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Covid vaccines for children are coming. So is misinformation.

Medical professionals and misinformation experts are warning that the push to vaccinate kids has already been seized on by groups looking to spread anti-vaccination messages.
Illustration of a child looking at Covid-19 vaccines and Covid-19 virus spores.
Vaccine advocates are pointing to videos already spreading quickly on social media as a harbinger for the kind of graphic misinformation that they fear most. Chelsea Stahl / NBC News; Getty Images

Dr. Natasha Burgert is well aware of the concerns parents have about the Covid-19 vaccines.

The Kansas pediatrician, who is a spokesperson for the American Academy of Pediatrics, said she’s already been counseling some parents about their fears. And she worries that they are entering a particularly sensitive time — one that anti-vaccination activists could exploit.

“If the anti-vaccine industry starts doing what we anticipate, with those very graphic and emotionally charged videos, and bringing out their supposed experts, I think it’s going to affect a new group of parents,” she said. 

Burgert and many other doctors, public health experts and misinformation researchers are anticipating a flood of anti-vaccine propaganda featuring younger children following last week’s vote by a Food and Drug Administration advisory committee to authorize Pfizer-BioNTech’s lower-dose Covid vaccine for children ages 5 to 11. The Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices unanimously recommended the Covid vaccines for 5 to 11-year-olds on Tuesday. CDC director Rochelle Walensky signed off on the approval later in the evening, opening the door for more than 28 million children to start receiving vaccinations on Wednesday morning.

Some fringe groups have already begun pushing the kinds of videos that the modern anti-vaccine movement was built upon: intimate, unverified videos and testimonies of children with alleged vaccine injuries that are visceral and effective, even while they give a false picture of the overall safety and importance of vaccines. These firsthand accounts present a challenge for platforms including TikTok, YouTube and Facebook and an opportunity for anti-vaccine activists to reach a new audience. 

Vaccine advocates are pointing to a recent example spreading quickly on social media as a harbinger for the kind of graphic misinformation that they fear most. 

The video, first posted to a fringe anti-vaccine website and then spread through mainstream sites including YouTube and Facebook, is only 30 seconds long, but devastating. In a carousel of vignettes, a young girl with a beaming smile digs in the dirt, dances on her front lawn and celebrates over cake with her family. It then cuts to a closeup shot of the girl’s face as she cries out in pain, her head wrapped in bandages and a tube through her nose. Later, three adults hoist her limp body into a wheelchair, then it quickly cuts to her hospital gown, an intravenous line in her hand and ends, lingering on a video of her legs as she shakes uncontrollably. 

The cause of the girl’s condition is unclear. Her mother said on a panel held Tuesday in Washington, D.C., hosted by Sen. Ron Johnson, R-Wisc., that she was injured by a Covid vaccine administered as part of a Pfizer trial at Cincinnati Children’s Hospital. (Johnson has been widely criticized for spreading  misleading claims about the vaccines.) The family’s lawyer, Aaron Siri — who also represents the country’s largest anti-vaccine organization, the Informed Consent Action Network — claims the doctors investigating the case misdiagnosed her myriad injuries as unrelated to the vaccine then downplayed them as abdominal pain. In the meantime, anti-vaccine activists have made the girl a poster child for their cause.

The mother of the girl and the group behind the ad have not provided any evidence that the girl was diagnosed as harmed by a Covid-19 vaccine.

The ad was paid for by the Vaccine Safety Research Foundation, an anti-vaccine group founded last month by veteran Silicon Valley entrepreneur Steve Kirsch, known for inventing the optical mouse, and more recently for advocating unproven Covid cures and against vaccines, which he calls “toxic.”

Burgert warned these tactics could be effective.

“They’re going to get their claws into a new group of hesitant families that otherwise have  got all of their vaccines on time,”  she said. “I’m concerned that they’re going to be able to use their manipulation tactics and psychological tactics to harness a new group of formerly pro-vaccine families into vaccine hesitancy.”

In a statement, the girl’s mother, Stephanie de Garay, said her entire family was “pro-vaccine” and that ads like the one featuring her daughter were necessary to “develop treatments for these harms.”

“It is unfortunate that ‘pro-vaccine advocates’ feel the need to dismiss those injured by vaccines in order to promote vaccines,” she said in an email.

Covid vaccine hesitancy among parents is already high, according to recent polling from the Kaiser Family Foundation. Twenty-seven percent of parents plan to vaccinate their children ages 5 to 11 “right away,” 33 percent will “wait and see,” and 30 percent say they “definitely won’t” get their children vaccinated. Five percent said they would only vaccinate their child to comply with a school mandate.

Vaccine injury or death is extremely rare, according to health experts. Yet narratives of  blood clots, heart attacks or deaths are wildly popular in some parts of the internet, racking up millions of mentions, according to data provided by Zignal Labs, which analyzes social media, broadcast, traditional media and online conversations about Covid. The mentions of vaccine injury and death have increased by at least 27 percent in the last four months, according to the data. 

There’s a reason that emotional, shocking anti-vaccine narratives often drown out fact-based ones. 

“The anti-vaccine industry playbook is effective. It works,” Burgert said. “And the success of vaccines is so quiet, so subdued, so commonplace.”

Social media platforms say they’re ready for the onslaught. 

YouTube announced a total ban on vaccine misinformation in September, and terminated the accounts of several prominent anti-vaccine influencers. In a statement, Elena Hernandez, a YouTube spokesperson, said: “We will continue to be vigilant and consistently apply the policies and systems we have in place to address vaccine misinformation.” 

 She said content from three new video partnerships with the American Academy of Pediatrics, Children’s Hospital of Philadelphia, and the American College of Physicians was expected in “the next month or so.”

Following the FDA’s announcement Friday, Facebook announced it would expand efforts on its social network and Instagram to connect parents with reliable information on Covid vaccines and enforce its existing policy to remove false claims. 

TikTok did not respond to a request for comment. 

Anti-vaccine activists have openly communicated their strategy to weaponize fears about Covid as a way to undermine confidence in all childhood vaccines. Del Bigtree, who hosts an internet talk show and is the head of the most well-funded anti-vaccine organization in the nation, was warning about the dangers of Covid vaccines in April 2020, nearly a year before they would become available. Anti-vaccine organizer Joshua Coleman expressed similar ideas in March 2020.

Since its initial release in December, the vaccine rollout has expanded to new classes and age groups. With each expansion, the newly eligible became “easy targets” for anti-vaccine propaganda, according to research from the Virality Project, a research consortium led by ​the Stanford Internet Observatory, which tracks Covid misinformation. 

“Anti-vaccine groups often distort mainstream news coverage and official statistics about adverse events like unexplained deaths and side effects caused from receiving the vaccine, omitting important context and reframing isolated incidents as evidence of widespread harm,” the Virality Project reported in March. “Unverifiable personal stories of adverse reactions will proliferate; these stories have been leveraged for years in childhood vaccine misinformation, and have strong emotional appeal.”

These personal, unverifiable stories have already found wide appeal on social media. In January, as vaccines became available to a wider group of adults, videos began appearing on social media showing women convulsing. Fact-checkers were unable to confirm their accounts. 

More videos emerged, and the alleged harms caused by the vaccines ran the gamut. In videos that went viral, women claimed that the vaccines made them infertile, caused them to shake uncontrollably and turned their bodies into magnets.

The anti-vaccine movement has spent years honing its messaging on social media, and more recently developed strategies to avoid more aggressive platform moderation. People in anti-vaccine groups now often modify language, create code words and utilize features  such as hashtags, private groups and cross-platform posting to  circumvent moderation. 

On Facebook, anti-vaccine posters have utilized the #protectyourfamily hashtag to create and promote a running collection of testimonials. The hashtag has more than 200,000 posts.

While Facebook provides tools for organizing and connecting, Instagram, TikTok and YouTube seem to be the favored method of creating content, which is later cross-posted to Facebook and Twitter. Facebook is also home to many public and private groups organized around these unverified testimonials. One group, named RealNotRare, which has 2,000 members, utilized Facebook to plan what appears to be a small rally on the steps of the Supreme Court on Tuesday. 

And it’s not just social media. While the anti-vaccine community has long relied on unverifiable testimonies as propaganda, most notably in the documentary “Vaxxed,” the messages were usually confined to anti-vaccine media and social media. With Covid came an alignment of messaging from anti-vaccine activists who rebranded under the “health freedom” movement, which has been embraced by some conservative media

Pro-vaccine activists say they’ve seen this play out before. 

“This is going to look a lot like the mid-2000s autism vaccine wars,” said Karen Ernst, executive director of Voices for Vaccines, a national nonprofit group that advocates for vaccination.

“It was framed as a good versus evil battle,”  she said, recalling the outcry from parents like Jenny McCarthy, who, misled by now-discredited research by Andrew Wakefield, believed that the measles, mumps and rubella, or MMR, vaccines caused autism. “On one side were the mama bears, the warrior moms, who would fight for their children. They were fighting against ‘the evils of Big Pharma who were clearly trying to damage and destroy their children with autism.’ We’re seeing the same moral battle play out that there are forces trying to harm children with a Covid shot now.” 

“There are zero social media platforms,” she added, “that are prepared for what’s about to happen.”