Objectives. To understand changes in how Facebook pages frame vaccine opposition.
Methods. We categorized 204 Facebook pages expressing vaccine opposition, extracting public posts through November 20, 2019. We analyzed posts from October 2009 through October 2019 to examine if pages’ content was coalescing.
Results. Activity in pages promoting vaccine choice as a civil liberty increased in January 2015, April 2016, and January 2019 (t = 11.33 [P < .001]; t = 7.88 [P < .001]; and t = 17.27 [P < .001], respectively). The 2019 increase was strongest in pages mentioning US states (t = 19.06; P < .001). Discussion about vaccine safety decreased (rs = −0.61; P < .001) while discussion about civil liberties increased (rs = 0.33; Py < .001]). Page categories increasingly resembled one another (civil liberties: rs = −0.50 [P < .001]; alternative medicine: rs = −0.77 [P < .001]; conspiracy theories: rs = −0.46 [P < .001]; morality: rs = −0.65 [P < .001]; safety and efficacy: rs = −0.46 [P < .001]).
Conclusions. The “Disneyland” measles outbreak drew vaccine opposition into the political mainstream, followed by promotional campaigns conducted in pages framing vaccine refusal as a civil right. Political mobilization in state-focused pages followed in 2019.
Public Health Implications. Policymakers should expect increasing attempts to alter state legislation associated with vaccine exemptions, potentially accompanied by fiercer lobbying from specific celebrities.
From the article:
To the extent that public health communications emphasize verbatim facts over the gist, or bottom-line meaning, of vaccination, vaccine opponents and proponents may be talking past one another, with proponents unable to convince opponents about the value of vaccination and conflating vaccine opposition with ignorance—a linkage that strengthens the claim that public health and medical officials are elitist. Thus, this framing presents health communicators with a danger and an opportunity. The danger is that public health practitioners, often with limited human and fiscal resources, cannot devote the sheer attention necessary to maintain a constant social media presence. Furthermore, they may wish to avoid the appearance of communications that could be judged to be partisan or political. By contrast, by empowering members of the public to make their own choices about vaccination, public health communicators must be equally empowered—but only if provided with adequate resources—to communicate the appropriate and compelling social context for vaccination decisions.Our results suggest that vaccine opponents are becoming increasingly organized with considerable political clout. Public health agencies and advocates must therefore build strong relationships with state policymakers so that they may take an active stance when proposed laws or exemptions would further threaten the public’s health. Finally, legislation is shaped by public opinion. Thus, continued protection of the public health will require sustained research into effective messages for communicating fact-based rationales for vaccination that are nevertheless targeted and tailored. These messages must be responsive to the contextual factors, specific values, and gists motivating vaccine refusal.