What is healthcare professionals’ role in public discussion surrounding vaccination in a post-truth world?

The news of the vaccine was, at least initially, heralded as the proverbial light at the end of the tunnel of disaster that has been 2020. As time has gone on “anti-vax” campaigners and conspiracy theorists have emerged from the dark enclaves of the internet to persuade the public of the perils of vaccination. My twitter feed has been filled with the background noise of spats and quarrels about the relative validity of each side’s arguments. Among this there are doctors who are genuinely concerned about the public health effect these “post-truth” opinions will have, and those outwith the medical community who have genuine concerns or questions regarding the vaccine. The fundamental issue is not that these conspiratorial views exist, they always have, but that the public gain so many of their views from social media, platforms that monopolise on and make money from perpetuating reductionist views. Maybe it is time, in this “post-truth” world, that the public health message we should be promoting as doctors is to moderate our use of social media and encourage people to seek truths from regulated and reliable sources in as much as these can exist.

There is no doubt that the business model of social media giants is somewhat sinister. The phrase “If you are not paying for the product, you are the product,” coined in the 1970s, has never been so relevant. Private human experience is no longer sacred, our views and our opinions expressed through these platforms are harvested in the form of data that is then used to predict our behaviour. The volume of data gathered from each individual is huge and these companies begin to know us better than we know ourselves. In itself, this may not immediately pose a problem, but when these data are used to enact complex, yet subtle, behavioural modification for the purposes of marketing and advertising, it poses somewhat more of an issue. Add in another level where data are sold to companies who do not have the purpose of selling us products, but instead use these advanced algorithms to shape our psychology shifting the manipulation from buying to voting, spending money to whether or not to get vaccinated. The business of data mining becomes more problematic, potentially putting even our democracy at risk. 

Shoshana Zuboff writes about the concept of “surveillance capitalism” in her epoch defining 2018 best-seller, The Age of Surveillance Capitalism. Zuboff, a Harvard Professor of social psychology defines surveillance capitalism as the “commodification of reality and its transformation into behavioural data for analysis and sales.” [1] By using social media we are providing enough data for these companies to know us well enough to predict how we behave and therefore how to modify that behaviour to their own ends. The more we use social media, the more vulnerable we make ourselves to being manipulated through the use of complex behavioural psychology. 

If you are a member of the public who has concerns about a new vaccine, you may tweet about it or put up a post on Facebook. To get you to engage with their platforms, the algorithm then inundates you with exponentially increasing volumes of click-bait about the risks of the vaccine in order to acquire your attention. Unfortunately, the nature of click bait is not to provide you with a balanced, factual account from a certified source, but a sensationalist read that often presents a reductionist argument. Nuance of human behaviour is eroded and leaves a vacuum which soon becomes filled with groups, often with opposing views, pitted against each other.

Social media is not a hypnotising machine forcing people to believe conspiracy theories, it is just a complex algorithm that is adept in using individual data in order to identify those people who are more susceptible to them. Post truth is not new, but the acceleration of society to a “post-truth” world is probably down to the juggernaut force of social media and surveillance capitalism. These thoughts are not new, but the cocktail of increased screen time driven by reduced daylight hours, prolonged lockdown and well-placed interrogation of new scientific discovery have no doubt catalysed the spread of misinformation. The real public health crisis here is about our use, our belief, and our understanding of the purpose of social media which threatens to undermine our understanding of the nebulous concept of “truth.”

How do we stop this? Like a drug we could go cold turkey. Or we could wait for the social media giants to ethicise their behaviour, although arguably the drug dealers are unlikely to change said behaviour when it is turning a profit. Regulation is the endgame, but we are not there yet. The pace of change is slow. Social media giants support economies and economies, as we now know too well, support healthcare. 

However, we could individually change our relationship and, more importantly our children’s relationships with social media in order to place more of an onus on “truth.” By attempting to begin to understand the potential for manipulation and curtail our use of the platforms we might not gain absolute control over the insidious effects social media has on us, but it will go some way to begin to shape our thought process and allow for critical appraisal regarding facts we are presented with. 

Instead of arguing with people on twitter to try and change a belief system that they are unlikely to change we are better employed reiterating the importance of critical thinking to our friends, families, followers and patients, regulating our use of social media, and at the very least accepting that when we do use it, it is more likely that it is using us. 

Clara Munro, Editorial registrar and clinical fellow, The BMJ, and general surgical trainee, North East England.

Competing interests: None declared.


1          The Age of Surveillance Capitalism: The Fight for a Human Future at the New … – Shoshana Zuboff https://www.theguardian.com/books/2019/oct/04/shoshana-zuboff-surveillance-capitalism-assault-human-automomy-digital-privacy