population control or surveillance.” While more common outside the U.S., this inaccurate statement has circulated in the U.S. recently. Vaccines do not contain any substances that can be used for surveillance, and no vaccine has been shown to cause infertility. However, it’s helpful to understand a twisted kernel of truth at the center of these statements: the U.S. CIA did, in fact, use a vaccination campaign to find Osama bin Laden, a misguided operation (and now-abandoned practice) that public health experts heavily criticized. 

“The government/Big Pharma are hiding vaccine harms.” There have been some very rare cases of pharmaceutical companies withholding information about a vaccine, but every approved vaccine has vast amounts of evidence from non-pharma-funded research that shows similar risks and benefits as pharma studies. And while the U.S. has a profit-driven health care system, nearly every high-income country in the world has a universal health care system in which it’s only in the country’s best interest to recommend vaccines that benefit the population’s health and do not cause harm. If vaccines had hidden harms, it would hurt the economies of any country with a national health care system, so they would not recommend those vaccines—and yet nearly every country recommends most of the same vaccines the U.S. does.

“I’m not anti-vaccine, I’m pro-safe vaccines.” This is a very common trope among anti-vaccine activists, but it obscures that everyone is in favor of “safe vaccines.” Those making this claim refuse to acknowledge that approved vaccines have met very high safety standards. A person repeating this trope is nearly always an anti-vaccine activist or someone unaware that they have fallen for an anti-vaccine trope.

These are only a handful of the many misconceptions about vaccines. For discussion of other common misconceptions, see this excellent paper from Vaccine as well as here, here, here (lots specific to COVID vaccines), here, here, here, and here. 

Effectively countering inaccurate information

Several methods can be effective in countering false or misleading information about vaccines: 

• Communicate the scientific consensus with supportive quotes from scientists and/or physicians and findings from research expressed in accessible language. 
• Prebunking: Much like a vaccine itself, prebunking inoculates people against misinformation before they encounter it by exploiting the primacy effect, a cognitive bias in which people remember the first piece of information they hear more easily and for longer than what they encounter later. The idea is to let people know what misinformation they are likely to encounter and either explain why it’s inaccurate or help them figure out why it’s inaccurate (sometimes through games). See this in-depth guide, this overview, and this guide from First Draft. 
• Storytelling: This has been one of the most effective tactics of the anti-vaccine movement because it is so effective. Stories tap into people’s sense of self and community while engaging them cognitively and emotionally. Research has shown that contextualizing facts with an illustrative, emotionally engaging anecdote or telling a conversion story (“I used to be anti-vaccine”) can be a powerful vehicle for accurate information, whether the speaker is a parent, physician, patient, or someone else. 
• Use of trusted messengers: Trusted messengers are members of the community who are perceived as trustworthy, credible leaders whose endorsement of information carries substantial weight. They can include religious, community, or business leaders as well as local politicians, grassroots activists, influential parents, local physicians or pharmacists, or other local influencers. Journalists who quote trusted messengers in stories about vaccines can help build trust with their audiences and reinforce the accurate information they include about vaccines in the story.

However, be careful to avoid these pitfalls: 

• Make sure the claim you are debunking is something that a substantial proportion of your audience actually believes and that it’s a claim you actually need to invest time in addressing. Sometimes outlandish or fringe theories are proposed that don’t require debunking because not enough people actually believe them and you run the risk of amplifying them (a variation of the Streisand effect). 
• As noted above, try to avoid restating a “myth” or misconception and instead phrase it as a question or state the actual factual information so that you are not inadvertently reinforcing the false information in the person’s subconscious, a phenomenon known as the illusory truth effect. 
• Avoid employing false balance, or false equivalence, where different, opposing perspectives as presented as equally valid in terms of the evidence supporting them when the evidence is not actually equal. This often was an issue in early reporting on vaccines and autism. See this excellent toolkit on avoiding false balance with vaccine information.
• Providing too much technical information can overwhelm someone, while not presenting enough can come across as patronizing. Strike a balance between the two, explaining as much as audiences need to know in lay language without going overboard. 

The following approaches have also been shown NOT to be effective in countering misinformation. 

• While providing factual information is important, it’s not sufficient alone to counter beliefs in misinformation—a concept called the deficit model. (See this nice explainer and this related paper.)  Facts (logos) must be paired with the emotional resonance of a story (pathos) and/or the credibility of experts (ethos). 
• Shaming or blaming people who have questions about vaccines or even refuse them is ineffective, especially compared to actually addressing people’s concerns. Instead, it can backfire by either stigmatizing and isolating people, making them less likely to engage with experts on health information, or it can give them attention and increase their platform.   

Tara Haelle is a freelance science/health journalist based in Dallas. She is author of Vaccine Investigation: The History and Science of Vaccines, and has covered vaccines for 15 years at National Geographic, Scientific American, The New York Times, and over a dozen other publications.