Elsevier

Vaccine

Volume 30, Issue 25, 28 May 2012, Pages 3778-3789
Vaccine

Anti-vaccine activists, Web 2.0, and the postmodern paradigm – An overview of tactics and tropes used online by the anti-vaccination movement

https://doi.org/10.1016/j.vaccine.2011.11.112Get rights and content

Abstract

Websites opposing vaccination are prevalent on the Internet. Web 2.0, defined by interaction and user-generated content, has become ubiquitous. Furthermore, a new postmodern paradigm of healthcare has emerged, where power has shifted from doctors to patients, the legitimacy of science is questioned, and expertise is redefined. Together this has created an environment where anti-vaccine activists are able to effectively spread their messages. Evidence shows that individuals turn to the Internet for vaccination advice, and suggests such sources can impact vaccination decisions – therefore it is likely that anti-vaccine websites can influence whether people vaccinate themselves or their children. This overview examines the types of rhetoric individuals may encounter online in order to better understand why the anti-vaccination movement can be convincing, despite lacking scientific support for their claims. Tactics and tropes commonly used to argue against vaccination are described. This includes actions such as skewing science, shifting hypotheses, censoring dissent, and attacking critics; also discussed are frequently made claims such as not being “anti-vaccine” but “pro-safe vaccines”, that vaccines are toxic or unnatural, and more. Recognizing disingenuous claims made by the anti-vaccination movement is essential in order to critically evaluate the information and misinformation encountered online.

Highlights

► Web 2.0 and the postmodern medical paradigm aid in spreading anti-vaccine messages. ► Evidence suggests online information may influence vaccination decisions. ► Tactics and tropes used online by the anti-vaccine movement are described. ► Awareness of anti-vaccine techniques is needed to recognize disingenuous claims.

Introduction

Vaccinations are a significant public health achievement, contributing to dramatic declines in morbidity and mortality from vaccine-preventable diseases [1]. However, by reading certain websites, one might be persuaded to think the opposite – that vaccines are actually ineffective, useless, or even dangerous. These are merely some of the arguments posed by the anti-vaccination movement, an amorphous group holding diverse views that nevertheless shares one core commonality: an opposition to vaccines. The popularity and pervasiveness of the Internet today has facilitated the transmission of such beliefs.

Many people search online for health information, and the information found impacts patient decision-making; it is therefore essential to understand what is shared online. This paper provides an overview of how the new generation of the Internet (Web 2.0) and its emphasis on user-generated content has combined with characteristics of the current postmodern medical paradigm, creating a new environment for sharing health information. The anti-vaccination movement has taken advantage of this milieu to disseminate its messages. Strategies the movement employs, found on various anti-vaccine websites, are then described; this includes various tactics the movement engages in (e.g. misrepresenting science, shifting hypotheses, censorship, attacking their critics), as well as commonly argued tropes (e.g. that they are “pro-safe vaccines”, that vaccine advocates are “shills”, that vaccines are unnatural, etc.). Such narratives may be compelling, and help anti-vaccination protests persist despite a lack of scientific support. Identifying and analyzing these tactics and tropes is not only an important exercise in critically evaluating medical advice found online, but also a necessary step in ensuring individuals searching online are not misinformed.

Section snippets

Web 2.0, health communication, and the postmodern medical paradigm

Though the exact definition of the term “Web 2.0” is debated, its meaning is generally derived from comparison against the first generation of the Internet – Web 1.0 [2]. The main difference between the two is the amount of interaction and user-generated content; whereas Web 1.0 content was controlled by the provider, Web 2.0 allows users to create information. Anybody can contribute content via blogging, photo-sharing, video-uploading, and more. The creation and sharing of user-generated

The influence of the Internet on vaccination decisions

Eighty percent of Internet users search for health information online [21]. Those most likely to do so are adults providing unpaid care for loved ones, such as children. The most recent statistics available show 16% of seekers searched online for vaccination information, and of this group, 70% say what they found influenced their treatment decisions [22]. Surveys indicate the Internet now rivals physicians as the leading source of health advice [3].

Despite anti-vaccine messages being more

The online anti-vaccination community

Anti-vaccine sentiments are not a new phenomenon. They can be traced back to the origins of vaccinology, with little change since [52], [53]. Pinpointing the beginning of the modern-day anti-vaccination movement may depend on one's age. The airing of a 1982 television documentary, DPT: Vaccine Roulette [54], prompted thousands of parents to withhold pertussis vaccines, inundated pharmaceutical companies with personal-injury lawsuits (many then stopped producing vaccines), and led the US

Conclusion

The techniques used by the anti-vaccination movement are cunning, for not only are their protests camouflaged in unobjectionable rhetoric such as “informed consent”, “health freedom”, and “vaccine safety”, they take advantage of the current postmodern medical paradigm. Calls to “do your own research before vaccinating” dovetail with the postmodern characteristics of patient empowerment and shared decision-making, where individuals play a more involved role in their healthcare. The Internet

Acknowledgements

Thanks to the various reviewers, whose suggestions were helpful in strengthening the focus of this paper.

Conflicts of interest statement: The author was invited to speak at the Immunization Action Coalition's Social Media Summit in June 2010, where she received an honorarium. This work was undertaken independent of any funding sources.

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