A vial of the COVID-19 candidate vaccine developed by Oxford University and AstraZeneca © University of Oxford/AFP via Getty Images

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The writer is a science commentator

Unspeakable dangers lurk everywhere. A new class of Covid-19 vaccines will turn humans into monkeys. The landscape is studded with 5G masts that transmit coronavirus.

Except that monkey-generating vaccines and virus-spreading telecommunications infrastructure do not exist (unless an infected person touches or coughs on a 5G mast, leaving traces of virus for others to pick up). The real threat comes from these conspiratorial fictions polluting the “infosphere”, the online information environment to which a person is exposed daily.

Researchers at the Oxford Internet Institute suggest that the infosphere should be considered a social determinant of health, alongside factors such as education, income and housing. Classifying it this way, write Jessica Morley and Luciano Floridi in Public Health Post, “recognises a direct correlation between exposure to poor information quality and poor health outcomes”.

Misleading information, Ms Morley explains, is packaged for online consumption in multiple guises: in search results; support groups promoting harmful behaviours such as anorexia; conspiracy theories such as anti-vax material that pop up on social media; unregulated health apps; and fad diets served up by celebrity “superspreaders” to Instagram followers.

Troubling ideas spread like dandelion clocks in the digital wind, exerting enough influence on individuals to sway health decisions. Sometimes, as demonstrated by the Vaccine Confidence Project at the London School of Hygiene and Tropical Medicine, misinformation and disinformation (MDI) can move the dial in the wrong direction.

Researchers asked 8,000 people in the UK and US if they would “definitely” have a Covid-19 vaccine. About 54 per cent in the UK, and 41 per cent in the US, said yes. Some of the same respondents were then shown an array of MDI, including tweets from celebrity accounts asserting that Covid-19 vaccines cause infertility. When surveyed after viewing it, willingness dropped by about 6 percentage points in the UK and 2 in the US.

Given that, according to some estimates, at least 55 per cent of people must be vaccinated to reach herd immunity, misinformation could tip the balance on how smoothly the world exits the coronavirus crisis. It is a global issue: France and Russia also score poorly on vaccine confidence.

People differ in their ability to judge the accuracy and trustworthiness of online information, a capacity known as e-health literacy (partly influenced by education level). Ms Morley, a former technology adviser to the UK’s health department, theorises that a phenomenon seen in online political messaging might apply here. “People with lower levels of e-health literacy might look for simpler indicators of what to trust, such as ‘likes’,” she says. “We know it happens in other domains: political information that gets more likes tends to be regarded as more trustworthy.”

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The Oxford researchers have had informal conversations with the World Health Organization. The agency has itself warned of a global “infodemic”, defined as an overabundance of both online and offline information which “includes deliberate attempts to disseminate wrong information to undermine the public health response and advance alternative agendas of groups and individuals”.

Formally recognising the infosphere could justify online intervention to protect public health. For example, the much-delayed online harms bill in the UK, which targets serious activity such as extremism and child sexual exploitation, could consider a wider range of health harms from MDI, Ms Morley thinks.

She acknowledges, though, that tackling outlandish ideas should not spill over into censoring legitimate scholarly disagreement. The Oxford researchers want to gauge public appetite for intervention online — and talk to policymakers about how to further public health goals without unreasonably curbing freedom of expression.

It was notable that, in the run-up to the US election, commentators seemed quicker to call out political MDI in the name of saving democracy. The Covid crisis is forcing a similar recalculation of whether free online expression, when invoked to spread distortions and falsehoods, carries an unreasonable cost to public health.

David Icke, the British conspiracy theorist whose unfounded tweet about Covid-19 vaccines causing mass infertility features in the Vaccine Confidence Project, is now banned from Facebook, YouTube and Twitter. That his paranoid outpourings are now falling on sterile ground feels almost karmic.

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