Facebook Pages, the "Disneyland" Measles Outbreak, and Promotion of Vaccine Refusal as a Civil Right, 2009-2019.

Objectives. To understand changes in how Facebook pages frame vaccine opposition.Methods. We categorized 204 Facebook pages expressing vaccine opposition, extracting public posts through November 20, 2019. We analyzed posts from October 2009 through October 2019 to examine if pages' content was coalescing.Results. Activity in pages promoting vaccine choice as a civil liberty increased in January 2015, April 2016, and January 2019 (t[76] = 11.33 [P < .001]; t[46] = 7.88 [P < .001]; and t[41] = 17.27 [P < .001], respectively). The 2019 increase was strongest in pages mentioning US states (t[41] = 19.06; P < .001). Discussion about vaccine safety decreased (rs[119] = -0.61; P < .001) while discussion about civil liberties increased (rs[119] = 0.33; Py < .001]). Page categories increasingly resembled one another (civil liberties: rs[119] = -0.50 [P < .001]; alternative medicine: rs[84] = -0.77 [P < .001]; conspiracy theories: rs[119] = -0.46 [P < .001]; morality: rs[106] = -0.65 [P < .001]; safety and efficacy: rs[119] = -0.46 [P < .001]).Conclusions. The "Disneyland" measles outbreak drew vaccine opposition into the political mainstream, followed by promotional campaigns conducted in pages framing vaccine refusal as a civil right. Political mobilization in state-focused pages followed in 2019.Public Health Implications. Policymakers should expect increasing attempts to alter state legislation associated with vaccine exemptions, potentially accompanied by fiercer lobbying from specific celebrities.

Vaccine Policy in the United States.

In an era when the success of the US vaccination policies to date is threatened by vaccine hesitancy, it is important for clinicians to have a working understanding of how vaccines are developed and recommended for use in the United States and how federal and state governments are coordinated to ensure a safe and effective vaccine supply. This article discusses the federal agencies involved in vaccine development and recommendation, other organizations involved in vaccine policy, and the role of vaccine-related public health law in promoting universal vaccination.

[Vaccines: history and stories between reality and imagination]. / La Storia e le storie sui vaccini. Un piano tra veridicità e fantasia.

Vaccinations and the controversy around them always go in parallel. We identified four categories blending in various amounts of truth and imagination: history, myths, shams and frauds. Over the years, they have alternated and sometimes transformed into one another. This sharp separation into categories is certainly academic and forced. In fact, the line between these aspects is not clear enough to allow a rigid and well-defined division. Our work starts from the category containing the most truthfulness: history, and goes on to analyze two categories that add fantasy to facts: myths and shams (or better, "old wives' tales"). The history deals with the topics of variolation and the first anti-vaccine activists' disputes. Myths that arose around immunization include immune overload, homeoprophylaxis, and excessive hygiene. In this context, immunization itself risked becoming a myth, being considered not amenable to improvements. In the category of old wives' tales we find rumors about the presence in the vaccines of considerable quantities of supposedly toxic components such as aluminum, squalene, Thimerosal and nanoparticles, as well as the existence of secret techniques of vaccine preparation that involve unethical procedures. The last category, fraud, is the poorest in both truth and fantasy but it is still hard to confront. The most famous fraud is the supposed link between vaccines and autism. In this frame, disinformation is certainly a fertile substrate for the emergence both of elements close to reality and of very imaginative ones. Vaccine hesitancy is believed to be responsible for decreasing vaccine coverage and increasing the risk of vaccine-preventable disease outbreaks and epidemics. The role of communication in immunization is essential to its success, especially taking into account the deep transformations the world of information is going through. The great multitude of voices seem to carry the same weight, but it is not so in science. Web searches are influenced by the filter bubble phenomenon, which contributes to the radicalization of people's opinion through cognitive isolation. A new, more effective strategy of communication is required in order to regain the trust of populations in immunization in a context characterized by the presence of groups impervious to scientific evidence.