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Anti-vaccination proponents inadvertently inspire pro-vaccination social media campaign

Vaccine opposition at a social media event inspired the creation of new guidelines to combat misinformation.

Jeff Lagasse, Associate Editor

(Photo by Halfpoint Images/Getty Images)(Photo by Halfpoint Images/Getty Images)

What can vaccine proponents, clinicians and public health communicators learn from "anti-vaxxers"? A lot, according to new guidance for pro-vaccination social media events written by University of Pittsburgh health scientists.

The five-part guidelines, published in the journal Vaccine, arose from an analysis of a grassroots pro-vaccination campaign organized last year by popular physician and social media personality Dr. Zubin Damania, colloquially known as "ZDoggMD." Unexpectedly, more than three-quarters of the tweets associated with the event were opposing vaccination, researchers found.

While the opposition was jarring, it did provide some constructive lessons.


Following two separate instances in November 2019 and January 2020 in which vaccination antagonists launched social media attacks and harassed, and personally threatened, clinicians who had posted positively on social media about vaccination, physician and social media personality Dr. Zubin Damania called on all healthcare professionals and vaccine advocates to speak up in support of vaccines using the hashtag #DoctorsSpeakUp on March 5, 2020. 

The event was supported by Shots Heard Round the World, a project of Public Good Projects, a public health nonprofit. Shots Heard was created in 2019 following a coordinated online attack against pediatrics practice Kids Plus Pediatrics.

The team turned to Twitter to collect all publicly available tweets with the #DoctorsSpeakUp hashtag posted on March 5, 2020 – a total of 106,275 tweets, of which 19,332 were original. 

They then analyzed a random sampling of original tweets, examining the type of account they came from (organization, healthcare professional, parent or a combination), whether they had pro- or anti-vaccine attitudes, and whether the tweet gave a personal narrative or made statements about research or science, or both.

In total, 78.9% of the tweets were anti-vaccine, despite the event being organized as a pro-vaccination campaign. Only 5.4% came from "bots," or automated accounts, which is lower than previous studies looking at bots that tweet about vaccines.

The numbers suggest a highly coordinated response by anti-vaccine antagonists, rather than a coincidental convergence.

After further examining the tactics the anti-vaccine movement used in co-opting the #DoctorsSpeakUp hashtag and event, Hoffman's team developed guidelines for future pro-vaccine media events, such as using best practices for risk communication, which include sharing personal narratives and citing scientific research.

Further guidelines include leveraging partnerships to create a broad coalition of vaccine advocates, maximizing inclusivity, sharing a list of suggested tweets with stakeholders and potential participants prior to the event, and training event participants on responding to messages clearly and with compassion.

With a grant from the Richard King Mellon Foundation, the Pitt team is expanding on this work to investigate COVID-19 vaccine misinformation by analyzing how people are connected on Twitter and what messages are being shared.

The goal is to guide the creation and dissemination of effective educational messaging about the COVID-19 vaccines that can be shared through multiple platforms – social media, television or in-person discussions – to help people who may be hesitant to receive a vaccine make fact-based decisions.


Skepticism about vaccines was high at first. Last fall, nearly half of older adults were on the fence about COVID-19 vaccination – or at least taking a wait-and-see attitude – according to a University of Michigan poll taken at the time.

But a follow-up poll released in March shows that 71% of people in their 50s, 60s and 70s are now ready to get vaccinated against COVID-19 when a dose becomes available to them, or had already gotten vaccinated by the time they were polled in late January. That's up from 58% in October.

There's more work that needs to be done in terms of getting the public fully on board. The Biden Administration has championed a $1.5 billion campaign aimed at boosting vaccine confidence and uptake across the country.

That's on top of $500 million the administration already pledged for related activities, including $250 million to fund grants for state and local health literacy projects and $255 million for the Centers for Disease Control and Prevention to fund local government efforts to focus on equity and confidence in underserved communities.

Twitter: @JELagasse
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