With every passing month, more and more data prove the effectiveness of our readily available COVID-19 vaccines. From the rarity with which vaccinated Americans wind up in the hospital to the recent FDA approval of the Pfizer shot, these vaccines have been shown to prevent serious illness and death from COVID-19. And yet many are unwilling to use them.
In some cases of vaccine hesitancy where people have genuine reservations about what they are being asked to take, the problem is inadequately communicated knowledge about the underlying science. Providing better information – preferably with the help of trusted community members like family physicians – can help alleviate such concerns. Reliable websites that debunk false claims are also useful.
But then there is a subset of ‘vaccine hesitancy’ that is rooted in skepticism, denialism, and in some cases, conspiracy theories about vaccines. When it comes to these individuals, the task is harder and requires a different approach.
Telling people ‘the truth’ about COVID-19 vaccines is likely to be an ineffective strategy for the many who believe that ‘the truth about harmful effects of vaccines is being deliberately hidden from the public’. If there is no trust in the integrity of science – or of government and public health authorities – then appealing to scientific evidence is hopeless as it is simply seen as part of the conspiracy.
Conspiracy theorists depict governments as dominated by evil forces including aliens, Satanic child abuse rings, and other equally implausible manipulators of ordinary people. This depiction of the world is terrifying, but also psychologically empowering because it casts believers in the intoxicating role of brave truth-seekers standing up to evil. This dovetails with other conspiracy theories, such as the 2020 election being implausibly ‘stolen’ by the Democrats, thereby further politicizing opposition to mask and vaccine mandates.
COVID-19 conspiracy theories come in many forms. Some claim that doctors are falsifying death reports to boost pandemic statistics. Others think that vaccines are dangerous and that alternative treatments such as Hydroxychloroquine and Ivermectin are effective.
It doesn’t help that political leaders and faux institutions are giving credence to such misguided beliefs. Both Hydroxychloroquine and Ivermectin have been promoted by populists such as Jair Bolsonaro in Brazil and Donald Trump here at home. The right-wing organization ‘America’s Frontline Doctors’ provides a white-coat veneer of scientific respectability to these claims. That same organization, however, includes Stella Immanuel who believes that dream sex with demons causes illness. A telemarketing service that partners with America’s Frontline Doctors called SpeakWithAnMD charges $90 for a consultation and a Hydroxychloroquine/Ivermectin prescription.
The company that produces Ivermectin, Merck, has warned against using this drug for COVID-19 and the FDA has issued a warning that Ivermectin horse paste and other livestock formulations are not for humans. Still, conspiracy theorists such as Senator Rand Paul argue that scientific research into Hydroxychloroquine and Ivermectin is being ‘suppressed’ for political reasons. When a company concerned about how its product is being misused is ignored, disinformation is truly out of control.
When trust in scientific medicine disappears, the doors open to all manner of ‘alternative’ therapies and flawed thinking. Stories abound on social media of people concocting their own cocktails of vitamins, horse paste, etc., and ‘curing’ themselves of COVID-19. As most cases of COVID-19 are mild, this kind of anecdotal evidence is totally unreliable. In all probability, the recovery would have happened anyway, without any self-medicating at all – which is why clinical trials are necessary to prove whether a drug works or not. Purveyors of alternative medicine have been quick to exploit the opportunity presented by this distrust in science and reliance on anecdotal information.
We were not surprised to learn that most COVID-19 vaccine misinformation online in the United States is driven by 12 individuals – the so-called ‘Disinformation Dozen’ – almost all of whom work in the ‘alternative medicine’ space as booksellers, chiropractors, vitamin peddlers, osteopaths and their kin in the pseudoscience world.
We have seen first-hand how misinformation can impact the fight against a public health emergency. For us, it was our work against AIDS denialism in the early 2000s.
Similar to the nowadays COVID-19 misinformation, South Africa’s AIDS tragedy was led by President Mbeki, who during the crucial period of the late 1990s and early 2000s, also promoted conspiracy theories. He suggested that immune deficiency was caused by poverty and that the pharmaceutical industry – in cahoots with the CIA – was seeking to profit by harming Africa with antiretroviral drugs.
Rather than invest in the necessary drugs, Mbeki’s health minister supported the ‘Rath Health Foundation’, a Netherlands-based company specializing in vitamins, to run a pseudoscientific ‘trial’ which reportedly spread misinformation about antiretroviral treatment and resulted in several deaths. More than 300,000 people were estimated in separate studies to have died unnecessarily because of the government’s delayed provision of antiretrovirals in the public health sector.
The symbiotic connection between AIDS denialism and ‘alternative’ healing modalities was and remains important. Joseph Mercola, the leading member of ‘The Disinformation Dozen’ of COVID-19 misinformation who is worth over $100 million, profits directly through the sale of his alternative products. Back then, we saw music and color therapies promoted as AIDS cures, as well as African potatoes and coffee enemas. Now, it is bleaches, horse-deworming medication, and fancy waters that allegedly cure or prevent COVID-19. It is amazing that so many people choose to believe that the vaccines are dangerous because they have not been properly safety tested for long enough, and yet are willing to pump themselves full of all sorts of chemicals they know next to nothing about but heard of on the internet.
Pointing out that supposedly ‘natural’, ‘holistic’, and ‘alternative’ therapies are just as governed by the profit motive as the pharmaceutical industry might give COVID-19 conspiracy theorists pause for thought. The Rath Foundation, the same organization that promoted AIDS misinformation, bizarrely, claims nowadays that micronutrients can reshape human DNA to prevent COVID-19 infection and that this is a more effective approach than ‘synthetic’ vaccines.
Countering their anecdotal evidence is also important. During the AIDS epidemic, some prominent AIDS denialists served as ‘living icons’ by claiming that they were ‘living proof’ that it was possible to live healthily by ignoring HIV prevention protocols and rejecting antiretroviral treatment. One of them was Christine Maggiore who campaigned against taking antiretrovirals for HIV prevention or treatment. Tragically, her baby daughter and then Maggiore herself died of AIDS.
These deaths were a major blow for AIDS denialism. During the AIDS epidemic, we were part of a collaborative website called ‘aidstruth.org.’ It is no longer actively updated but retains an online presence. We used it to debunk AIDS denialist claims, but our most popular and probably most influential page was called denialists who have died. While this might appear macabre, even uncivilized to some people, the page was important in countering the narrative that AIDS could be beaten through alternative remedies. They were sad, but important, counter-narratives. When the online leaders of AIDS denialism died of AIDS-related illnesses, many of their followers took heed and changed their minds.
Contemporary stories about vaccine skeptics who have died of COVID-19 regretting they had failed to get vaccinated, and of family members changing their minds after losing unvaccinated loved ones to COVID-19, may now be playing a similar role. A recent report documenting the large number of conservative anti-vaccination radio talk show hosts who have died of COVID-19 is especially welcome. In many cases, their spouses take to the internet to beg people to get vaccinated.
These stories are important at pushing back against misinformation, and we need more of this kind of reporting. The American pandemic will not end while so many unvaccinated people are playing a key role in spreading the virus further. Anything that persuades some of them to think more carefully about the poor choices they are making could help the nation finally return to normality.
John P. Moore
Dr. John P. Moore is a tenured Professor of Microbiology and Immunology at Weill Cornell Medical College in New York. He received his B.A., M.A., M.Phil. and Ph.D. degrees from Cambridge University, UK. He moved to the USA in 1992, joining the Medical College in 2000.
Moore was an Elizabeth Glaser Scientist of the Pediatric AIDS Foundation and held a Merit Award from NIAID. He is an Editorial Board member for several journals, and has served on multiple study sections and review committees for NIH and charities.
Moore’s research for many years has focussed on understanding how HIV-1 enters cells and how to inhibit virus entry with specific drug candidates and antibodies. He presently directs intra- and multi-laboratory projects involving the design of HIV-1 envelope glycoprotein trimers for neutralizing antibody induction and structural studies. Some of these immunogens are now in Phase 1 clinical trials. Since March 2020, a significant proportion of Moore’s time has been spent on virology and vaccine topics related to SARS-CoV-2 and the COVID-19 pandemic, particularly to provide guidance to reporters and members of the public.