Facts alone, it seems, are not enough to dissuade the growing number of those with anti-vaccination sentiments. Bred in the petri dish of platforms such as Facebook, anti-vaxxers have their ideas reinforced by echo-chambers of social media, and evidence that emerges backing the science can even have the effect of reinforcing their ideas.

A new study out of Pittsburgh University in Pennsylvania has shed some light on who these people are, and how they stack up their arguments. The research divided them into four distinct sub-groups – trust, alternatives, safety, and conspiracy.

Those with ‘trust’ issues were suspicious of the scientific community and its institutions; ‘alternatives’ were those who preferred homeopathic remedies and, for example, thought that eating yoghurt cures HPV; ‘safety’ worriers focused on the risks of vaccination and morality of it; and ‘conspiracy’ theorists tended to believe the government was hiding information – such as that the polio vaccine doesn’t actually exist, the pesticides cause the clinical symptoms of diseases, or that man didn’t really land on the moon.

The research, titled “It’s not all about autism: The emerging landscape of anti-vaccination sentiment on Facebook”, analysed a sample of 197 individuals who reacted to a video on Facebook promoting the HPV (human papillomavirus) vaccine. It looked at their social media activity, discovering they also tended to post about other health issues such as fluoridation. The vast majority – 89 percent – were women, and in spite of the video coming from a local Pittsburgh GP practice, the posters came from nine different countries.

The work has provided insights into the type of tactics that are unlikely to work with each group of people. For example, those with trust issues are not going to be convinced by bombarding them with messages from the Centers for Disease Control.

The lead author of the research, Beth Hoffman, hopes the work will provide tools to combat the spread of fake news over vaccines. Something that might work is to get GPs from around the globe more engaged on social media, to create a pro-vaccine network, with tailored messages for people who are vaccine-hesitant.

“They could create messages that have a connection with them; saying ‘I, too, am concerned that my children and your children have too many chemicals in them; that’s why I make recommendations to limit soda consumption … vaccines are a way to boost the body’s natural immunity’. Right there we are taking back the conversation and reframing these words that resonate with people such as ‘natural’, or ‘safety’ to hopefully better meet parents where they’re at with their specific concerns.”

Using fiction to combat fictitious messages is another idea. Hoffman cites the plot line of a recent Madam Secretary episode in the US where there is a global measles outbreak. Health authorities have since commented that the show portrayed the issue well.

“It is a blurring of the line between fiction and reality but at the same time if 14 million people are watching that episode on TV, that’s a lot of people,” she says. The issue was also handled recently in an episode of Call the Midwife.

Hoffman says anti-vaxxers are skilled communicators over social media – and health officials are asking how they can also become skilled at delivering their points.

“Identifying these groups may be a way to provide more effective messages that don’t backfire,” she says.

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