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Incorrect or misleading vaccine information can impact public confidence in vaccines and lead to reduced demand and uptake. When misinformation is shared with deceptive intent, it is defined as disinformation. Whether the motive is sinister or not, the impact is often the same. In the case of the 2019 Peshawar incident in Pakistan, polio-related misinformation fuelled by social media led not only to vaccine refusal but to violence. Communication strategies have a major role to play in identifying the extent of vaccine-related misinformation and in addressing its root causes before dire outcomes occur. Featuring selections from The CI's Polio Network, this Drum Beat explores some of the thinking, action, and resources on misinformation (including disinformation) borne out of a concern about truth and accuracy in this increasingly digitally connected world.
1.Misinformation: Susceptibility, Spread, and Interventions to Immunize the Public by Sander van der Linden This review provides a conceptual overview of recent literature on misinformation - defined here as false or misleading information masquerading as legitimate news, regardless of intent - along three major theoretical dimensions: susceptibility, spread, and immunisation (boosting psychological immunity to misinformation). [Mar 2022]
2.The Psychological Drivers of Misinformation Belief and Its Resistance to Correction by Ullrich K. H. Ecker, Stephan Lewandowsky, John Cook, et al. This article describes the cognitive, social, and affective factors that lead people to form or endorse misinformed views and the psychological barriers to knowledge revision after misinformation has been corrected. It provides guidance on countering misinformation, including educational and preemptive interventions, refutations, and psychologically informed technological solutions. Finally, it looks at broader societal trends that have contributed to the rise of misinformation. [Jan 2022]
3.Vaccine Hesitancy in Online Spaces: A Scoping Review of the Research Literature, 2000-2020 by Timothy Neff, Jonas Kaiser, Irene Pasquetto, et al. Though vaccine hesitancy, misinformation, and online environments offer different sets of issues, health officials and researchers acknowledge overlaps, as achieving broad acceptance of vaccines requires understanding information ecosystems. To that end, this article reviews 100 articles published from 2000 to early 2020 that explore aspects of vaccine hesitancy in online communication spaces and identifies several gaps in the literature that suggest future research needs/directions. [Oct 2021]
4.Characterizing Polarization in Online Vaccine Discourse - A Large-scale Study by Bjarke Mønsted and Sune Lehmann Online misinformation has been linked to decreased vaccine confidence, with social media being recognised as a contributor to the propagation of false information and fringe narratives. Using a sample of over 60 billion tweets, this study of the vaccine discourse on Twitter presents analyses of the interplay between strong vaccination stances, social network structure, and the information sources shared by users in vaccine-related contexts. [Feb 2022]
5.The Case for Tracking Misinformation the Way We Track Disease by Erika Bonnevie, Jennifer Sittig, and Joe Smyser Misinformation threatens the public's health, the credibility of institutions, and the safety of experts and frontline workers. However, few public health organisations are capable of tracking and responding to disease-related misinformation as it happens. This commentary explores how big data - specifically, publicly available media data - can facilitate efforts to understand and respond to misinformation. Since 2017, The Public Good Projects (PGP) has used supervised machine learning to aggregate and code millions of conversations relating to vaccines and the COVID-19 pandemic broadly, in real time. The authors examine PGP's experiences with, and learnings from, this monitoring. [May 2021]
6."Does Pakistan Still Have Polio Cases?": Exploring Discussions on Polio and Polio Vaccine in Online News Comments in Pakistan by Muhammad Ittefaq, Annalise Baines, Mauryne Abwao, et al. Polio vaccine hesitancy and resistance remain high in some areas of Pakistan – in part due to, or at least exacerbated by, the aforementioned Peshawar incident. This study investigates readers' discussions in the English version of the Pakistani Dawn media group (Dawn.com) to investigate perceptions of polio, including but not limited to that incident. Since the Peshawar incident, the government of Pakistan has launched the Perception Management Initiative and blocked more than 700 social media pages related to anti-vaccination propaganda. The researchers suggest that additional studies could explore the spread of misinformation on social networking sites and investigate how to counter it. [Dec 2020]
7.Misinformation, Infighting, Backlash, and an 'Endless' Recovery; Policymakers Recount Challenges and Mitigating Measures after a Vaccine Scare in the Philippines by Mark Donald C. Reñosa, Jonas Wachinger, Kate Bärnighausen, Vivienne Endoma, Jhoys Landicho-Guevarra, Jeniffer Landicho, Thea Andrea Bravo, Mila Aligato, and Shannon A. McMahon Following vaccine scares, personnel engaged in vaccine promotion often must negotiate the fallout while continuing to address preexisting, broader challenges in vaccination rollout. This study explores the perspectives of policymakers in the Philippines who are involved in ongoing public health efforts to rebuild and expand vaccination efforts after the 2017 Dengvaxia vaccine scare, which has had domino and spillover effects, years later. "Respondents...saw social media as playing a decisive role in spreading misinformation or emotionalized images (e.g. children allegedly dying from the vaccine) in the Philippines, leading to widespread suspicion of vaccines and the government..." They offer recommendations for bolstering vaccine uptake after such a crisis. [Aug 2022]
8.Understanding the Reasons for Refusal of Polio Vaccine by Families in Quetta Block, Pakistan by Muhammad Samsoor Zarak, Hamaiyal Sana, Zara Arshad, et al. Eradication of polio has yet to be achieved in countries like Pakistan, where a surge in number of polio cases was reported in 2019. A major reason given for this regression was the increase in vaccine refusals by parents and caretakers. This paper attempts to explain why Pakistan has been experiencing high caseloads despite achieving record success in vaccine coverage and political and community engagement. Overall, the most prevalent reason for refusal was misconception about vaccines, reported by 34,943 (56.4%) individuals. "Efficient strategies are required to address misconceptions in this red zone of poliovirus transmission in Balochistan." [Aug 2022]
9.Exploring the Effect of Misinformation on Infectious Disease Transmission by Nabeela Mumtaz, Caroline Green, and Jim Duggan It is clear that vaccine-related misinformation can spread rapidly on social media. This paper starts from the premise that the diffusion of ideas or information spreading in this way is analogous to the transmission of an infectious disease. In that vein, the research reported here models the impact of vaccine confidence on the transmission of infectious diseases. The results show that higher vaccine confidence can mitigate against the impact of misinformation, and by doing so can contribute to the enhanced control of an infectious disease outbreak. [Apr 2022]
10.UNICEF Experience in Supporting Communication in the Introduction of Novel Oral Polio Vaccine Type 2 (nOPV2) This study documents the United Nations Children's Fund (UNICEF)'s communication-centred efforts to support the introduction of novel oral polio vaccine type 2 (nOPV2). For example, in the case of UNICEF Republic of the Congo, teams worked with leaders and influencers in areas where refusals and reluctance were registered due to misinformation. Meetings were organised to provide traditional leaders with guidelines. When frontline workers registered a refusal in the community, traditional leaders were approached and reminded about the guidelines so they could support parents in accepting vaccination. [Oct 2021]
11.Technique-based Inoculation against Real-world Misinformation by Jon Roozenbeek, Cecilie S. Traberg, and Sander van der Linden During the COVID-19 pandemic, misinformation and conspiracy theories that have proliferated online have been linked to diminished willingness to follow health guidance measures and reduced intentions to get vaccinated. This study's two separate experiments ask whether technique-based inoculation - a framework for reducing susceptibility to the techniques and strategies that are commonly used to mislead or misinform people - can (i) reduce susceptibility to real-world misinformation that went viral on social media and (ii) confer cross-protection against misinformation that inoculated individuals were not trained to recognise. In short, the results "corroborate previous findings that playing [the online game] Bad News improves people's ability to spot misinformation..." [May 2022]
12.Addressing Myths and Vaccine Hesitancy: A Randomized Trial by Maryke S Steffens, Adam G. Dunn, Mathew D. Marques, Margie Danchin, Holly O. Witteman, and Julie Leask One frequently used strategy to counter misinformation is to repeat specific examples of myths before debunking them, but the worry is that repeating a myth may backfire by rendering it memorable and thus likely to be recalled as true. The aim of this study was to compare how different text-based debunking strategies affect parents' agreement with vaccination myths and their intention to vaccinate their children. In short, posing myths as questions may be an effective debunking strategy when paired with corrective text. The study also shows that repeating vaccination myths is not necessarily harmful. [Oct 2021]
13.WHO Competency Framework for Health Authorities and Institutions to Manage Infodemics: Its Development and Features by Sara Rubinelli, Tina D. Purnat, Elisabeth Wilhelm, Denise Traicoff, Apophia Namageyo‑Funa, Angus Thomson, et al. In April 2020, the World Health Organization (WHO) Information Network for Epidemics (EPI-WIN) produced an agenda for managing the COVID-19 "infodemic": an overabundance of information, including mis- and disinformation. EPI-WIN also articulated the need to create a competency framework for infodemic management (IM) to assist institutions in reinforcing their IM capacities and implementing effective IM processes and actions. This paper presents the resulting WHO framework for IM. [May 2022]
14.How to End Infodemics: Working Group on Infodemics - Policy Framework Published by the Forum on Information and Democracy, this report identifies structural challenges that contribute to the threat of misinformation and offers a wide list of recommendations on how to address a phenomenon that threatens democracies and human rights, including the right to health. These structural challenges are related to: the lack of transparency of online platforms; the way that content, including reliable news and information, is moderated on these platforms; and the virality of disinformation shared on private messaging apps. [Nov 2020]
15.Countering Online Vaccine Misinformation in the EU/EEA by Thyra de Jongh, Bea Rofagha, and Liana Petrosova In light of the role public health authorities can play in identifying and countering online vaccine misinformation, this study, commissioned by the European Centre for Disease Prevention and Control (ECDC), explores: the main sources of online vaccine misinformation in the European Union (EU)/European Economic Area (EEA); the evidence base for how to counter online vaccine misinformation; the strategies national public health authorities use to counter online vaccine misinformation; and related training needs in the EU/EEA. [Jun 2021]
16.Polio Toolkit This web-based repository of social and behaviour change (SBC) resources is designed to improve sharing of information, SBC guidance, and learnings between the GPEI, local partners, organisations, and frontline workers working to eradicate polio worldwide. One area of the site provides learning opportunities, including access to UNICEF's framework approach to misinformation management. [2022]
17.Demand Strategy Builder South and Southeast Asia has seen decreasing demand in immunisations. Pakistan's Peshawar incident and the Philippines' Dengvaxia scare caused a drop in trust in all routine vaccination that has been exacerbated with rising dis- and misinformation globally. In response to these trends, UNICEF's Regional Office for South Asia asked Common Thread to develop this practical manual to help immunisation managers take quick, effective action to address low uptake of vaccination in the region. [Apr 2021]
19.Disinformation Toolkit 2.0 Adam Fivenson From InterAction, a community of non-governmental organisations (NGOs) active globally, this toolkit examines the many ways disinformation is impacting the work of NGOs and civil society organisations across sectors of international development and provides guidance as to how these organisations can respond - and are responding - to this threat. [Oct 2021]
20.E-learning: How to Address Online Vaccination Misinformation Developed by the ECDC, this e-learning course offers evidence-based strategies and tools to address online vaccination misinformation. It is designed to support public health practitioners and risk communicators in fighting the spread of vaccination misinformation on social media and other digital platforms. [Jun 2022]
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