To address this expanded threat to US public health and security, we recommend three measures consistent with a so-called whole of society approach, 36 in which public health agencies collaborate with diverse (eg, academic, civic, and private sector) stakeholders.
First, we suggest the development of networked communities capable of reaching the public at the right time, at the right place, and with the right messenger about vaccine-related information—especially to pre-empt and pre-bunk 37 well funded and amplified messages disseminated by the anti-vaccine movement. This action entails a shift in approach for the US public health communication model, from the use of one credible messenger (that is vulnerable to discrediting attacks), to a broad, diverse, and coordinated network of expert messengers and influencers. These stakeholders—including leaders of local, historically marginalised, or faith communities 38, 39—can simultaneously share similar messages of factual information to their specific audiences. 40 Such an aggregated, coordinated approach makes it difficult for anti-vaccine activist efforts to undermine public trust in messages and lone experts.
Second, we suggest input is solicited from outside the usual public health agencies. Countering the array of expanded efforts by anti-vaccine activists and groups or individuals who influence or monetise disinformation efforts necessitates a wide breadth of expertise. Thus, interdisciplinary and intersectoral collaborations (eg, the Virality Project
10) are essential for developing effective responses. 41
Third, we suggest these networked and coordinated communities are leveraged to counter relevant trends in anti-vaccine efforts. This action will include separating narratives about liberty from anti-vaccine attitudes and mitigating anti-vaccine activist harassment of public health communicators. Separating these narratives requires diverse, trusted voices to stress the value of collective action to secure public health gain and economic security, while being mindful of public concerns for personal liberties that vary in form and intensity across social groups and locations. Activating networks to publicly aid individuals facing harassment will provide victims with valuable credibility and support from professionals and the general population (eg, the Shots Heard Round the World initiative 42).