Facebook Created the Perfect Platform for COVID Vaccine Conspiracies

Kaleese Williams had stayed away from Facebook and Instagram before COVID-19 hit. But during the early lockdowns, the 37-year-old was stuck on her North Texas farm with her husband, her three-year-old son, and her chickens and goats. She was also left without a source of income. Williams sells essential oils for a Utah multi-level marketing company called Young Living.

She normally set up booths at conferences and other events, earning a little money while socializing with people. “Quarantine isn't much fun,” Ella Williams says. "So I started thinking, 'What's wrong with sharing on social media?' Her plan was to take her essential oil business to Instagram, where she could sell to people she met there.

Williams decided to spend on an online course called 'Ready Set Gram Pro'. She promised to help her create a "highly engaged" community on the photo-sharing app that would "generate leads and ongoing sales." Watching tutorials on the web and participating in Zoom sessions, she learned tricks to attract potential clients to her profile, for example, by commenting on the posts of wellness influencers.

As she grew her following to over a thousand users, she grew fond of Instagram, especially the 'natural life' parts of the app. Williams already had an aversion to traditional medicine after being bullied during a bout with cancer in 2017, during which she says her doctor failed to disclose to her that a treatment she underwent could cause infertility. She was now spending more and more time consuming information about different forms of alternative medicine, such as naturopathy and functional medicine.

That's where she started reading about the COVID-19 vaccine. She came across posts based on unsubstantiated rumors that Pfizer and Moderna vaccines were toxic, caused adverse reactions, and could carry infertility risks. Soon she became convinced that Food and Drug Administration (FDA)-approved vaccines, which have few side effects and are almost completely effective in preventing hospitalization or death from COVID, were not for her. "It's scary," she says. “I believe in the immune system. I don't believe in vaccine-induced herd immunity."

One would think that during the worst pandemic in a century virtually everyone would be desperate for a vaccine that promises to help them get their lives back. But you would be underestimating the power of Facebook and Instagram to provide all the tools necessary for anti-vaccine activists and other welfare marketers to engage. Over the years, these opportunists have cultivated a strategy optimized for the social age. Anti-science skepticism trickles into Facebook groups and Instagram stories and posts, where algorithms reward content that elicits strong emotional reactions, further amplifying misinformation.

These social media influencers, legitimized by their sizable followings, had an entire year to cast doubt on COVID vaccines before Facebook took significant action. They have taken advantage of public confusion, and mixed messages from government and health officials, on everything from masks to side effects to vaccine safety. Facebook's official stance is that it doesn't ban posts unless they "cause imminent harm," a threshold the social network claims vaccine misinformation has crossed only months into the global inoculation campaign.

Although doubts persist and anti-vaccine lies continue to circulate on the Internet, the CEO of Facebook, Mark Zuckerberg, staunchly defends the actions of the social network. His critics say the company hasn't done enough yet. “The content that their websites keep promoting, recommending and sharing is one of the biggest reasons people are refusing the vaccine,” Pennsylvania Democratic Rep. Mike Doyle said at a March 25 congressional hearing with Zuckerberg and his social media peers. "And things haven't changed."

In October 2020, a group of wellness gurus with millions of social media followers met virtually to discuss a landmark opportunity. The world was months away from immunization against COVID-19, with several vaccine makers signaling that they would soon apply to the FDA for emergency use authorization. These vaccine skeptics saw an opportunity to push a counter-narrative.

In a series of discussions, speakers discussed the promise of the coming months. "All the truths that we've tried to spread for many, many years, people are listening to them," said Robert F. Kennedy Jr., one of the leading vaccine conspiracy theorists. "Those seeds are falling on very fertile ground."

For years, activists -- some with medical credentials, some without -- have attracted a following, especially among mothers of young children, by falsely claiming that routine measles and mumps vaccinations can cause autism and other ailments. Although the vast majority of Americans have ignored it and continue to get vaccinated, measles, which the Centers for Disease Control and Prevention (CDC) declared eradicated from the United States two decades ago, has reappeared in recent years. Even slight drops in vaccination rates can erode the herd immunity needed to keep certain viruses at bay, and in 2019, the United States saw a 300 percent increase in measles cases. Among the causes of the outbreaks: “misinformation in communities about the safety” of vaccines, according to the CDC.

With COVID, adults, not children, were the first to get the vaccine. Still, vaccine skeptics took aim at a group whose fears they knew well: young women. Last fall, groups began circulating on Facebook and Instagram a now-deleted blog post of unknown origin that quoted two doctors with an inaccurate but frightening headline: “Pfizer Research Chief: COVID Vaccine Is Sterilization female”. He falsely claimed that the vaccine contained a spike-shaped protein that could block the creation of a placenta and render women infertile.

This claim was false, but it compounded the real uncertainty. Pfizer and Moderna had not yet specifically tested their vaccines in pregnant or lactating women, and the FDA's emergency use authorization does not cover pregnancy. The guidance from the American College of Obstetricians and Gynecologists only goes so far as to say that "vaccines should not be withheld from pregnant or lactating individuals." Still, by February, more than 3,000 pregnant women had signed up for a US government follow-up program after receiving COVID vaccines, and so far there have been no red flags. More recent studies have found that vaccines are not only effective in pregnant women, but also pass antibodies to their newborns. And because pregnant women are at higher risk of dying from COVID, many doctors recommend that they get vaccinated anyway. “Women are confused,” says Lori Metz, a licensed clinical social worker in New York who specializes in fertility. "Their doctor may say one thing, and then they read a blog that starts to pull on all these other fears."

This gray area was fertile ground for anti-vaccine activists. In December, Del Bigtree, founder of the Informed Consent Action Network, shared the fake sterilization post with hundreds of thousands of his followers on Facebook and Instagram. Subsequently, the blog was shared on Facebook more than 25 thousand times. “I'm seeing this everywhere!” a woman named Emily wrote along with a screenshot of the fake Pfizer blog, which can still be found circulating on Facebook in multiple languages. "I'm starting to believe this." Commenters flooded his post with more (completely bogus) “evidence” backing up the claim. Some said this proved another discredited conspiracy: that the COVID vaccine is part of the global depopulation effort funded by Bill Gates.

The effects of this disinformation are already reflected in the survey data. Of people who say they're not likely to get vaccinated, more than half of US women are worried about side effects, compared with 44 percent of men, according to a survey by the US Census Bureau. from March 3 to 15. Many of the women who are already eligible are refusing the vaccine, according to surveys and interviews of more than a dozen people. More than a third of nurses, a largely female group and one of the first to receive the vaccine, are not confident that the COVID-19 vaccine is safe and effective, according to the American Nurses Foundation. And a March survey by the Washington Post and the Kaiser Family Foundation found that 18 percent of health care workers are not planning to get vaccinated.

The high rates of rejection and doubts among health workers are an alarming indicator. Vaccines are widely seen as the country's best chance to end a pandemic that has killed more than half a million Americans and sparked a global financial crisis. Epidemiologists estimate that vaccinating 70 to 85 percent of the US population would trigger the herd immunity needed to get back on track. If even high-risk frontline workers, who have seen the devastation of COVID firsthand, don't want the vaccines, experts fear that enough people in the general population won't be vaccinated either, allowing the virus to continue to circulate.

In the face of Internet memes and anecdotes, Pfizer has offered scientific jargon. “It has been incorrectly suggested that COVID-19 vaccines will cause infertility due to a very short amino acid sequence in the spike protein of the SARS-CoV-2 virus that is shared with the placental protein, syncytin-1” he said in response to a news story about the rumour. "The sequence, however, is too short - four shared amino acids - to plausibly give rise to autoimmunity." It was perfectly accurate, but disinformation was infinitely more shareable, says Karen Kornbluh, director of the Digital Innovation and Democracy Initiative at the German Marshall Fund of the United States. "People who support science have to improve the way they tell the story," she says.

In the early months of the COVID pandemic, Zuckerberg went to great lengths to position himself, and by extension Facebook, as a source of good, science-based information. He hosted Anthony Fauci, the nation's top infectious disease officer, several times for live question-and-answer sessions, and had his company develop a COVID-19 page with information on social distancing, testing and the face masks.

As for all that misinformation about vaccines circulating on his platform, Zuckerberg already said in September that he did not think it appropriate for his company to withdraw most of it. "If someone points out a case where a vaccine has caused harm or is concerned about it, it's a hard thing to say, in my view, that shouldn't be allowed to express at all," he told the Axios news site. "There's a fine line between a significant level of high energy around an important issue and something that can be tilted to do harm."

On February 8, nearly two months after the start of vaccination in the United States and a year after the start of the COVID-19 crisis, Zuckerberg backpedaled and decided that misinformation was, in fact, causing harm. At the time, online skepticism was manifesting in actual decisions not to get vaccinated. Facebook declared that Instagram accounts and Facebook groups that repeatedly shared false information about vaccines would be banned and that vaccine advocates would be less prominent in search results, a move critics had urged for years. Kennedy, Bigtree and other big names lost their access to Facebook. But many others do not. In a test search for “vaccines” on Instagram a few days after the announcement, most of the top 20 accounts offered by the platform were explicitly vaccine skeptics. The sixth on the list was called @antivaxxknowthefacts (profile: “Inject vegetables, not vaccines”). The eighth was called @anti.vaccine. The twelfth, appearing just before @covidvaccineinjury and @anti_vaccine_4_life, was @vaccinefreedom, the National Vaccine Information Center account, with 54,000 followers, the same group that sold tickets to the October conference Kennedy spoke at.

Facebook told Bloomberg Businessweek that since February it has removed 2 million anti-vaccine content that violated its policies. But by then many of these conspiracies had reached people like Williams on his North Texas farm and continue to circulate in ways that Facebook's automated cleanup tools can't find as easily, such as through screenshots, in comments. and in group messages.

Worse yet, the misinformation seeded by vaccine skeptics on Facebook has spread into the real world, including in nursing schools. A Houston nursing student says her clinical professor proudly declared to the class that she was not going to get vaccinated. The person administering the vaccinations on campus was also abstaining. A 28-year-old nurse from Southfield, Michigan, says she turned down the first chance to get vaccinated because she's trying to have a baby. She had seen the statements on the Internet, and "even though you're in the medical field," she says, "you just don't know."

Monika Bickert, Facebook's content policy executive, weighed in on the timing of the move in a call with reporters in February. She said the World Health Organization (WHO), the CDC and other public health experts advised the social network to take stronger action because misinformation was convincing people not to get vaccinated. That was the proof Facebook needed that content on its site was causing "real-world harm." This was the same criteria that the social network used during the 2020 US presidential election, when it refused to deactivate #StopTheSteal groups that were spreading the lie that President Donald Trump had won the election. Instead, Facebook slapped a note on their posts saying that Joe Biden had actually won the election. On January 6, violent rioters stormed the US Capitol, a partially planned attack on Facebook. Only then did the company begin banning #StopTheSteal groups and suspending Trump's account.

Facebook's approach of allowing fake vaccine content to remain online and merely verifying it may be even less effective than its attempts to curb disinformation and political incitement. People who have already bought into vaccine conspiracies are unlikely to be swayed by a misinformation label, and labels are easily ignored. Instagram users now see a popup when they search for “vaccine” asking if they really want to see the results. Easily discarded with a touch.

At the heart of Facebook's misinformation problems is the very design of the social network. After the 2016 election, in response to criticism of Facebook's growing role in political polarization, the company made a crucial change to how its platform works. Zuckerberg announced a new mission statement: Build community and bring the world closer. That meant highlighting Groups, for people to come together for shared interests, rather than arguing about the news. This change also helped Facebook increase revenue by getting more content into people's feeds. Before, users mostly saw what their friends or their friends' friends posted; now, everything shared in a group you belong to also appears in your feed, creating more space for ads.

Facebook's algorithm recommended groups to its users based on what people with similar interests tended to like. So, if you join a group about vegan cooking, Facebook can recommend a group about natural medicine. If you joined that group, Facebook might suggest another about vaccine harm. And so users found communities, some of which pushed them into disinformation holes. The social network uses similar mechanisms to personalize the recommendations of Instagram accounts to follow. "Once you find someone," Williams says, "you're able to find someone else."

At the same time, Facebook and Instagram also highlighted what it called "meaningful" conversations — that is, posts that generated a lot of comments very quickly. The change, intended to highlight pregnancies, engagement announcements and other big life events, also boosted controversial, surprising or frightening content that sparked debate, such as anti-vaccine posts. Well-meaning people trying to debunk vaccine misinformation in the comments have helped it go viral by telling Facebook's algorithm to post the entries to more people's feeds.

Instagram was fertile ground in its own way. Health is one of the fastest growing categories, and some of the biggest names on the platform live in a genre widely known as wellness. A subgenre of these influencers, like the ones that attracted Williams, offer pseudoscientific strategies for healthy living. Good-sounding lifestyle options (plant-based diets, detox teas) are offered to users alongside questionable medical advice. For example, when the COVID virus hit, some of these influencers claimed that a healthy diet, exercise, and the supplements they promoted were the best ways to avoid getting the virus.

Behind these claims there is usually a profit motive. The big names in the anti-vaccine movement, Bigtree and Kennedy among them, make money from speaking engagements, webinars, or supplement sales. An Instagramer sells $15 packs of stickers that read: “Vaccines can cause injury and death” and “I will never get vaccinated against COVID-19.” Another touts what he claims are trainings to eliminate COVID. A third, who claims to be a naturopathic doctor, charges $295 for a vaccine consultation, or $49.97 for a webinar, and offers discounts on supplements and air purifiers to rid the environment of "toxins." A disclaimer section at the bottom of her website says the information is "for educational and informational purposes and is NOT medical advice." On her Instagram page, she has no liability report.

For example, you can talk to doctors who have spent the last year in COVID wards, and they will tell you that they are spending more and more time convincing their patients of something wildly false that they have read on Facebook. "I've had countless patients tell me that COVID isn't real and it's no worse than the flu," says Ryan Marino, a Cleveland-based medical toxicologist. Now people are telling him that he doesn't want the vaccine either, and not just young women; anti-vaccine activists have spread lies among other vulnerable groups, especially black communities. Marino is part of an informal group of health workers who spend their spare time on social media trying to fight bad information with good. Marino's medium of choice is Twitter, but there are also doctors like him on Facebook, Instagram and TikTok.

This is exactly the kind of behavior that Facebook says will overcome the vaccine misinformation rampant on its platforms. "Research shows that the best way to combat vaccine hesitancy is to connect people with trusted information from health experts," says Facebook spokesman Kevin McAlister, pointing to the company's COVID-19 Health Information Hub. Studies have revealed that direct facts hardly change opinions; personal stories from known sources work much better.” At first, Danielle Belardo thought, like Facebook, that sharing science-based information would do some good. When the virus began to spread in March, Belardo, then a cardiology fellow in Philadelphia, was reassigned to the COVID wards. She spent the day tending to patients, some on ventilators, others barely able to breathe on their own, all without the proper protective gear for her. “It was very hard,” she says. “I would go to work, I would see the virus, I would see the death, and then I would come home to see a ton of misinformation online.”

She already had a good following on Instagram thanks to her posts about plant-based nutrition. Early in the pandemic, she decided to use her platform to debunk false claims about the virus that causes COVID-19. Her first publications were technical and scientific, and sought to clarify the facts. When she received harassment and angry comments, which were many, she responded to the criticism. "I was doing it wrong, and a lot of doctors were doing it wrong," she says. "We were highlighting the posts that were fake and linking directly to them, driving more traffic to those posts, boosting them in the algorithm."

Belardo, who is now director of cardiology at the Institute for Plant-Based Medicine in Newport Beach, California, no longer engages directly with the lies, because that only draws more attention to the logic of Facebook and Instagram. Instead of her, she tries to share things that she knows will play: memes, selfies, personal stories and question-and-answer posts. She has been relatively successful. Her number of followers has increased by tens of thousands of people. But her posts continue to attract plenty of anti-vaccine commenters, despite blocking anyone who harasses her.

Marino says he, too, is inundated with harassment and death threats, and not just online. People have shown up at his workplace; others have called the hospital where he works to try to get him fired. “I have had patients accuse me of profiting from COVID, of doing tests just because they pay me to make a diagnosis,” she says. "Meanwhile, leading figures in the anti-vaccine movement have been doing very well financially."

Despite her success in creating a larger following, efforts like those of Belardo and Marino have yet to reach Williams. Algorithms show people more of what they want to see. "To be completely honest, I haven't seen doctors recommend the injection," says Williams. And even if he saw it, he says he wouldn't believe them.