Behavioural interventions to reduce vaccine hesitancy driven by misinformation on social media

"Anti-vaccine campaigns proliferated during the covid-19 pandemic... Once covid-19 reached pandemic status, social media was acknowledged as the epicentre of misinformation leading to hesitancy, and consequently, interventions to tackle hesitancy have globally focused on delivery through social media...

A 2021 randomised controlled trial (RCT) found that exposure to misinformation about covid-19 vaccines lowered the intent of recipients to vaccinate, even among those reporting before exposure that they would 'definitely' accept vaccination. Similar findings globally indicate that social media dynamics exacerbated the sharing of misinformation, reduced vaccination rates, undermined trust in reliable information, magnified polarisation, and damaged the perceived credibility of institutions. These challenges remain today.

Approaches to reducing vaccine hesitancy

Standard behavioural approaches to encourage vaccination include mandatory vaccination and regulation for healthcare professionals, incentives, public health communication campaigns, and engaging trusted leaders. Contemporary methods have started to be implemented on social media, including debunking (fact checking specific claims after they have reached social media users) and 'pre-bunking,' a behavioural approach in which users are taught about how 'fake news' works before exposure. Other intervention types include warning ('inoculating') people about manipulation tactics using non-harmful exposure as a tool to identify misinformation, and using accuracy prompts to trigger people to consider the truthfulness of material they are about to share on social media platforms, without stopping them from posting...

Such behavioural approaches to misinformation on social media have shown promise in reducing the sharing of disinformation and misinformation and in changing people’s beliefs...

Evaluating interventions to reduce vaccine hesitancy

Two interventions that increased vaccination uptake used targeted messages through Facebook adverts and personalised influencer content...

Developing better interventions to confront vaccine hesitancy on social media

... We provide 10 insights based on the existing evidence that should help provide a clearer and more specific, evidence driven toolkit of approaches to reduce vaccine hesitancy...

• Debunking efforts have shown mixed effects on social media— ... [N]ow, the immediate priority for this approach is to determine if inoculation based on pre-bunking can reliably reduce the noxious effects of next widespread waves of misinformation and resulting misbeliefs...
• Raising the quality and visibility of reliable health information can counter misinformation— ... To increase campaign effectiveness, interactive designs and visual aids such as posters or videos help target populations see and engage with accurate, accessible information throughout a campaign. Making it easier to find such materials is paramount, starting with search engine optimisation to increase visibility of campaigns...
• Blanket bans can drive groups and activities underground—Broad social media bans of individuals or of specific content can paradoxically result in the spread of misinformation and can galvanise problematic echo chambers by driving discussion into private social media groups or closed forums. Such closed environments are unlikely to include different viewpoints or corrective information, so misinformation is more likely to be reinforced. Rather than rely on outright bans, policy makers and content managers should explore methods that limit the spread and influence of misinformation.
• Social media platforms need to be part of the solution—If social media platforms are the epicentre of misinformation, then social media companies need to be part of the solution. During the covid-19 pandemic, social media platforms took a more interventionist approach to content moderation than before (and, in some cases, removed or limited covid-19 misinformation and conspiracies). Some of these approaches are now being rolled back, and social media researchers’ access to data about behaviour on the global platform X (formerly Twitter) is being limited. Content labelling and corrective actions have produced some positive effects, but social media companies should be more proactive in dealing with the proliferation of misinformation on their sites. We endorse calls to make data available and to work with researchers and regulators in all countries to enable developing effective solutions.

It is worth it to get these campaigns right

... One important step towards developing more effective interventions is the close monitoring of public perceptions and opinions about vaccination and services. Digital technologies make it possible to analyse large quantities of 'social listening data' in real time. Such information would complement the evidence we already have from a variety of study types, improving the design of new, robust, and appropriately targeted interventions. Because most published interventions focused on attitudes and intentions rather than on actual vaccination, however, there remains an urgent need for direct partnerships between behavioural researchers with healthcare clinics and public health agencies. Meaningfully developing those partnerships promises direct benefits for more reliable scientific insights that would improve the health and well being of entire populations."