Online 'anti-vax' campaigns and COVID-19: censorship is not the solution.

Vaccine scepticism has existed since the advent of the technology itself. However, the mass uptake of social media is blamed for the significant traction recently gained by the ‘anti-vax’ movement. A recent report found that 400 anti-vax social media accounts contain 58 million followers based primarily in the US, UK, Canada and Australia. Misinformation campaigns such as these have contributed to the decline in routine childhood vaccination uptake, infection outbreaks stripping numerous European countries of their ‘measles-free’ status and the World Health Organization naming vaccine hesitancy as a top ten threat to global public health.

The international spread of SARS-CoV-2 has focussed the attention of anti-vax campaigners on the development of vaccines against COVID-19. Since the start of the pandemic, the largest anti-vax social media accounts have gained more than 7. 8 million followers, an increase of 19% since 2019. This has triggered the UK government and social media platforms to agree a package of measures to reduce online vaccine disinformation, including the labelling of posts marked as untrue by third party fact checkers. However, as vaccine trials report encouraging results, , there have been calls to introduce emergency laws that impose financial and criminal penalties on social media platforms that do not remove vaccine misinformation or fail to close down anti-vax campaign groups. Whilst tackling widespread vaccine misinformation is of vital importance, laws of this nature should not be implemented for three main reasons.

Firstly, many people have legitimate concerns around the safety and efficacy of COVID-19 vaccines due to factors including the speed of their development, the underrepresentation of ethnic minority groups in clinical trials and the unknown longevity of their immunological effects. The public must feel freely able to voice these concerns, raise challenging questions and expect transparent replies from trusted institutions. An unintended effect of shutting down anti-vax groups may be to silence those with legitimate questions for fear of shame or ridicule and lead them to harbour greater suspicion of public health authorities and sympathise with anti-vax rhetoric.

Secondly, such emergency laws would enforce censorship and deplatforming and threaten the democratic cornerstone of freedom of speech. All ideas – even the bad ones – must be allowed a public airing, and their qualities debated in the marketplace of ideas. It is through this process that institutions foster influence, respect and public trust, by presenting empirical evidence, reasoned arguments and a scientific method based on critical thinking. Conversely, widespread deplatforming of anti-vax campaigners is unlikely to dissuade those sympathetic to these messages but rather reinforce their strongly held beliefs about vaccine conspiracies while deepening their mistrust of public health authorities. In addition, removing the social media stages of anti-vax campaigners is likely to drive them underground to adopt alternative stages that are more difficult to identify, monitor and respond to with public health messaging. The lack of evidence to support censorship as a reliable means of producing desirable health behaviour change should deter against the deployment of this strategy.

Thirdly, the features of an ‘anti-vax campaign’ are themselves undetermined and, depending on the breadth of the definition imposed, may include both the mere voicing of concern for vaccine safety and the intentional distribution of dangerous falsities. Governments will be without the substantial resources required to identify all online anti-vax campaigns and thus will be forced to handover decision-making powers to social media platforms themselves. This is unlikely to be an optimal strategy for the delivery of public health messaging and risks triggering dangerous normative shifts in the ability of social media platforms to control what the public is and is not able to see.

The anti-vax movement poses a huge threat to global public health, particularly in the era of COVID-19. However, censorship and deplatforming are unlikely to improve this situation but may unintentionally exacerbate it. Instead, governments should recommit to providing clear, consistent, regular, frequent and accessible public health messaging that is highly visible to the public and transparent about what is, and is not, known to the scientific community. Attention should be drawn to the plethora of benefits enjoyed by humanity to date as a consequence of global mass vaccination programmes and contrasted with the recent setbacks and harms caused by prominent campaigns of anti-vax misinformation. In this manner, public trust in vaccination programmes, medical professionals and public health institutions will be reinstated at the time it is needed most.