Last year, Saphinah Kenyando was struggling to decide whether to get vaccinated against Covid. Kenyando, who is 38 and teaches chemistry and biology at a high school in Kenya, had read about horrifying side effects—blood clots, long-term disabilities—that sounded worse than the virus itself. She watched a (possibly doctored) clip from former US President Donald Trump saying that the effects included gruesome facial deformities that develop as a person ages. And she wondered whether the rumors circulating on Facebook, WhatsApp, and YouTube were true—that a person could take the jab and drop dead shortly thereafter.
In addition to her academic role, Kenyando also serves as the school chess coach, a duty she takes very seriously. She believes the game imparts valuable lessons to students: Make the right move, and you’ll reap the benefits. Make the wrong one, and you’ll be forced to deal with the fallout. “Chess is life,” she says. “Every decision we make in life is about the game of chess.” That’s how Kenyando framed her own decision on whether to get herself and her children vaccinated against Covid. She decided to hold off until she had more information.
The misleading posts Kenyando had seen were just a small portion of the avalanche of disinformation that flowed through social media in Kenya as the pandemic intensified and the virus infiltrated the households of everyday Kenyans. Wanja Kimani, a house cleaner in Nairobi, read that the vaccine could cause mental illness. Lucy Wambui, a human rights activist in Nairobi, heard that Covid doesn’t exist in the slum where she lives and concluded that the vaccine is a way to control populations in neighborhoods like hers. She warned her own elderly father that he shouldn’t get vaccinated.
In the United States, the proliferation of disinformation about Covid vaccines and treatments has been widely publicized, and most of these myths come from a few powerful influencers. Last year, the anti-extremism group Center for Countering Digital Hate found that 65 percent of vaccine disinformation on Facebook and Twitter came from just 12 people, including the activist Robert F. Kennedy Jr. and the natural lifestyle influencer Dr. Joseph Mercola. The target audience, the media reports, is in bastions of American conservatism—in rural communities, among evangelical Christians, and among Trump voters.
But there is increasing evidence that American vaccine disinformation campaigns don’t stop at the borders. Over the last year, global public health experts have documented rising rates of vaccine hesitancy in other parts of the world, from Africa to South Asia, from Eastern Europe to South America. While some disinformation is locally sourced, these experts have traced many of the myths to American anti-vaccine activists who create an onslaught of social media content at virtually no cost, says Imran Ahmed, CEO of the Center for Countering Digital Hate, based in Washington, DC, and the United Kingdom. They can afford to “flood the zone and see what sticks.” In the United States, it might be a patriotic meme about how vaccine mandates are a form of government overreach; in other parts of the world, a post that plays up historical distrust of Western interference into local communities might gain more traction. Each piece of disinformation has a way of finding “the right audience,” Ahmed says, “like a homing missile.”
Covid didn’t create vaccine skepticism. The health experts we spoke to described how anti-vaccine groups began sowing the seeds of distrust in the developing world long before the pandemic. But much as in the United States, what started as a fringe phenomenon in many countries has been gaining momentum. The biggest worry is that this rising tide of vaccine hesitancy could undo 100 years of progress in combating the spread of infectious disease, bringing back polio, measles, and many other easily preventable deadly illnesses. Angus Thomson, who studies vaccine disinformation as a senior social scientist with UNICEF, is alarmed by reports worldwide. “It’s painting a global picture, and it feels like we’re climate scientists in the early days,” he said. “You get the distinct feeling that there is a massive sea change occurring.”
In 2019, Steven Lloyd Wilson, an assistant professor of politics at Brandeis University who studies disinformation, was invited by a colleague to participate in a World Health Organization conference about vaccine hesitancy. At the time, he was only vaguely aware of the anti-vaccine movement, and what he knew of it was mostly based in the United States. “I’m a political scientist. I’m looking at political issues,” he said. “It just wasn’t on my radar—anti-vaccination is a public health thing. This isn’t political.”
Nevertheless, one of his colleagues persuaded him to launch a study about the influence of foreign disinformation on vaccine acceptance around the world. In February 2020, he teamed up with a doctor in South Africa to collect and analyze negative social media posts about vaccines and compare that data with vaccination rates and attitudes.
Wilson wasn’t anticipating much to come out of the analysis. “I expected there to be some little statistically significant effect,” he recalled. So he was floored when the study ultimately found that negative vaccine posts were highly correlated with both skepticism of vaccines and declining vaccination rates all over the world. “We were very happy that our research design really worked,” he said. “And simultaneously very disappointed in the state of the world, that this was something real and worldwide.”
In part, the breathtaking success of worldwide anti-vaccination campaigns is due to the fact that there is an entire, incredibly lucrative cottage industry devoted to pumping out vaccine disinformation. Many of the most successful anti-vaccine activists rake in advertising money from their popular YouTube channels; some further enrich themselves through sales of supplements, detox regimens, and other wellness products, the Center for Countering Digital Hate has found. Social media makes it cheap and easy to reach international customers—and international versions of popular social media platforms lack even the basic disinformation censors found in American versions. Children’s Health Defense, the prominent and influential anti-vaccine group led by Robert F. Kennedy Jr., recently launched a European version of its site. Joseph Mercola, the influential anti-vaccine osteopath, offers Spanish and French editions of his site; his videos have been translated into many languages, according to the New York Times. In a 2017 affidavit, Mercola reported his net worth to be in excess of $100 million.
American influencers’ messages often resonate with communities that seem to have little in common with the United States, says Joe Smyser, CEO of Public Good Projects, a nonprofit in Washington, DC, that collaborates with UNICEF on studying vaccine hesitancy. Recently, his team followed the path of an American op-ed criticizing pandemic restrictions from its origin in the United States all the way to East Timor, where it took off on local social media. And when Kentucky Republican Sen. Rand Paul said he opposed government vaccine mandates, “that got a lot of traction in social networks across Vietnam,” Smyser says. “It was used to push back against the Vietnamese government and Vietnamese public health officials.”
But there is another reason that anti-vaccine content finds its way around the world, with consequences even more dangerous and pervasive than those from anti-vaccine activists. In his study, Wilson’s team found that foreign governments—particularly Russia—were amplifying all kinds of messages both in support of and against vaccines. This is a well-established destabilization tactic that leverages social media to polarize an entire population around a particularly contentious issue—Russia used it to undermine the 2016 US presidential election, for example. The point isn’t to promote any single viewpoint; it’s to sow chaos. “A lot of the time, you’ll have bots pushing six completely contradictory, mutually exclusive stories,” Wilson says. “But what unifies all of them is trying to get people to throw up their hands and say, ‘I guess it’s impossible to know what the truth is.’”
Just as Wilson was wrapping up his study, the pandemic began—and suddenly, his research took on new meaning and urgency. Around the world, social media channels were flooded with wild claims about the new disease and the tools to fight it. He watched in horror as powerful people—even heads of state—amplified the “disinformation campaigns online that have managed to blow it vastly out of the original proportion of a few individuals who were hardcore believers.”
Which narrative takes off in any given country depends on the culture and history of the place. In May 2020, Kenyan evangelical pastor Fred Akama posted a rant on Facebook, which began “THE GATES OF BILL SHALL NOT PREVAIL.” Bill Gates “predicted that a viral pandemic would hit the world,” the post continued, with the clear implication that the philanthropist was somehow complicit in and profiting from the creation and spread of Covid. Akama also accused Gates of having unethically close ties with the World Health Organization and vaccine producers and called him an enemy of the Christian faith. He has more than 15,000 followers on Facebook.
Akama wasn’t the only social media influencer in Kenya warning about Bill Gates’ motives. “If you look at the kind of stuff that is circulating in East Africa…you find that the content seems to be very similar,” says Eric Mugendi, who works at Meedan, a San Francisco–based technology nonprofit supporting fact-checking and verification of organizations. “The kind of language that was being used and the types of people who were spreading it—a lot of times it was religious leaders,” Mugendi says, arguing that anti-vaxxers often link their arguments to Gates and liberal philanthropist George Soros. They accuse them of wanting to test vaccines’ efficacy on Africans, profit from vaccine sales, control the human population through microchipping, and prevent the growth of the African population.
Disinformation campaigns that play up nefarious motives of powerful people are common worldwide. In the United States, a widely shared video called Plandemic popularized the conspiracy theory about Gates early in the pandemic. This strain of disinformation is particularly effective in Africa because of deep-seated anxiety that Western governments want to slow population growth in the developing world, notes Wilson of Brandeis University. “The unifying factor is encouraging distrust of elites and experts and Westerners on any level,” he says.
Ultraconservative groups in Africa have a long history of spinning a variety of Gates conspiracy theories. The anti-abortion movement in Africa has employed this tactic for at least a decade. In a 2017 article in Pacific Standard, Kathryn Joyce reported on a prominent Nigerian anti-abortion activist Obianuju Ekeocha, who in 2012 spoke out against a Gates Foundation contraceptives campaign. American anti-choice groups helped Ekeocha create a new group, Culture of Life Africa. This complemented an ongoing campaign by Human Life International, a hardline US anti-abortion group operating around the world. Its mission? To spread the message that “Western governments and NGOs are using great sums of money and influence to destroy the traditionally life-loving African culture.”
There’s a convergence these days between seemingly unrelated public health issues, as many of the same US-sponsored organizations that oppose abortion have pivoted their messaging to address Covid vaccinations. One such group is CitizenGO, an ultraconservative petition mill with outposts worldwide. CitizenGO Africa, whose anti-abortion work Mother Jones covered here, is led by a Kenyan woman named Ann Kioko, who was trained in workshops by the American Leadership Institute, a conservative organization that counts former Vice President Mike Pence, Sen. Mitch McConnell (R-Ky.), and Karl Rove among its distinguished alumni.
In 2020, CitizenGo posted an online petition titled “Bill Gates and WHO: Hands Off Africa” intended to send a “firm message to the Bill Gates Foundation and the World Health Organization that Africa is not a test lab, Africans are people with human dignity and Africans will not be used to try vaccines whose purpose is not known.” The petition accuses Gates of having Covid vaccines “tested on Africa as he stages them [vaccines] as the only solution to the pandemic.” It also accuses Bill and Melinda Gates of attempting to control the African population via contraception and abortion. “Melinda Gates told the Washington Post she is frustrated with the Trump administration’s decision to cut funding for international ‘reproductive-rights projects,’ (READ ABORTION) calling it ‘incredibly disappointing,’” the petition read.
In some ways, the extreme paranoia about birth control efforts could be understandable, given the legacy of the staggering violence of colonialism in Africa—and that history of exploitation continually undermines public health campaigns. But it was a specific strain of disinformation about a tetanus vaccine that allowed rumors about secret forced sterilization to flourish. Alphonce Shiundu, the Kenya editor of Africa Check, a fact-checking nonprofit that promotes accuracy in public debates and the media, says his organization has traced the origins of this myth to an event in 1994. Researchers in India were “developing a contraceptive vaccine to help women prevent unplanned pregnancy.” Its active ingredient was part of a hormone called human chorionic gonadotropin, known as hCG, which is produced during pregnancy. To make the vaccine, researchers “coupled hCG to a protein similar to the tetanus toxin.” When a woman was jabbed, her immune system would fight both the protein and the hCG hormone, an Africa Check report recounted.
Although this contraceptive vaccine was completely unrelated to the tetanus vaccine, the American anti-abortion group Human Life International leveraged the research from India and used it to mount a disinformation campaign in Mexico, the Philippines, and Nicaragua, claiming that the tetanus vaccine alone would reduce a woman’s fertility without her knowledge.
The World Health Organization tried to quash the rumors and followed up with extensive independent testing and found that, “without exception, when interpreted by independent laboratory staff, including those in the Philippines that conducted the original tests which started the rumor, all samples of tetanus toxoid vaccine have proved negative for hCG.”
Even MaterCare International, a group of Catholic obstetricians and gynecologists, issued a statement saying, “If tetanus toxoid vaccines given to millions of women in many countries were capable of causing infertility there would by now be ample demographic data to confirm this. We know of no such data.”
But the damage was done.
Fast-forward two decades: In 2014, the Kenya Catholic Bishops Association fought vigorously against a tetanus vaccination campaign in the country. Perhaps the most prominent anti-vaxxer was Dr. Stephen Karanja, previously the chair of the Kenya Catholic Doctors Association. (In addition to his assault on the tetanus vaccine, Karanja opposed schoolgirls being vaccinated against cervical cancer, arguing that the human papillomavirus (HPV) vaccine was unnecessary because it affected those “whose lifestyle involves irresponsible sexual behaviors.”) And in 2019, a Facebook post by a Kenyan user that was made to look like a news article made the rounds in Kenya, announcing: “Abortion drugs discovered in Bill Gates’ vaccines. UNICEF, the World Health Organization, and the Bill and Melinda Gates Foundation have been accused of secretly sterilizing millions of women in Africa by doctors in Kenya after abortion drugs were discovered in tetanus [vaccines].”
Unsurprisingly, when Covid vaccines became available in Kenya in 2021, Karanja came out vehemently against them, recommending hydroxychloroquine tablets instead. He died of complications from Covid last year. Karanja’s death didn’t stop other Kenyan influencers from running with his infertility narrative. Public health experts are trying hard to counter it, but they have found time and again that the distrust of the West has staying power, says Shiundu. “The anti-vaccination movement just keeps harping on it and just keeps redirecting it every time.”
Now, in Kenya and other parts of the developing world, public health experts worry that anti-vaccine activists will leverage fear and uncertainty around Covid vaccines to undermine long-standing and highly effective vaccination programs in the developing world. There are signs of this happening already, even as global nonprofits are fighting the disinformation at its source. UNICEF and the Public Good Projects have teamed up to monitor and report new strains of vaccine disinformation as they emerge with a surveillance tool called the Vaccination Demand Observatory. On their public dashboard, which is updated weekly, anyone can see examples of social media posts making false claims about vaccines. In April, the VDO dashboard reported upticks in disinformation around the vaccines for cholera in Bangladesh, rotavirus in Egypt, and typhoid in Nepal. That trend is particularly worrying in the context of pandemic-related disruptions in routine vaccination programs. According to the World Health Organization, as of May 2022, vaccination campaigns in 43 countries are still postponed. In April, WHO warned of a “perfect storm” of conditions for a measles outbreak, noting that in many countries an uptick in cases had already begun.
In Kenya, vaccine denial and rejection also fosters a dangerous economy of charlatans “selling health misinformation,” says Mugendi of Meedan. The Kenyan health system is biased toward the rich. Those who can afford good treatment buy it. Those who can’t, take shortcuts. People try dangerous treatments to find a silver-bullet cure at low cost, which creates an underground market of false cures and false hope. It also “makes people question genuine actors in the space,” Mugendi says.
Disinformation thrives even in rural places with limited access to social media. Hayi Hassan, 62, and Hussein Ali, 75, are Somali animal herders living in Northeast Kenya who didn’t get the vaccine because they’d heard it could cause blood clots or death. “I was told that when you’re injected, exactly after four months you will die,” Ali says. Neither of them believes Covid is serious. “I haven’t seen any people dying in Garissa town, so I’m probably safe,” he says. What’s more, as elders, they figure they’ll likely die soon anyway. At their age, the idea of walking 37 miles in the blazing sun to get to the nearest hospital for a jab they think they don’t need sounds ludicrous.
Through word of mouth, says Public Good Project’s Smyser, anti-vaccine messages take on a life of their own. In one case study in Papua New Guinea, the team looked at the spread of vaccine disinformation in a remote village. “Nobody had a phone, except for one guy who used to climb up to the top of the hill, and climb a tree, and hold the phone up, and download a bunch of stuff,” Smyser recalled. “And then he’d bring it back down and the whole village would read it.”
The very ubiquity of these rumors makes combating them a challenge. Yet some fact-checking agencies report that they have made modest progress. On a recent day, the Vaccine Demand Observatory’s tool reviewing social media posts included one on false claims about Covid vaccines for children in Vietnam, another about rumors about vaccine dangers promoted by Bangladeshi politicians, and another on disinformation about the safety of Covid vaccines for older adults in East Timor. This kind of surveillance isn’t for the general public as much as for researchers, who can learn a lot from tracking the paths of disinformation in real time.
The global development nonprofit IREX has developed media literacy curricula that it tailors to individual countries. “It’s going to look different depending on the content and the context, geography, culture,” says Katya Vogt, the director of the project. “You can’t just create one multi-use tool.” In Ukraine, for instance, the group worked within the school system, weaving lessons on how to identify disinformation tactics into the literature, social studies, and history lessons. In Tunisia and Jordan, the program administrators determined that it would be more effective to train youth leaders to teach groups of their peers and create their own social media content about spotting disinformation.
In Kenya, nonprofits are working to improve media and digital literacy. Africa Check has hired a slew of Fact Ambassadors to promote accurate information through Kenya’s social media and other channels. Those ambassadors “will come back to us with anecdotes about how they sent something to one of their relatives in a WhatsApp group who kept on sending all these conspiracy theories and treatment regimens for Covid-19,” says Shiundu of Africa Check. “And these people, after they reluctantly read, they were exposed to accurate information, and they slowly updated their beliefs.”
Last year, Kenyando, the school teacher who wavered on the Covid vaccine, was virtually introduced to Peter Ongera, a Fact Ambassador, who helped correct some of the misinformation and disinformation she’d absorbed over the past two years. Kenyando had another compelling reason to get the jab: One of her students had qualified for the African Individual School chess championship, and Kenyando needed to be vaccinated to travel to Ghana, where the tournament would be held.
Kenyando got the shot. Then she took her children to get vaccinated. “I took them having done my own analysis,” she says. She listed her reasoning as wanting to “protect myself and family because of the nature of [my] work. As a teacher and sports lady I interact with so many people,” and because it “was a requirement from the employer to have all teachers vaccinated.”
But she worries that the same myths she saw are still circulating. “The falsehoods about the Covid vaccine, much of it was online,” she says. “There is power in information. Irrespective of how it comes, the first moment that somebody gets the information, they take it as the true Gospel.”