Five Best Practices for Online Communication about Vaccines: Lessons from Israel

Vaccine Puzzle. Photo by Gerd Altman/Pixabay

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“Please don’t go near the new RNA vaccines […] They pose a mortal danger! They cause genetic modifications […] that cause not only sterility but a whole host of diseases”. These are a few of many rumors concerning the COVID-19 vaccines that have been circulating on Israeli social media recently. This represents a deluge of (mis)information that has been spreading for months in the Israeli and international digital public sphere, concerning everything from whether COVID-19 actually exists, to its origins, to how it can be prevented and how it can be cured.

In many online communities in Israel, 2020 was the year of conspiracy theories, miracle drugs and bogus warnings – such as the warning that hand sanitizers might spontaneously combust if left in a vehicle for too long on a hot day. As a response, groups of experts in Israel have been communicating with the public directly to debunk COVID-19-related and other misinformation, through networks that helped Israel be more prepared when the pandemic arrived. Researchers have sought to understand their networks, techniques and procedures to derive best practices which can be used to devise science communication strategies worldwide.

Like many other countries, Israel has been experiencing an “infodemic” – a term the World Health Organization uses to describe an “overabundance of information”, that includes both valid knowledge claims, as well as “deliberate attempts to disseminate wrong information to undermine the public health response and advance alternative agendas.” In Israel, the COVID-19 infodemic comes on the heels of a “silent” outbreak of polio in 2013-2014 (when a wild poliovirus was isolated from sewage samples, but no cases of paralysis were found) and an outbreak of measles in 2018-2019 (with thousands of confirmed cases). Each of these outbreaks triggered a flurry of responses, such as catch-up vaccination campaigns (for both outbreaks) and a local, small-scale ban on unvaccinated children from attending certain kindergartens (for the measles outbreak). Anti-vaccine activists were quick to denounce these steps and publicly criticized them as unnecessary, reckless and harmful, foretelling the dynamic that would unfold in 2020.

Media outlets and non-profits take on misinformation in different ways

Since COVID-19 became a national concern, several individuals and organizations have been involved in disseminating reliable information about it in the Israeli public sphere. Much of the time, this required addressing false and misleading claims that had already become widespread. Some notable media outlets operating in this space include MeHaTzad HaSheni (“On the Other Hand”), a fact-checking TV program produced by Kan, the Israeli public broadcasting corporation; HaMashrokit (“The Whistle”), a fact-checking newspaper section of the Globes Newspaper; and Lo Relevanti (“Irrelevant”), an independent fact-checking website. These were joined by several non-profit organizations, including the Davidson Institute of Science Education (the educational arm of the Weizmann Institute of Science); the volunteer-based organization Maddá Gadol BaKtaná (“Little Big Science”), dedicated to science communication; and, last but not least, Mida’at, another volunteer-based organization, which specializes in public health promotion.

Prior to the COVID-19 outbreak, these actors took different approaches to science communication. Most science communication outlets, such as news organizations, built audiences on platforms such as Facebook pages, and focused on disseminating research findings using what was a mostly one-way communication model. Meanwhile, certain non-profit organizations, like the Davidson Institute and Mida’at, established specialized networks of science communicators and operated dedicated online communities that allowed for dialogical models of communication. One example is Mida’at’s Facebook group “Talking about Vaccines,” which now has over 53,000 members and over 100 experts. In this group, experts have been providing answers to questions about vaccines on a volunteer basis since October 2013. The experts include physicians, nurses, scientists, medical students and scientists-in-training. These pre-existing networks helped Israeli society be more prepared when the pandemic arrived at Israel’s shores by providing a salient and independent voice for public health. This partly compensated for the weaknesses of politicians and health officials, whose responses were often slow, politicized or otherwise out of touch with the public, leaving the medical establishment struggling to establish trustworthiness among many audiences in Israel.

Dealing with the COVID-19 Infodemic: Lessons from the Israeli experience

How can science communicators worldwide deal with the infodemic? And in terms of science communicators, this implies all of us. Liz Neeley’s Atlantic piece from March 2020, How to Talk About the Coronavirus, argues that “[w]e are all science communicators now: COVID-19 has conscripted us”. To this point, perhaps the Israeli experience can be instructive in deriving best practices on how to effectively counter online misinformation and conspiracies.

An Israeli study set out to understand how experts in science and health communicate with the public in online communities, especially in the face of pervasive misinformation. The research focused on Talking about Vaccines as well as a similar group dedicated to nutrition, operated by a group of registered dieticians (hereafter, the nutrition group). Since the research was conducted before the COVID-19 pandemic, the main issues discussed in Talking about Vaccines were routine childhood vaccinations and the measles outbreak.

To gain insights into the experts’ experiences and subjective understandings of this issue, the study focused on interviews with volunteer experts experienced in online outreach: ten with a sample of Talking about Vaccines’ experts and ten with experts from the nutrition group. The interviews focused on the experts’ motivations for participating in the group, their perceptions of the askers, and the considerations that they had in mind when composing their answers. (Many interviewees commented about other aspects of the threads as well, such as pointing out good and bad answers provided by other participants.)

Five “best practices” for communicating the science behind vaccinations 

The study derives a set of five “best practices” for online vaccination advocacy, based on themes that recurred when experts described their approaches. These themes are made up of three goals and two constraints: The three goals include encouraging the consumption of reliable scientific knowledge, establishing competence and establishing benevolence. The two constraints are maintaining integrity and clarity.

Goals

Encourage consumption of reliable scientific knowledge: Throughout the pandemic, the scientific and medical establishment has been engaged in a “credibility contest” with its detractors, with accusations of corruption recurring in anti-vaccine and pandemic-denialist rhetoric. Hence, science communicators should not only convey reliable knowledge about COVID-19 and the vaccines but build trust in the scientific institutions and processes which produce that knowledge. Science communicators should be prepared to discuss knowledge claims both in procedural terms (e.g., were the Pfizer-BioNTech COVID-19 vaccine safety trials designed and performed properly?) and in social-institutional terms (e.g., were the methods and results open to the scientific community, to regulators, or to the public? How independent was the oversight over the results of the safety trials?).

Simultaneously, equipping individuals with some basic media literacy skills is likely to improve their consumption of health information. The website Sifting Through the Pandemic by digital information literacy expert Mike Caulfield serves as an excellent resource for learning these skills in the context of COVID-19. The main idea guiding this project is that we should avoid engaging deeply with sources of misinformation, because that would detract from our precious attention spans that should be allocated to better treatments of an issue. Avoiding deep engagement would also have further effects in the future, such as enhancing our ability to retrieve reliable information about that issue from memory. Hence, when coming across suspicious content, we should all quickly assess the source before deeply engaging with it in the first place. By pointing to resources like these, science communicators can encourage consumption of reliable scientific knowledge.

“Stay in your lane” and rely on experts with established competence: Beyond making the case for mainstream science, experts sought to persuade askers that they, personally, were reliable sources of information by emphasizing their credentials and by providing direct evidence for their claims in relevant documents, such as the official vaccination guidelines of the Israel Ministry of Health. The experts also reported restricting themselves to answering questions within their fields of expertise. For example, researchers repeatedly mentioned that they were careful not to encroach into the territory of clinicians, such as physicians and nurses, and vice versa.

How can science communicators and laypeople apply these practices? It is unavoidable that an average citizen’s knowledge of the issue is necessarily limited. Most people cannot stay abreast of all the new research papers and do not have the time to evaluate and integrate them all either. In this sense, ‘staying in your lane’ and ‘acting with intellectual humility’ is probably best explained by science communication expert Liz Neeley in her March 2020 Atlantic article, How to Talk About the Coronavirus:

“Seek out and respect the expertise of those with domain-specific knowledge. Revise your positions as new information accumulates. Accept and acknowledge the limits of your knowledge, even as you work to expand it.”

Establish benevolence: Benevolent experts are those that “[offer] advice or positive applications for the trustor or (more generally) for the good of society” (Hendriks et al., 2016, p. 153), rather than out of some ulterior motive. Experts reported that they made efforts to quell askers’ fears and empathize with them, to avoid aggression and moralizing, and to distance themselves from the medical establishment. That means letting go of judgment, listening to your interlocutors and building on shared identities and values, like the importance of protecting families and keeping businesses open. Science communicators worldwide would do well to adopt Talking about Vaccines‘ experts’ practice of talking about themselves using professional and personal identities, such as “a scientist and a mother” or a “medical student and a father.”

Constraints

Maintaining integrity: Integrity, in this context, is defined as adherence to a reliable belief-forming process and to the rules of one’s profession. According to the theory of epistemic trust, experts must be perceived as people of integrity to be considered trustworthy. Integrity is similar to benevolence but characterized by a commitment to ethical and epistemic standards, rather than to the perceived interests of the trustor or of society. The expert interviewees sought to maintain integrity in several ways, but perhaps one of the most important ways was by acknowledging the risks of vaccination preemptively, alongside the benefits. This reflects an adherence to the ethical principle of informed consent, which obliges health professionals to provide patients with the burdens, risks, and expected benefits of all options, including forgoing treatment. Science communicators worldwide should be sure to acknowledge risks as well as the benefits of any healthcare intervention. For example, as one of the interviewees from the Israeli study stated:

“I try to give broad, balanced answers, not “yes, get vaccinated, absolutely.” I mean, [you should] explain the data, the considerations, be open to the idea that bad things happen too, there are side effects. Not to hide it and sweep it under the rug, I don’t know, I think that among certain people this creates trust.”

Maintaining clarity: In an academic setting, experts can often afford to  use jargon and assume a great deal of prior knowledge from their readers, but science communicators addressing the public must be succinct and use everyday language as much as possible – especially when writing a Facebook comment. A few interviewees made brief remarks about the importance of keeping the explanations clear and to-the-point, to avoid information overload and to make sure the message gets across. On the other hand, while avoiding scientific jargon is generally considered a good practice, science communicators should also avoid using overly simplified language because it might be perceived as condescending.

Putting it all together

Stay in your lane. Point people to reliable scientific knowledge. Affirm shared values and identities with your audience. On the one hand, these are general principles that are true in any context, be it climate change, animal experimentation or GMOs. On the other hand, COVID-19 makes for a unique context for science communication, because it is so pervasive, and has affected every aspect of our lives, raising the stakes higher than ever. A politicized and lackluster governmental response to the pandemic has arguably bred suspicion toward COVID-19 mitigation and containment policies among the Israeli public, although the rapid vaccine rollout and the high uptake seems to have recently taken the edge off the criticism. Thankfully, non-governmental organizations have filled a large part of the void over the past year, thanks to the pre-existing networks of science communicators and online communities and the accumulation of communication know-how from years of outreach conducted before the pandemic.

When looking to improve science communication in the future, perhaps non-profit organizations in other countries could take a page out of the book of Israel’s network of science communication organizations and their online outreach practices. These five practices are sure to be practical for science communication organizations around the world.

 

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The Israel Public Policy Institute (IPPI) serves as a platform for exchange of ideas, knowledge and research among policy experts, researchers, and scholars. The opinions expressed in the publications on the IPPI website are solely that of the authors and do not necessarily reflect the views of IPPI.

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