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This award-winning blog supplements the articles in Hospital Infection Control & Prevention.

Expert: Anti-Vaxxers Will Try to Undermine Pandemic Vaccine

By Gary Evans, Medical Writer

In a move that threatens uptake of an eventual SARs-CoV-2 vaccine, the nation’s anti-vaccine movement is framing an immunization refusal strategy based on civil rights arguments that likely will be underscored by conspiracy theories, says researcher David A. Broniatowski, PhD, a professor of engineering and applied science at George Washington University in Washington, DC.

Broniatowski previously published research on how Russian anti-vaccine bots and trolls were mobilized during the 2016 presidential election.1 That paper was followed earlier this year by a study on how vaccine communications have been weaponized through identity politics.2 His latest paper — an analysis of 204 Facebook pages of anti-vax groups — traces how a large measles outbreak in Disneyland in 2015 led to the emergence of a common anti-vaccine narrative, “emphasizing civil rights and freedom from elitist government vaccine opposition.”3

Hospital Infection Control & Prevention (HIC) asked Broniatowski to comment on the implications of these findings on an eventual COVID-19 vaccine in the following interview, which has been edited for length and clarity.

HIC: Do you think this established vaccine resistance will affect the uptake of an eventual COVID-19 vaccine?

Broniatowski: Yes. One of the things that is interesting about the COVID discourse online is that it really draws pretty heavily on what we’ve seen before in the anti-vaccine communities. A lot of the things we are seeing around COVID — not just about a vaccine but wearing masks — are basically a page out of the anti-vaxxer playbook . A lot of the strategies and approaches that these vaccine opponents have been using and really developing and testing for the last five years have parallels in COVID-19. We saw the movie "Vaxxed" released in 2016, and that really put civil liberties as an issue on the map. Before that it was localized in California and it was one of many issues. That [film] really made it an issue. People learned a lesson — these kinds of movies are effective. Then we saw "Plandemic" show up in the COVID discourse. This is another professionally produced movie. So, we are seeing similar sorts of strategies.

HIC: Will the widely perceived politicized response to the pandemic be an issue in refusing vaccine?

Broniatowski: I think we can expect to see that when a COVID-19 vaccine is available there is going be a sort of hardcore group of people that will oppose it. It could be a pretty precarious situation because any vaccine that gets released — if we are talking about releasing it on the timeline that the president has said — there is already going to be the perception that it was rushed. There is going to be all the political overtones of that. That is going make things a little more dicey and then on top on that we have all these existing narratives and rationales for why people shouldn’t take it. What our studies show is we have very motivated groups of people who are actively mobilizing in state-level politics. Not only are we going to see people refusing to take it as individuals, but I think we are probably going to start seeing groups of people mobilizing to pass legislation to make it harder for us to reach herd immunity using the vaccine.

HIC: Why do these groups seem so drawn to conspiracy theories?

Broniatowski: There are a few reasons. I don’t think that any of these are the complete reason, but they are contributing factors. First of all, a lot of conspiracy-oriented groups incorporate anti-vaccine tropes. For example, QAnon has been in the news a lot recently. They have incorporated anti-vaccine tropes into their mythology — also chemtrails, antifluoride, flat earth. Just about every conspiracy theory under the sun shows up in some form or another on QAnon. They don’t necessarily care if the conspiracy theories are right or wrong — in many cases they contradict each other. It allows the theory itself to spread and gives them something to hang their hat own.

Beyond that, conspiracy-oriented thinking has been present in anti-vaccine discourse basically since there has been anti-vaccine discourse. When you are talking about opposing vaccination you are fundamentally talking about — especially in the civil liberties world — issues of health freedom. In this particular case, it is about do you have a choice about whether or not you want to be vaccinated? If you believe the government or somebody who is vaccinating is out to get you, if you believe some conspiracy theory like people are going to profit off of your poor health — you are more likely to refuse to be vaccinated. If you just leave it at it’s your choice to vaccinate or not — [most people] think it’s a good idea. You have to tell them it’s their choice and give them a “why” it is a good choice not to vaccinate. It’s framed as freedom of choice, but the implicit assumption is vaccine is not the right choice. This is something public health officials could take advantage of. If we make the cases that vaccination is the right choice and appeal to people’s values — everybody wants to save lives. If we can make the case that vaccinations save lives in a convincing manner, and do that in a way that is culturally sensitive, that will work in our favor.

For more of this interview, see the November issue of Hospital Infection Control & Prevention.


  1. Broniatowski DA, Jamison AM, Qi S, et al. Weaponized health communication: Twitter bots and Russian trolls amplify the vaccine debate. Am J Public Health 2018;108:1378-1384.
  2. Broniatowski DA, Quinn SC, Dredze M, et al. Vaccine communication as weaponized identity politics. Am J Public Health 2020;110:617-618.
  3. Broniatowski DA, Jamison AM, Johnson NF, et al. Facebook pages, the “Disneyland” measles outbreak, and promotion of vaccine refusal as a civil right, 2009-2019. Am J Public Health 2020;110:S312-S318.