Misinformation Challenges Global Vaccine Efforts

John Whyte, MD, MPH; Melissa Fleming


January 27, 2021

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  • We are in an "infodemic," in which the rapid and far-reaching spread of inaccurate information confuses the public and stokes mistrust.

  • The United Nations (UN) created "Verified," an initiative to flood the internet with scientifically accurate, interesting, and consumable content.

  • "Take care before you share" is a new UN slogan encouraging people to pause, think through, and verify the source before sharing something on social media.

  • No country is safe until all countries are safe. We need at least 70% vaccination worldwide to overcome the pandemic.

  • The hope is that healthcare workers around the world will be vaccinated by summer 2021.

This transcript has been edited for clarity.

John Whyte, MD, MPH: Welcome, everyone. You're watching Coronavirus in Context. I'm Dr John Whyte, chief medical officer at WebMD.

We talked about COVID-19 being a pandemic, literally affecting every country on this planet. We're seeing differences in terms of how different areas of the world are addressing it and different cultural issues in terms of communications around vaccine confidence.

To help provide some insights, I've asked Melissa Fleming to join me today. She's the under-secretary-general for global communications at the UN. Melissa, thanks for coming on today.

Melissa Fleming: It's great to be with you, John. Thanks for the invitation.

Whyte: We've spent a lot of time on this show talking about different communication issues around the vaccine, around COVID, and misinformation that exists in the United States. But this really is a global problem. I want to hear your thoughts. What are we seeing around the world in terms of who is communicating information in a good way? Where are we seeing some of these challenges? What can we learn by looking at the global efforts?

Fleming: Well, it has been an unpredictable experience going forward. I have to say one thing: Where we have seen strong, responsible leadership — political leadership based on science — we've seen less of believing in miracle cures and thinking that the coronavirus is a hoax. We're seeing more adherence to mask wearing and social distancing. So, the political leadership is really key.

But where that is absent, what we're finding, is just fertile ground for misinformation to flourish. The misinformation does not have to originate in that country and in that language. What we have is the first global pandemic in the social media age, and that means that a piece of misinformation produced in the US travels around the world and can end up in a poorer, developing country, translated and adapted to local needs, and cause a lot of damage. So it's really a challenge and quite a race to compete with some of this compelling, emotive misinformation that is endangering people's lives.

Whyte: We've become a society where, in many ways, there's an attack on science. We used to say, "I don't understand science." But now people are saying, "I don't believe in science" or "Melissa, that's your opinion, but this is mine," even when the facts don't support what they're saying. How did we get to this point? It's really a global problem, isn't it?

Fleming: It is. It's funny, though. When you look at the polls, you still see that doctors and scientists are the most trusted public figures or leaders in society. So it's not all lost. That said, science has really taken a huge beating. That is because there's so much lack of trust, due to the kind of media environment that populations are exposed to these days.

It's a media environment that is "polluted." It has good information and people who are genuinely trying to guide the public with science-based content. But it's polluted with bad information; some of it deliberate, some of it just based on rumor. It's very difficult for the public to figure out where the truth is. Therefore, they begin to mistrust the information that's appearing in their feeds and are starting to trust the people they know who might not be scientific experts.

What we need to do (and are trying to do) at the UN is to bring back science as something to pay attention to. We are taking the PDF document the UN agencies or public health institutions are putting out there for the public to try to figure out, and optimizing the key content there for social media so that it can compete with some of this misinformation. It can build trust and pull people back to the trusted organizations that are going to guide them in their best interests and for their own health.

Whyte: I want to follow up on some more specifics. I like the metaphor that there is pollution out there, this misinformation. You're working very hard to clean up this pollution. Tell us some of the specific projects and products that the UN is working on.

Fleming: When the pandemic hit the world, the World Health Organization coined the phrase "infodemic," which was spreading alongside the pandemic. Infodemic is this mixture of good information with bad information, creating confusion and everything that we don't need for a pandemic. What we realized is that we were not just in a public health crisis; we were in a communications crisis as well.

So we decided to start an initiative. We partnered with a social mobilization organization called "Purpose" to start an initiative called "Verified". The goal was to flood the internet with socially optimized content based on science that is consumable, interesting to read, travels well on social media, has a real distribution plan, and at the same time helps to fight misinformation.

"Verified" has been our initiative since the start of the pandemic. We've adapted it and moved it forward. We have different kinds of mechanisms, depending on the issue. It's incredible that we still have to put out public health guidance that's very basic — wear a mask, socially distance. It's incredible that it's still necessary.

Now the vaccine is on everybody's mind. And this is first and foremost in our communications strategy right now — how to promote vaccine equity and at the same time vaccine trust. What we see now is the shift in misinformation to not just say, "This is a hoax," but to say that the vaccine is dangerous or "don't take it." So we really have a big challenge ahead, not just here in the United States but in countries all over the world.

Whyte: Tell viewers where they can learn more about Verified — Twitter and other platforms — and we'll post it here as well.

Fleming: Oh, that's great. Thanks, John. We thought that it would be really important to be able to involve people in our initiative because we also know that we (as in the UN, from New York headquarters) can broadcast this out, but it's not necessarily going to reach everybody. We have been deploying our offices around the world in every country to adapt our content in different languages and to push it out.

We've also been asking members of the public to sign up as information volunteers, to be our digital first responders — to learn about misinformation, but also to share our content in their own groups and their own communities. You can find out more about it and sign up on shareverified.com. We'd love to have you.

Whyte: We really encourage everyone to take a minute and do that, either during this broadcast or immediately after. Didn't you also have an effort where you encouraged people to pause, to think twice before posting something on social? It's very easy to all of a sudden have some emotion or thought and want to put it down on social. Sometimes that can cause some harm.

Talk to me about this idea that when we're talking about COVID, maybe we should think twice before posting.

Fleming: Absolutely. What we were seeing when studying the misinformation phenomenon, and how it was traveling, is that there are certain factors that needed changing, including the social media platforms. The platforms have taken several measures to slow the spread of misinformation and halt it, in some cases, which is commendable. Much more needs to be done.

There's also individual action and responsibility. We don't want to put everything on the individuals because it really isn't their fault. But on the other hand, we need everybody to take part right now because it is damaging lives and risking lives.

We studied behavioral science on the internet, and we found that this type of misinformation is produced in a way to make you feel emotive, a certain "Oh my God, miracle cure!" Maybe "I'm going to send this and aunt so-and-so won't have to die from COVID." Or there is "All of this lockdown has been for nothing; this whole thing is a hoax." Basically, if your heart starts palpitating when you're reading something, maybe there's a good chance it might not be true. So we're trying to educate people, even just to take a few seconds' pause. Our slogan, which we hope is going to become a behavioral norm, like "Don't drink and drive," is "Take care before you share."

Whyte: Take care before you share. I like that.

Fleming: Yes, that's it. If you even just say that and then you look at it, the source, and that photograph — is it really a current photograph or maybe it's from somewhere else? Very often, though, the source is a good place to look. Does it come from a reputable media organization or person? We're also trying to give people the tools to detect — to be their own detectives on the information.

Whyte: We do need to be our own detectives. And we need to look at the sources, see if it's corroborated somewhere else. That gut reaction — "Does this make sense?" Isn't the challenge that everyone's an armchair epidemiologist nowadays? Everybody's an expert because they have a Twitter handle or a blog. But that's actually not the case, and sometimes folks don't realize that that doesn't make you an expert, and that there is expertise in the area of science and public health issues.

Fleming: Which is why it's really great that there are doctors like you who know how to communicate, because I think this is one of the issues. We're getting people who are not experts or scientists but are savvy communicators. Then we have the doctors and the scientists who are busy saving lives but haven't learned the skills of communication, which is so critical.

Whyte: I was going to say that. That has been a challenge, and we should acknowledge that. Public health departments are often understaffed and underresourced. At government agencies (I worked at one), we parse every word very carefully. Twenty, 30 people touch a document sometimes before something goes out. It's probably the same where you are. It makes it very hard for people to relate and understand. We have a language of parlance in medicine and in health that doesn't necessarily make sense to other people.

Have you ever seen anything in your career that's similar? In some ways, we saw all these misperceptions and misconceptions about HIV. But we didn't have social media to amplify everything. Does anything even come close in your career?

Fleming: In the scale of misinformation, conspiracies, rumors, no. In the public health sphere, this is unprecedented and will be studied for a long time. This issue also affects everyone in the world. There's such a high level of interest, and that means that there's a high level of opportunity for exploitation of people's fears, of people's desires.

We're seeing people trying to profit from these fears. With COVID, there are already people peddling vaccines online for profit. It is an unprecedented situation. We've seen misinformation and disinformation for a long time on climate denial.

Whyte: That's somewhat similar, but not to the scale. In terms of vaccine confidence, something that we've been talking about and trying to work together on, it's a global issue. People forget that.

We really need to have 70% -80% herd immunity around the world. Otherwise, there will be significant challenges to truly crush the pandemic. How confident are you from where you sit that we'll be able to reach this goal of herd immunity globally?

Fleming: First of all, I'm so glad you said that so people understand. Because every time I listen to the news here in the US or when I'm in Europe, it's all about vaccinating our nationals. I think we really need to get into the public consciousness that we are never going to be safe — one country will never be safe until all countries and all communities are safe. This is what the UN, with WHO, UNICEF, and the vaccine alliance CEPI [are focusing on]. We have this mechanism called COVAX, which is to ensure that the poor and the middle-income countries, the most vulnerable, the people in conflict areas, can get the vaccine.

The issue is that it needs to be financed, and the manufacturers need to supply the doses. So there are issues involved. Right now, what we're seeing, if you look at the map, is that the wealthy world, the richer countries, are well underway in starting to vaccinate their populations. On the other part of the map, particularly in the Global South, there's nothing. So we're trying to bridge that disparity through advocacy through this mechanism.

Even if you don't really care, it's in your enlightened self-interest to make sure that everyone around the world receives this vaccine. We need to have at least 70% of the world vaccinated if we're ever going to overcome this crisis. It also has an economic dimension if we ever want to recover. We do have the mechanism and we can do it. It's possible. It just requires funding and a little thinking beyond your own border to other parts of the world and people of the world.

Whyte: Tell me where you think we're going to be this summer. That's what everyone's asking, so I'm going to ask you: Where are we going to be globally?

Fleming: Globally, we really hope that through more vaccines being approved by WHO, we're going to at least start seeing that healthcare workers around the world have been vaccinated. That is an absolute priority by the summer. That's what we'd love to be able to see, so that at least the healthcare systems are shored up. At the same time, there's a whole preparedness effort going on in those countries by WHO and UNICEF to make sure that the health systems are ready when the doses of vaccine come to those countries and that they're able to distribute.

There are many countries in the world that are very pro-vaccine, often very poor countries. And there are many poor, middle-income countries that have very strong public health systems and are already used to vaccinating their people. So, what we might see is that if the supply is there, they might be better at distributing to their populations than some of what we're seeing in less centralized health systems, like here.

Whyte: Especially if you have vaccinations that may not require the logistics of multiple shots and super-cold temperatures.

Fleming: The cold chain. Exactly.

Whyte: Will we see a resurgence of global travel? Or will that require a bit more time than the summer?

Fleming: I think we're all hopeful. But again, in the richer countries that have the supply and are already rolling out vaccine programs in a big way, you probably could see travel within the countries come back. But as soon as it becomes global, if you're traveling to other countries that are not as advanced in vaccines, then we're going to have to pause and wait for that kind of global ability, that freedom of movement and travel that we so enjoyed and probably took for granted until this time. I can tell you that I'm looking forward to that day. But I don't think it is as close as this summer.

Whyte: You've given us a lot to think about. You've reminded us that no one's safe until we're all safe. Think before we share, right? And verify. We need to be our own detectives in some way in terms of what we read in print and on social as well. Anything else you want to leave our viewers with?

Fleming: I think that it's a trying time. Probably the viewers here have a real interest in public health information that is accurate and verified. Let's celebrate and trust our healthcare people, friends. They are the pillars of our community. And let's give science the credit that it deserves and the trust that it deserves.

Whyte: That's good. We need to trust science. Melissa Fleming, I want to thank you for taking the time today and sharing your insights. And thank you for all that you're doing globally around the world to improve communication about COVID.

Fleming: Thank you so much for having me, John.

Whyte: If you have any questions about COVID, drop us a line. You can email me at drjohn@webmd.net, as well as post on social on Twitter (WebMD or Medscape), Instagram, Facebook, or Pinterest. Thanks for watching.

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