By: Natalia Jucha, PharmD Candidate c/o 2022 and Zarin Chowdhury PharmD Candidate c/o 2023

             Effective September 29^th of 2021, YouTube will be banning prominent anti-vaccine activists and blocking channels promoting anti-vaccine misinformation. The company recently announced its expansion of medical misinformation policies. This includes prohibiting the sharing of  misinformation regarding currently administered vaccines that are approved and confirmed to be safe and effective by the World Health Organization (WHO) and other health officials.⁵ YouTube has hired thousands of moderators and has utilized high-tech image and text-recognition algorithms in an effort to police misinformation.

YouTube has mentioned that approximately 130,000 videos spreading misinformation about Coronavirus disease 2019 (COVID-19) vaccines were removed from its platform in the past year. The platform previously banned misinformation specific to coronavirus vaccines, but now, its updated policies will also block misinformation about routine immunizations, like those for measles and Hepatitis B, as well as general false statements about vaccines.¹ YouTube did, however, state that there will be exceptions to the new guideline in place. As a platform that promotes public discussion and debate, content about vaccine policies, new vaccine trials, and historical vaccine successes or failures will continue to be allowed. Additionally, personal testimonies with vaccines are allowed so long as the channel does not promote vaccine hesitancy, defined as a delay in acceptance or refusal of vaccination despite its availability.^6,7

In 2019, the WHO listed vaccine hesitancy as one of the top 10 threats to global health as it “threatens to reverse progress made in tackling vaccine-preventable diseases.”⁶ Social media, while providing an unprecedented capacity for the public to communicate, has also been a major factor in the rise of unconventional opinions damaging to public health. Vaccine hesitancy is not a new phenomenon, however the proliferation of anti-vaccination misinformation through social media has given it new urgency, especially in light of the COVID-19 pandemic and hopes for widespread vaccination. 

Majority of the misinformation that has circulated about COVID-19 vaccines has focused on vaccine development, safety, and effectiveness, as well as COVID-19 denialism. Monitoring online data related to vaccines can track vaccine misinformation in real-time and assist in negating its impact. According to the Centers for Disease Control and Prevention (CDC), monitoring through social media listening is a key strategy to quickly identify and address misinformation about COVID-19 vaccines.⁸ Effective utilization of these strategies will serve clinicians well in providing individuals with the information they need to make well-informed health decisions, therefore negating the harmful effects of circulated misinformation.

A recent randomized controlled trial was conducted in February 2021 that measured the impact of COVID-19 vaccine misinformation on vaccination intent in the UK and USA. Overall, the authors found that regardless of previous intent to vaccinate, an individual’s intent decreased with an increased amount of misinformation.⁴ This study does not mimic real-life social media exposure, which is driven by complex algorithms that recommend more content that is similar to the content an individual is already interacting with as well as new content that potential followers, friends or family may send to each individual. The realm of social media and the algorithms that drive “viral” and recommended content, are very complex and cannot be replicated by a single study. However, this study does show how misinformation can lead to individuals making different decisions than originally intended.

Pharmacists can proactively engage with patients and the public regarding the accuracy of health information. It is important to listen with empathy and when possible, to correct misinformation in personalized ways. In addressing patients’ concerns, every effort should be made to minimize the usage of technical language.² Individuals who do not speak the technical language may struggle to make sense of the material which can lead to misunderstanding or alienation. When possible, healthcare professionals should aim to find opportunities to promote health literacy on a regular basis.³ This involves communicating effectively and paying close attention to what the patient is saying, and screen for language barriers. By increasing their health literacy, clinicians are providing patients a greater opportunity to recognize when the information being presented to them is inaccurate, consequentially allowing them to make better informed health decisions.⁸ Aside from increasing health literacy, pharmacists can impact the underserved population by being more involved in the community: for example, by holding educational vaccine campaigns in church or local gatherings.³

YouTube’s policy decision to ban misinformation from the platform is a step forward in the right direction towards providing patients with the information needed to make well-informed health decisions. As algorithms on social media tailor content for viewers based on their previous engagement with content, misinformation becomes a vicious cycle for those that are already doubting vaccinations and other health-related information put out by practitioners and the government. Other social media platforms should follow suit in protecting public health as well as curbing misinformation. Lastly, healthcare professionals should correct false or misleading health information, share truthful health information, and direct people to reliable sources of health information within their communities and spheres of influence. After all, health and well-being are values that should be shared by everyone.

References: 

1. Alba, Davey. YouTube Bans All Anti-Vaccine Misinformation. The New York Times. https://www.nytimes.com/2021/09/29/technology/youtube-anti-vaxx-ban.html. Published September 29, 2021. Accessed October 26, 2021.
2. Confronting Health Misinformation: The U.S. Surgeon General’s Advisory on Building a Healthy Information Environment. https://www.hhs.gov/sites/default/files/surgeon-general-misinformation-advisory.pdf. Accessed October 26, 2021
3. Grindrod K, Waite N, Constantinescu C, Watson KE, Tsuyuki RT. COVID-19 vaccine hesitancy: Pharmacists must be proactive and move the middle. Can Pharm J (Ott). 2021;154(3):133-135. doi:10.1177/17151635211005763. Published April 19, 2021
4. Loomba, S., de Figueiredo, A., Piatek, S.J. et al. Measuring the impact of COVID-19 vaccine misinformation on vaccination intent in the UK and USA. Nat Hum Behav. 2021; 5: 337–348. https://doi.org/10.1038/s41562-021-01056-1. Accessed October 26, 2021
5. Pruitt-Young, Sharon. YouTube Is Banning All Content That Spreads Vaccine Misinformation. NPR.  https://www.npr.org/2021/09/29/1041493544/youtube-vaccine-misinformation-ban. Published September 29, 2021. Accessed October 26, 2021
6. Ten Threats to Global Health in 2019. World Health Organization. https://www.who.int/news-room/spotlight/ten-threats-to-global-health-in-2019. Accessed October 26, 2021
7. Managing harmful vaccine content on YouTube. YouTube Official Blog. https://blog.youtube/news-and-events/managing-harmful-vaccine-content-youtube/.  Published 2021. Accessed October 26, 2021.
8. How to Address COVID-19 Vaccine Misinformation. Centers for Disease Control and Prevention. https://www.cdc.gov/vaccines/covid-19/health-departments/addressing-vaccine-misinformation.html. Published 2021. Accessed October 26, 2021

Published by Rho Chi Post