How the US Government Used Social Media to Promote Anti-Vaccination in the Philippines

It’s clear to me that the US government has been studying anti-vaccination, and not just for public health reasons.

Last month, Reuters reported that during the COVID-19 pandemic, from 2020 to 2021, the US military used fake anti-vaccination Twitter/X profiles to discourage COVID-19 vaccine uptake in developing nations, including the Philippines. 

The Pentagon employed the most classic anti-vaccination talking points that I also found in my anthropological work among anti-vaxx and vaccine refusing parents in rural Arkansas right before the COVID-19 pandemic. 

In the summer of 2019 (halcyon pre-pandemic times!), I spent about ten weeks living in a small rural community in the Arkansas Ozarks, conducting interview and visiting homes and community gathering places, in order to learn more about the manifestation of anti-vaccination in a rural setting. As a former unvaccinated child myself, I was curious about how rural vaccine hesitancy and anti-vaccination differed from the more “typical” manifestation – wealthy white women in coastal urban enclaves. 

I am sure that the anti-vaccination landscape has changed quite a bit since the COVID-19 pandemic. As COVID vaccination refusal has become more socially acceptable and even socially mandated in some circles, it (anecdotally) seems like there is a trend of people refusing the COVID vaccines and then developing refusal towards other vaccines. 

There are several themes in the posts from government operatives that I also found during my study: 

Ingredients & Religious Doubts

Some of the posts focused on the alleged inclusion of pork gelatin in the Chinese Sinovac vaccine. By planting this idea in areas of the world with large Muslim populations, there was concern about Sinovac being haram, or forbidden under Islamic law. This reminded me of a statement one of my more religious participants made: “you can’t be Christian and vaccinate [your kids] because there’s aborted fetal tissues in your vaccines.”

Ingredients in general are a big topic of discussion among vaccine hesitant and anti-vaccination parents. As one of my participants cautioned her friend, “just read the ingredients on some [vaccines], and if you’re still comfortable with it, then do what you feel is best.” One of the parents in my sample, a former nurse, said that they would likely be more willing to vaccinate “if there were clean vaccines”.

Many of these parents in Arkansas were already putting a lot of physical and emotional labor into helping their child avoid exposure to undesirable chemicals. They grow organic vegetables and/or homestead, avoid chemicals in cleaning or personal care products, they avoid most pharmaceuticals and instead use minimally processed plant or animal products. 

Ultimately, the line between what is considered “clean” and “chemical” is quite blurry, and the parents in my study often deferred to what they described as their "intuition” or “common sense” when it comes to making these distinctions between “clean” and “chemical”. Across the sample, the ingredients in vaccines were rated as “unclean” or some variation of undesirable by all participants. 

 

The Origin

The main objective of the posts were to sway public opinion against China. One tweet read “It’s normal for Filipinos not to trust China, given the number of problems they gave us??” 

In Arkansas, suspicion towards vaccine makers and their intention for creating and marketing the vaccines were common. 

My participants understood the pharmaceutical industry as an indisputably negative force in the world and had trouble seeing how any product they created could be a net positive. My most vehemently anti-vaxx participant told me about their distrust of Google as a search engine since Glaxo-Smith-Kline, a pharmaceutical company, bought Google share and that since the purchase, the Google search results for things like “breastfeeding” show results promoting the use formula over breastfeeding. 

Many parents also didn’t like the messaging that said that their child might die if they don’t get vaccinated – “I think it’s really just pharmaceutical companies making profits…I mean I could be wrong, they could be legitimately scared for our kids, but at the same time…” 

Side Effects

Another post included in the Reuter’s investigation contained claims about the side effects of the vaccine and alleged that some vaccine recipients had to go to the hospital. 

Side effects are a fairly common topic among the general public. In my career in public health and my personal life, I’ve encountered a lot of confusion about what “vaccine side effects” are and what they mean. 

For pediatric vaccines, these conversations revolve around and extend beyond the disproven connection between the measles-mumps-rubella (MMR) vaccine and autism. In the anti-vaxx community in Arkansas, my participants labeled everything from febrile seizures to chronic ear infections as a side effect of pediatric vaccinations. This forms a vital part of the “vaccine stories” swapped by (mostly) mothers and thus cited as influences towards anti-vaccination. 

Something else important to note that vaccine hesitancy and anti-vaccination, like any good marketing scheme, thrives on word-of-mouth. As I mentioned previously, the “vaccine story” of a trusted other was often listed as a significant factor in the decision not to vaccinate, and in a small rural community, were frequently passed around. 

The vaccine stories I heard had several common characteristics: an adverse health event that occurred shortly after vaccination, where no other cause could be identified by either the parent or health workers; a child that began to show signs of a developmental delay months to years after vaccination, or a child that in some way deviated from what’s considered the normal course of development (like not meeting milestones, perceived changes in temperament, etc.). These diverse outcomes are attributed to vaccination, even when the child grows into a normal or neurotypical kid. 

Obviously concerned parents link these scary incidents to the most recent big health event in the child’s life. It doesn’t help that the public health office I worked in during this time echoed with the screams of children during their annual “back-to-school” vaccination events. Parents in my study often recalled great discomfort at watching their infants get injected with needles. 

This is not to say that parents are touting their child’s vaccine story as a way to proselytize. Merely being open about their children’s vaccination status is enough to convert other people in their social circles, something that other anthropologists of anti-vaccination have found as well. Most of my participants told me that it was revolutionary for them to see that they could go against medical advice or social norms, elect to not vaccinate, and that their children would still be healthy – their social circle showed them “another way of doing things”.  

Why Does This Matter? 

The US government must stop using public health activities as covers for intelligence operations, especially public health activities that are as fraught as vaccination. 

In 2011, the US military used a fake hepatitis vaccination campaign to get DNA samples from children in Abottabad, Pakistan in the hopes of identifying Osama bin Laden’s children in the hunt for the man himself. This led to later attacks and killings of public health workers providing polio vaccinations, and a fatwa by the Taliban against vaccination programs. Today, Pakistan is one of two countries that have not eradicated polio (the other is Afghanistan). 

In 2014 the White House announced that the CIA will discontinue the use of vaccination campaigns as cover for espionage. 

With the kind of government skepticism present in some rural American communities, setting the precedent that vaccination campaigns are a forum for government surveillance endangers public health. 

When I finally managed my first focus group nearly a month into my stay in 2019, my participants told me that, prior to my arrival, folks in the community were getting calls from the CDC asking about their vaccination status, “and then – no offense – you pop up”. Regardless of the veracity of these calls, folks were spooked and nervous to talk to me until the word got around that I grew up unvaccinated.

Using public health campaigns for anything other than public health is irresponsible. Even in the vaccinating mainstream, public health has become politicized. We’ve lost the trust of the public and it makes it quite difficult to complete the activities that will improve the health and wellbeing of our citizenry. 

And finally, the way that social media has become a venue for geopolitical wars of influence (Russian election interference on Facebook, and Chinese espionage/propaganda on TikTok) makes me wonder if this is a sign for us to log off of social media entirely.