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Why Idaho is fertile ground for vaccine misinformation, and what to do about it

FILE - In this Aug. 11, 2019, file photo, an iPhone displays the Facebook app in New Orleans. Facebook says it’s going all in to block the spread of bogus vaccine claims. In practice, that means the social network plans to ban a new bunch of false claims in addition to the old bunch of false claims about vaccines or COVID-19 that it has already banned. (AP Photo/Jenny Kane, File)
Jenny Kane/AP
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AP
FILE - In this Aug. 11, 2019, file photo, an iPhone displays the Facebook app in New Orleans. Facebook says it’s going all in to block the spread of bogus vaccine claims. In practice, that means the social network plans to ban a new bunch of false claims in addition to the old bunch of false claims about vaccines or COVID-19 that it has already banned. (AP Photo/Jenny Kane, File)

The Idaho Department of Health and Welfare is working to tamp down misinformation around COVID-19 in the state — specifically on the department’s Facebook page. Last week, the agency announced it would block members of the public from posting on its page after sharing or promoting misinformation there.

But these days on social media, fighting misinformation can feel like paddling against a tidal wave. How did we get here? And how can we be sure we’re not spreading misleading or incorrect information in our own lives?

Joining Idaho Matters to talk about the effects of misinformation during COVID-19 is Dr. Kolina Koltai, a researcher with the Center for an Informed Public at the University of Washington.

"It's no longer relegated to like fringe or smaller niche communities online. You can read a news article and just go in the comments and see vaccine misinformation, right? You cannot escape it."
Dr. Kolina Koltai, researcher with the Center for an Informed Public at the University of Washington.

Read the full transcript here:

Gemma Gaudette: You're listening to Idaho Matters, I'm Gemma Gaudette. The Idaho Department of Health and Welfare is working to tamp down misinformation around COVID-19 in our state--specifically on the department's Facebook page. Now last week, the agency announced it would actually block members of the public from posting on its page after sharing or promoting misinformation there. However, these days on social media, fighting misinformation can frankly feel like you're battling against a tidal wave. How did we get here and how can we be sure we're not spreading misleading or incorrect information in our own lives? Well, joining us today to talk about the effects of misinformation during COVID is Dr. Kolina Koltai, a researcher with the Center for an Informed Public at the University of Washington. Dr. Koltai, thanks so much for joining us today.

Dr. Kolina Koltai: Thanks for having me here, Gemma.

Gemma Gaudette: So your work is focused on vaccine misinformation in particular--which I mean, we all know is a hot topic these days. So I'm curious about when and why you got interested in studying this. I mean, did you have any idea how important this topic would be before COVID started?

Dr. Kolina Koltai: That's a great question. I have been studying this probably since about 2015. I used to live in California, and very famously we had a measles outbreak in some of the Southern California theme parks. And it just kind of got me questioning and thinking like this question of why are people not vaccinating? And I always thought, vaccines are good. And it really didn't settle well with me to say like, 'Oh, these are just people who are uneducated or people who are dumb or entitled' sort of these like throwaway responses. And I think I just kind of been stuck on that question ever since 2015.Really focusing initially on like childhood vaccines, and obviously, I have always thought it was a really important topic. I spent many years thinking about it, and now it's definitely, I think, one of the most important topics today.

Gemma Gaudette: Oh, 100%. Ok, so let's step back for a minute, because I'm curious about how does this moment in vaccine misinformation maybe compare to other times? And I ask this because, you know, you see a lot of things on social media, in other places comparing this to the smallpox vaccine--but everybody got vaccinated, right, and we were able to eradicate smallpox.

Dr. Kolina Koltai: Right. So anti-vaccination sentiment or vaccine hesitancy has been around for as long as there's been vaccines, so like hundreds of years. We see even like cartoons depicted in the 1800's of like people who are heads into vaccines or propaganda from the anti-vaccination league. So this is something that's been happening on for a very, very long time. It boiled well before social media, right? But you know, as we normally think about vaccines, most people didn't really have to think about vaccines until they became a parent, you know, deciding whether or not they're going to vaccinate their child. Most people don't have a flu shot requirement at their work or anything. And so there is always the potential for this to really explode and sort of the modern day anti-vaccination movement. We've seen an increase in vaccine hesitancy and anti-vaccination sentiment and content, really something... like a "pinpoint moment" is the very famous lancet paper in 1980 by Wakefield that initially linked autism or autism spectrum disorder ASD to the MMR--which is the measles, mumps and rubella vaccine--and really sort of that movement growing over the years. And then over the past, like, I think, five, six years, we've seen it really explode with the prevalence of that content on social media spreading to different communities globally--even beyond just the U.S. And so I would say that...I often call it a perfect storm of everything you need to happen to really sort of have widespread vaccine hesitancy that we're seeing today, right? You had to have a brand new vaccine, social media misinformation already being an issue, the tying with vaccine sentiment, with political ideology...for a long time, it was actually rather nonpartisan. You'd get five people who are left leaning and right leaning who are vaccine hesitant. It didn't really matter by party. But as we see that, you know, science is inherently political and vaccines really being tied to politics over the past like five years, different representatives supporting a parent's right to choose bills--which are just bills for parents to choose to like, not vaccinate--we see outbreaks happening, measles happening more in the U.S. It's just everything you needed. Then the pandemic hit, which is basically just like...you imagine throwing a bunch of gasoline on kindling, and that's where we are here today.

Gemma Gaudette: Yeah. So I'm curious, is successful... Viral vaccine misinformation rooted in some type of truth or—in your research—is it always a complete lie?

Dr. Kolina Koltai: That's a really great question—I say it's sometimes a little bit of both, right? I would say that a lot of the narratives sort of these overarching ideologies or the reasons why people are not vaccinating —those haven't actually changed, right? A lot of the narratives we saw prior to the pandemic are the same narratives that we're seeing today, just being applied to the COVID vaccine. And when we look at these, you know, there's sometimes some bit of truth to them. So one of the big bits of misinformation that you have probably seen around is this idea of like related to VARS, which is the vaccine adverse reporting system, which is a system that is set up by the CDC for people to report vaccine injuries or side effects. So you can imagine you go and you get a shot and you're like, 'Oh, my arm is kind of swollen.' You can actually go and report that and be like, 'I had a swollen, you know, red injection site at the vaccine.' The issue with that is that it is not meant to be a comprehensive system, and it's also...anyone can go and submit something into it. So you go in there, you can even see things like,'Oh, I was hit by lightning afterwards or I got superpowers after getting vaccinated.'

Dr. Kolina Koltai: There really isn't any way to verify the data that's in this self-reported system, so people might think they have a side effect that's actually not related to it. Some people use it jokingly, and some people argue that might be even underused. But the point is it is meant to be used as a signaling system. So when you see misinformation out there or content, it says here is, say, CDC data or evidence or proof of all the injuries or all the deaths from, say, a COVID vaccine, we know we can't actually fully trust that data because there could be people and they're inflating the data say, like, here's all these proof of injuries when they're not really happening. And so there's at some point like that is misinformation. But there does have some nugget of truth because it is still a CDC system. We just can't verify it. So you can see how misinformation can be really powerful if you just see a Facebook post that says, here's all the numbers of reported deaths this week from the vaccine. That sounds so scary. It sounds horrifying. You don't want to have death from a vaccine. But in reality we see very little, very few injuries.

Gemma Gaudette: Hmm. So how much does social media play in this? I mean, as you said, we've seen vaccine hesitancy, you know, for the last 100 plus years. I mean, social media hasn't been around that long.

Dr. Kolina Koltai: Right, so I would say, like the reasons why people are not vaccinating...those are the same. It's not necessarily because of social media. Social media is the avenue in which we are getting this information right. You know, it's no longer the fliers people are posting up—although you do still see fliers around, people still doing that. It just allows people to be able to find these networked communities, which you're able to actually connect with people. So prior to the pandemic, imagine you're a parent tried to navigate whether or not you're going to vaccinate your kid. You might bring this up to your pediatrician, to maybe your friends and your family. And they're just like, 'Oh, what? You're not vaccinating? That sounds crazy.' You know, you have this really visceral reaction from everyone that you're not vaccinating. And then you go to find an online community and they're like--let's listen to your concerns, your fears, yes, absolutely you should not be vaccinating and they give you a bunch of evidence of why you shouldn't vaccinate. And suddenly you're like, 'Oh, maybe this is actually the right way, people here were wonderful, and they're kind of either willing to listen to me.' And you got exposed to a lot of misinformation...so people fall into these communities. Before that, it was much harder to find those communities in those spaces. And I would say prior to the pandemic, oftentimes it was a little bit trickier to find vaccine misinformation. You'd often have to go to a specific vaccine, say, Facebook group or a specific website. But nowadays, because, you know, the pandemic and the vaccine is like the number one topic on all our minds, you can literally find it anywhere, you know? It's no longer relegated to like fringe or smaller niche communities online. You can read a news article and just go in the comments and see vaccine misinformation, right? You cannot escape it.

Gemma Gaudette: Ok, so also, though, we're finding that it's not just anti-vaxxers who are spreading misinformation or misleading information. I want to give you an example. I mean, a couple of weeks ago, just here in Idaho, there was a claim that went viral because some of our hospitals here are under a crisis standards of care right now. So there was this information that a universal Do Not Resuscitate order was in place. So basically people thought that means if your heart stops while you're in the hospital, I mean, guess what? They're not going to resuscitate you. That is false, but it spread quickly. And now the state and our health systems are actually having to try to correct that. So what does that example illustrate for you, because I think there's this idea that only anti-vaxxers are spreading misleading information.

"Vaccine misinformation is prevalent and can impact anyone. It does not matter necessarily how educated you are or how much background you have in health care[...]anyone could fall subject to vaccine misinformation."
Dr. Kolina Koltai, researcher with the Center for an Informed Public at the University of Washington.

Dr. Kolina Koltai: Yeah, that is absolutely not true. I don't know a single person in the world who's never spread misinformation, right? I think we're all absolutely capable of doing that. I know that I probably have done it myself in my life. I definitely times I could think back in my youth, I probably still do it all again.

Dr. Kolina Koltai: Yeah, in my youth, like last week, right? It could happen to anyone. And it's not a political leaning thing. People ...there could be right leaning news and left leaning news that also has misinformation. What misinformation does it...I often tell people is that when you read something online and it creates sort of this emotional response in you, so reading something that says, like, 'oh, you're not going to resuscitate anyone if you come in'—that creates an almost like, 'oh my gosh, the hospital is not going to help me.' And that to me, should be your first signal and saying, like, 'wait, maybe something is wrong here', right? If something is a really shocking or really emotionally charged bit of information, you know, take a moment, pause. Don't just immediately freak out. Don't just immediately want to share that with everyone, which is our instinct, right? Like, we see something that's shocking or something that we want to be able to tell our loved ones or our friends or our network. We want to share that, you know—you can imagine on a lesser sort of impact, like if you see a celebrity death, right, you see that and you're like, 'oh my gosh, this person died. I got to tell everyone.' And you realize, 'oh no, it's a hoax. It's not true.' And you know, the risk of that is really minimal, right? You're like, 'oh, it's corrected. This person is alive and it's fine.' But really, the effects of misinformation...when it spreads this quickly is that it often spreads quicker and faster and wider. Then often the debunk, which comes out later. It is very, very quick and easy to create misinformation—particularly ones that have that emotional charge. And then the debunk doesn't always reach to the people, and sometimes it's too late for it to actually have an effect because now you're ready and your hesitant. The example that went viral actually a few weeks ago was there is a news story that was posted by the Rolling Stone about how...oh, I have to remember which state it was...I think Oklahoma...where they're turning away gunshot victims because the hospitals are so overloaded with ivermectin like overdoses and people with COVID. And actually, that wasn't true. And that was a case probably of a little bit of bad reporting on their side because they didn't do any fact checks and verify, they just got a statement from someone who actually didn't have any evidence. But you saw that headline go everywhere--gunshot victims being turned away because the hospitals are so overloaded--and that spread widely. I even saw that rather had the same sort of reaction like,'oh my gosh, that seems ridiculous,' right? And the reality is that that's not the case. And so anyone can absolutely follow through—it even happens from a mainstream media source. It's not just sort of your fringe networks. Rolling Stone is a household name, and it could still happen with them.

Gemma Gaudette: So before I let you go, I want to ask you one more thing about misinformation, and this is in regards to medical providers because we have seen numerous physicians around the country spread misinformation. But specifically, here in Idaho, Dr. Ryan Cole is on the Central District Health Board. This covers the Boise metro area, just among other regions, and he has referred to vaccines as quote 'needle rape', and he questions their efficacy. So how how does this affect public health and trust when you have physicians giving out misinformation?

Dr. Kolina Koltai: I think this is some of the hardest misinformation to combat, when it comes from health care providers, be it a nurse or be it a doctor. Because it's a lot harder for a nuanced conversation, right? The way that I used to often talk about trying to talk through the decision of whether or not to vaccinate is to talk to your health care provider, talk to your doctors. And when we have doctors, who have this sort of inherent trust and expertise we give to them, pushing out misinformation, it tells us one or two things: one that actually vaccine misinformation is prevalent and can impact anyone. It does not matter necessarily how educated you are or how much background you have in health care...anyone could fall subject to vaccine misinformation. You know, they say the organization America's Frontline Doctors is really powerful, particularly to health care providers, because it uses their language—but it's still pushing out vaccine misinformation. So just because you're a doctor doesn't mean you're immune. But the advice that I give to people when you see sort of this disconnect, when you see some doctors, you might trust supporting vaccines and some other doctors saying not supporting it. The important thing to remember is that science is a consensus, right? So it's not very just about like the one rogue doctor, especially if no one else is able to say, replicate that study or have that same evidence or come to that same conclusion. The point of like an experiment or a study is we have it being conducted in many different labs by many different scientists all across the world. And if overwhelmingly the consensus is yes, masks work and yes, the vaccine is safe and the yes, the vaccine works—it's like if that is what the overwhelming majority of scientists and doctors are saying, that proves that like the evidence suggests that yes, it is safe and necessary and efficacious. Science is that consensus. If you were to make a volcano—like with baking soda and vinegar—anywhere in the country, it's going to do the exact same thing every time, right? And maybe it goes weird in one spot. You're like, 'oh, that's crazy', but you're like, 'oh, maybe something weird and funky happened there', you know, it's something weird and funky happened everywhere. Then we say, like, 'oh, maybe the baking soda vinegar thing is not working anymore.' And so the science is about that consensus. So I urge everyone to think about when they see like, 'oh, here's this one doctor, here's the one whistleblower.' Even though that's a very sexy idea of the whistleblower, the rogue renegade standing up against sort of like 'big pharma 'and it's like...no. At the end of the day, science is this consensus. That's why you replicate studies. That's why you have it being conducted all around the world. We've had millions and millions of people who take the vaccine now and they've all come out safe and fine and being protected against COVID. So that is...I don't personally know Dr. Ryan Cole, but it sounds like he's putting out a lot of misinformation. And I would say, you know, that is one doctor. What are the rest of the doctors in Idaho saying? And I would guess that they're saying take the vaccine.

Gemma Gaudette: I want to thank you so much for talking with us today about misinformation. We've been speaking with Dr. Kolina Koltai. She researches vaccine misinformation at the University of Washington.

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Frankie Barnhill was the Senior Producer of Idaho Matters, Boise State Public Radio's daily show and podcast.

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