How, then, to push back against them? Does sympathy with parents who are spooked by vaccines help to bring them around, or is it better to be tough? Over the past few years, both of these tactics have been tried in Italy, a country where, starting in about 2012, vaccination rates plunged. In 2015, Italy had one of the lowest rates of vaccination against measles in Europe. At 85 percent, the rate was lower than India. In 2017, Italy suffered a predictably large outbreak of measles, with more than 5,000 cases and four deaths.
It’s not hard to work out how this happened. Italians have famously low levels of trust in their government, and a tradition of medical hoaxes. On top of that, the issue became politicized: Italy’s Five Star Movement — a “non-party” party, founded by a comedian and formed on the Internet — spent a long time nodding and winking to anti-vaxxers . Unsurprisingly, a movement founded on hatred of “the establishment” was also suspicious of the medical establishment . In both Italy and the United States, the arguments behind the campaign are the same: the fear (derived from a now-discredited scientific paper) that the most common childhood vaccines cause autism; the belief that vaccines are a rip-off perpetrated by Big Pharma; the conviction that the dangers of vaccines have been deliberately concealed.
Facing all of this, one Italian doctor snapped. “At a certain point,” Roberto Burioni told me, “I decided that the misinformation was too much and I had to do something.” Burioni, a distinguished virologist and university professor, declared an online war on the anti-vax movement: “If they can write on social media, then I can do it too.” He posted stories of people maimed and disfigured by the complications of infectious diseases. He deconstructed anti-vax arguments. He also argued individually with anti-vaxxers, ridiculing them as uninformed: “I tried to show how stupid they are. How fake and nonsensical are the things they are saying.”
Burioni gained a huge following, which he followed up with a prize-winning book, “Vaccines Are Not an Opinion.” He became part of a pro-vaccination, and pro-science, counter-movement that led the previous Italian government to require all children to be vaccinated before attending preschool, on pain of exclusion. Although the Five Star Movement is now in government — and a Five Star politician is the health minister — the backlash is so strong that although they have discussed removing this requirement, they haven’t done it yet.
But was Burioni’s method the only way? Roberta Villa, a science journalist and writer, is one of several people who have their doubts. She, too, has a social media following, especially on YouTube, where she presents videos on vaccines and other health issues, sometimes against the backdrop of her kitchen.
She doesn’t attack nervous parents: “I believe that you cannot get anyone’s attention insulting them.” Instead, noting that there is sometimes a grain of truth at the root of conspiracy theories — that, for example, some vaccines have historically had some side effects — she tries to address their fears as legitimate, and then bring them gently around.
She points out that the most recent statistics show that only 0.5 percent of Italian parents are hardened anti-vaxxers, but that another group, parents with vague vaccine anxieties, is much larger. This is the group that she thinks gentle persuasion will bring around, especially by acknowledging, from the start, that “you have absolutely the right to be afraid.”
But what if both are right? That is, what if Burioni’s more brutal, “here are the facts” method and Villa’s gentler tactics simply work on different kinds of people? There are Italians who will be moved by forceful communications from a genuine expert, there are Italians who will be moved by gentle persuasion from someone who seems simpatico, and there are Italians who will be moved by government policy. And that has further implications: It means that any counter-disinformation campaign might require more than one tactic, more than one message and more than one kind of messenger if it is to succeed.
In a world where conspiracy theories — medical, scientific and, of course, political — are proliferating, this is more than just a useful insight. It should be the beginning of a new way of thinking about long-term strategies to deal with disinformation more generally. Italian vaccination rates are up, epidemics are down, and it took different kinds of people using different kinds of language to make that happen.