Abstract:
The online anti-vax community has utilised the Twitter platform as a means of disseminating false and misleading information regarding the efficacy of vaccines. By acting as a refracted public, this anti-vax community has engaged in some insidious strategies and tactics that has resulted in a significant increase in vaccine hesitancy within the public.
Social media platforms, such as Twitter, have created space for many online communities to flourish, which has resulted in positive relationships forming between users. However, it has also allowed a specific subset of like-minded users, commonly referred to as anti-vaxxers, to connect with others and slowly grow their online following. This online community of anti-vaxxers function as a refracted public on Twitter, gathering and disseminating misinformation regarding vaccines through clever strategies designed to capture the attention of a specific audience. This online anti-vax activity exploded in the wake of the SARS-CoV-2 (COVID-19) pandemic, and despite well-intentioned attempts by Twitter to curb the spread of vaccine-related misinformation, it caused a global rise in vaccine hesitancy.
Online Communities
The rise of information and communication technologies has created a vast number of “technologically-mediated communities” (Delanty, 2018, p. 201), that may no longer have a solid, spatial place, but instead are “more fluid and temporary forms of social relations sustained only by processes of communication outside of which they have no reality” (Delanty, 2018, p. 201). Communities are no longer only in-person gatherings of individuals with strong ties to each other (Hampton, 2016), instead they have been transformed and expanded by communication technology; for example, social media platforms (Hampton, 2016). These social media platforms, such as Twitter, have given users the ability to share their thoughts without much consequence – it has created opportunities for people from different walks of life, who have similar thoughts and opinions, to meet in virtual spaces (Benoit & Mauldin, 2021). This can be a negative thing as much as it can be a positive, as it allows space for extremist communities to band together (Kata, 2012).
The Online Anti-Vax Community
The online anti-vax community are an extremist group of like-minded individuals that are opposed to vaccines – they do not believe they work, deem them unsafe and often distort or reject the science behind them (Benoit & Mauldin, 2021; Khadafi et al., 2022). Delanty (2018) asserts that like-minded individuals who discover each other online, tend to create groups that “affirm one’s prejudices” (Parsell, 2008, as cited in Delanty, 2018, p. 219), and previous studies have found that anti-vaxxers are resolute in their beliefs and not open to accepting the possibility of being wrong (Kata, 2012; Mitra et al., 2016). The anti-vax community online uses Twitter to amplify their views and opinions (Maci, 2019) and “disseminate messages, facts and beliefs” (Betsch et al., 2012, as cited in Benoit & Mauldin, 2021, para. 4) that are against forms of vaccination. Delanty (2018) explains that “the sharing of information” (p. 205) is a key objective of virtual communities, which aligns with the anti-vaxxer’s ultimate aim to share and spread misinformation.
This virtual community of anti-vaxxers has grown exponentially online (Benoit & Mauldin, 2021; Blane et al., 2022; Muric et al., 2021), particularly in response to the COVID-19 pandemic (Armitage, 2021; Blane et al., 2022; Muric et al., 2021; Nasralah et al., 2022). Their online activities have had such an effect on their audience, across multiple social media platforms, that the World Health Organization has listed vaccine hesitancy as one of the top ten threats to global health (Armitage, 2021; Astrup, 2019; Khadafi et al., 2022; Nasralah et al., 2022).
So, What is Vaccine Hesitancy?
Vaccine hesitancy is a reluctance in the recommendation to vaccinate (Astrup, 2019), either oneself or one’s children. It has a negative effect on society as a whole, as it endangers the protection that herd immunity brings (Alvarez-Zuzek et al., 2022). Muric et al. (2021) mentions a multitude of studies that show vaccine hesitant individuals tend to be much more easily influenced by misinformation than pro-vaccine individuals, and more obviously swayed by emotional appeals (Nguyen & Catalan-Matamoros, 2022). The prevalence of anti-vax misinformation online has lowered vaccine trust (Bradshaw, 2022) and in addition, Astrup (2019) found that apprehensions regarding vaccinations can have an effect on others in their social circle (Alvarez-Zuzek et al., 2022).
Refracted Publics
In order to spread their opinions and beliefs on Twitter, anti-vaxxers have devolved into operating as a refracted public. Refracted publics “are shaped by circumvention” (Abidin, 2021, para. 8), they assist in allowing communities to post and spread content that can be extremely harmful to other users (Abidin, 2021). They engage in a delicate balancing of their own online visibility in order to “redirect audience interest” (Abidin, 2021, para. 1) to where it is most needed. This dissemination of anti-vaxxers’ views and beliefs on Twitter, has caused an increased level of “information distrust” (Abidin, 2021, para. 9), leading to a rising scepticism in the safety of vaccines. This distrust was exacerbated in part by an infodemic triggered by COVID-19. Infodemics on social media occur when there is “perpetual content saturation” (Abidin, 2021, para. 9); platforms are flooded with a constant stream of endless information, including false information, to the point that consumers become overwhelmed and unable to completely absorb it all (Abidin, 2021; Skafle et al., 2022). This continuous stream of information, and subsequent scepticism of it, are further examples of the way the anti-vax community online is operating as a refracted public (Abidin, 2021) on Twitter. By taking advantage of this phenomenon, anti-vaxxer’s have created a higher level of vaccine hesitancy by amplifying their anti-vaccination messages through insidious strategies, such as clickbait tactics, hashtag jacking and social steganography (Abidin, 2021).
Clickbait Tactics
Anti-vaxxers use conspiracy theories to create a negative narrative surrounding vaccines (Ginossar et al. 2022; Nasralah et al., 2022), particularly by enticing their audience into clicking additional links that lead to harmful vaccine misinformation. This is a strategy known as clickbait; anti-vaxxers’ use conspiracy theories as a controversial subject that grabs attention and increases the interest of their audience (Abidin, 2021), particularly from the vaccine hesitant crowd. One such conspiracy theory that gained traction during the COVID-19 pandemic on Twitter, is that the vaccine was created to harm the general public, instead of protecting it (Kata, 2012; McCarthy et al. 2022). Kata (2012) describes this tactic as a “toxin gambit” (p. 3783) that is designed to scare individuals about particular ingredients in vaccines. Anti-vaxxers shared this controversial misinformation on Twitter through links that connected to websites, that then led to harmful misinformation on the ingredients of vaccines (Low, 2021; Malisch, 2022). Since vaccine hesitant individuals tend to have a higher lack of trust in vaccines to begin with, they are therefore more inclined to believe such conspiracy theories, resulting in a decrease in the intention to get vaccinated or to vaccinate their children (Ginossar et al. 2022; McCarthy et al., 2022).
Hashtag Jacking
Anti-vaxxers take advantage of a feature on Twitter known as the ‘hashtag’. This is a word or series of words that follow the pound symbol (#); these keyword/s then become hyperlinks that enable users to find related subjects (Khadafi et al., 2022). In addition to this, if enough users tag the same thing, these topics can become trending, which will then increase its visibility on the platform and potentially affect public opinion (Khadafi et al., 2022). Anti-vaxxers on Twitter have engaged in insidious hashtag jacking, a strategy that Abidin (2021) describes as a way for users to latch onto a particular hashtag and inundate a platform, with the aim being to “mock, satirize or negatively critique” (Gilkerson & Berg, 2018, as cited in Abidin, 2021) it.
#DoctorsSpeakUp
The hashtag #DoctorsSpeakUp was originally created by a doctor intent on spreading a science-backed, pro-vaccination message on Twitter (Bradshaw, 2022). However, the anti-vax community hijacked this message and twisted it to fit their own narrative, turning the hashtag into “questions such as, ‘When will #DoctorsSpeakUp that vaccines harm and kill children?’” (Morris, 2022, as cited in Bradshaw, 2022, para. 1). Bradshaw (2022) found that 71% of users who tweeted #DoctorsSpeakUp were from anti-vaxxers flooding the Twitter platform with tweets on topics such as vaccine injury and uninformed doctors. Hoffman et al. (2021) found that anti-vax tweeters participating in the #DoctorsSpeakUp hashtag were more likely to use personal narratives and anecdotes. This plays on the emotions of their audience, which can often be the catalyst for vaccine hesitant individuals to reject vaccines (Nguyen & Catalan-Matamoros, 2022). The switch from doctors promoting the COVID-19 vaccine to anti-vaxxers condemning it was very effective in changing the narrative from an informed (science-backed) pro-vaccination message to an anti-vaccination message, veiled in fear and distrust. Furthermore, since vaccine hesitant individuals are much more likely to believe a negative change in COVID-19 vaccine information (Sharevski et al., 2022), it also had the effect of generating additional distrust in it (Bradshaw, 2022). Anti-vaxxers on Twitter use hashtags as a “weapon” (Khadafi et al., 2022) and by repeatedly using this insidious hashtag jacking strategy, the anti-vax community sows a deeper vaccine distrust and lures the vaccine hesitant further onto their side.
Social Steganography
A common anti-vax expression, particularly throughout the COVID-19 pandemic and beyond, is “I’m not anti-vaccine, I’m just pro-safety” (DanielRollTide, 2021; Tuijnman, 2020; Victory, 2023). The anti-vax community uses this statement as a form of dog-whistle, garnering support for their movement – who can argue with being pro-safety? – while simultaneously revealing their allegiance to the anti-vax community by then providing misinformation and seeding doubt regarding the efficacy of vaccines (Kata, 2012). Dog-whistling is a strategy of refracted publics known as social steganography and it is a way to implant a different kind of meaning into a seemingly innocuous message (Abidin, 2021). An example of this can be seen with Dr. Bob Sears, an American doctor and author known for his anti-vaccination/pro-safety stance, including delaying vaccines for children (Offit & Moser, 2009). Throughout the COVID-19 pandemic, Sears’ dog-whistles were shared on many platforms, including Twitter (kath2cats, 2020). Given the fact Sears is a doctor, therefore a figure of authority, creating doubt surrounding the COVID-19 vaccine has a greater negative effect on the vaccine hesitant and a potentially damaging effect on their children (Offit & Moser, 2009; Gorski, 2015). These dog-whistling tactics work particularly well on the vaccine hesitant individual; viewing blatant anti-vaccine information that appears in a balanced/safe way invokes their fears surrounding it and can result in an inflated awareness of potential vaccine risks and side effects (Kata, 2012; Skafle et al. 2022).
Twitter’s Role
Despite these damaging strategies used by the anti-vax community on Twitter, the platform has attempted to do its part in eliminating the amount of misinformation flowing on it (Burki, 2020). By placing warning tags on posts, limiting, removing and even banning users that post misleading and incorrect vaccine related information, the platform has greatly reduced and restricted the prevalence of anti-vaccine content online (Blane et al., 2022). However, it has not completely eliminated pockets of anti-vax rhetoric from remaining active on Twitter (R.FreedomWaves, 2023; TheChiefNerd, 2023) and since anti-vaxxers tend to be resolute in their beliefs, it likely never will (Armitage, 2021). While Twitter’s misinformation policies have been a great step in halting the viral spread of misinformation, it has not been a complete fix – some individuals still remember, and even believe, posts that have been labelled as such (Burki, 2020). Furthermore, censoring and shutting the anti-vax community down completely may cause vaccine hesitant individuals with valid concerns or questions to “sympathise with anti-vax rhetoric” (Armitage, 2021, para. 3). Indeed, Skafle et al. (2022) found that the vaccine hesitant disregarded platform warning tags if the message “aligned with their personal beliefs” (para. 24). Therefore, health professionals and governments need to focus on being far more transparent in their online messaging (Armitage, 2021; Ginossar et al., 2022; Nasralah et al., 2022). This can be done by building on “e-Health literacy” (Skafle et al., 2022, para. 37), so that vaccine hesitant individuals can accurately deconstruct vaccine misinformation; post more frequently; and act faster in addressing anti-vax claims (Burki, 2020).
Anti-vaxxers have devolved into a refracted public on Twitter by utilising sinister strategies such as clickbait tactics, hashtag jacking and social steganography. They specifically target vaccine hesitant individuals and destroy their faith in, and understanding of, vaccines. To its credit, Twitter has attempted to do its part in helping eliminate the extensive reach of the anti-vax community on its platform. By implementing the use of warning tags on posts and even banning blatant offenders, it has managed to greatly reduce the amount of anti-vax content posted. However, it is clear that more needs to be done in order to properly address the concerns of the vaccine hesitant, before they are swayed by the strategies and tactics of this refracted public on Twitter.
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Hi L, The thing is the paper is mainly concentrated on the African continent particularly.If you make an analysis of…