There are increasing calls to discipline or de-credential doctors who are spreading anti-vaccine, anti-mask, and other pandemic misinformation. While statistics show that 96% of US physicians are vaccinated, a small number of physicians are able to wield an outsized influence on public opinion, especially via social media. These doctors repeatedly conduct rallies, give media interviews on major networks, and advise politicians who have control over statewide policies that affect schools and public spaces.


Appeal of Misinformation & Conspiracy

Misinformation spreads six times faster on Facebook than factual science-based posts, as it offers something both shocking and aligned with pre-existing beliefs or biases. Prior trauma or having anxiety can also make one more prone to belief in conspiracy. In fact, conspiracy beliefs can act a lot like addiction. The pandemic itself, and even Zoom, have increased paranoia for everyone.


Certifying & Accrediting Bodies

As seen with the case of disgraced Andrew Wakefield, however, even removal of credentials does not prevent someone with medical training from being a leader of anti-vaccine misinformation. Instead, the “martyr” role of being “silenced” or disciplined will feed conspiracy theories of “suppression of the truth” and fuel celebrity status. Highly resourced and motivated groups also give a disgraced doctor a platform, like when an anti-vaccine group flew Wakefield to speak to Somali refugees in Minnesota and to Orthodox Jews in NYC. Communities that have actual experience of government harm resulting in refugee status or historically marginalized communities, like religious minorities, are then taught to fear the US public health system.

Marketing & Influencer Perverse Incentives

Healthcare marketing is a $17.4 billion industry. While marketing and reputation management have been important ways for health systems and the medical industry to grow their reach and revenue stream, the metrics reward more “clicks.” This means a previously credible scientist who grew a following as a “contrarian” has an outsized influence as an alternate news source from established, credible professional groups. This is seen with the controversy of non-pediatrician Vinay Prasad repeatedly speaking to media advising to not trust the American Academy of Pediatrics policy on masks in schools, simultaneously blocking the majority of pediatricians on Twitter, leading to the @BlockedByVinay parody account.


Slander Industry & Reputation Management

Recently, a New York Times article featured the “slander industry”—companies that perform reputation management also do consulting work to slander and smear. This culture of smearing a rival or mentee exists within academia and medicine, even involving a board of medicine in Texas. These dynamics make the lay public see science itself as too political to be trustworthy, priming for appeal of misinformation about science or doctors. A post of someone with “establishment” credibility claiming to “expose” a shocking truth spreads quickly. In fact, in the Brian Deer investigative reporting of Andrew Wakefield, Deer explains that Wakefield’s primary objective had been a business one: he had filed a patent on a competing vaccine to the MMR. By discrediting the existing vaccine, Wakefield could open the market to his own product to generate profit, yet he is a “hero” of a movement that takes a moralistic stance against pharmaceutical profits, a favorite topic of anti-science conspiracy theorists. Slander that appeals to conspiracy theorists is often a tactic of business rivalries.


Data Manipulation, Deep Fakes & Mistrust

A common slogan of those who spread misinformation is, “The data don’t lie,” whereas data can be manipulated in a number of ways. A closer look at most misinformation on vaccines or masks shows poor data integrity: misuse of a database, inclusion/exclusion criteria that do not support conclusions drawn, or mislabeled axes on graphs. More recently, there was a shocking article on a mother using deep fake technology against her teen daughter’s sports “rivals.” She used artificial intelligence software to generate fake nude images of minors, then used fake accounts to send these to the girls’ coach. Similar deep fake technology can be used to fake “evidence” used to “prove” conspiracies. Additionally, parents fearing online sabotage of their children are primed to distrust rather than trust. If an anxious parent is offered a vaccine for their child, described online as controversial, they will opt out. This is especially so given false online rumors about fertility. Retracted studies also confuse.


Using Trusted Relationships in the Community

Dr. Todd Wolynn recently published a piece in Nature on the best practices, as a practicing physician, to make progress with hesitant families who are exposed to misinformation online, in their communities, in their places of worship, etc. Many families will trust their own family physician. Making your own videos for your own community or working with faith groups can convince groups with distrust of government or authority. Marginalized communities respond better to in-person, community outreach from those who are trusted community members. Medical centers, like Boston Medical Center, with established relationships of trust for serving marginalized populations are successful in their use of “SciComm,” or Science Communication, using joyful, inviting, fun videos of healthcare workers of the communities served. HHS partners with community and faith groups to disseminate factual vaccine information.

Ultimately, the antidote to conspiracy and disinformation is NOT more data from a scientist nor authoritarian censure via license, but focusing on the trust our patients have in us via humanism and authentic community connections.