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A taxonomy of anti-vaccination arguments from a systematic literature review and text modelling

Nature Human Behaviour volume 7, pages 1462–1480 (2023)Cite this article

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Abstract

The proliferation of anti-vaccination arguments is a threat to the success of many immunization programmes. Effective rebuttal of contrarian arguments requires an approach that goes beyond addressing flaws in the arguments, by also considering the attitude roots—that is, the underlying psychological attributes driving a person’s belief—of opposition to vaccines. Here, through a pre-registered systematic literature review of 152 scientific articles and thematic analysis of anti-vaccination arguments, we developed a hierarchical taxonomy that relates common arguments and themes to 11 attitude roots that explain why an individual might express opposition to vaccination. We further validated our taxonomy on coronavirus disease 2019 anti-vaccination misinformation, through a combination of human coding and machine learning using natural language processing algorithms. Overall, the taxonomy serves as a theoretical framework to link expressed opposition of vaccines to their underlying psychological processes. This enables future work to develop targeted rebuttals and other interventions that address the underlying motives of anti-vaccination arguments.

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Fig. 1: PRISMA flow diagram and precedents.
Fig. 2: Frequencies of the attitude roots.
Fig. 3: Visualizations of attitude roots in Study 1.
Fig. 4: Visualizations of attitude roots in Study 2.
Fig. 5: Text classification experimental set-up.

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Data availability

All datasets used in this article are publicly available at https://osf.io/e4yp6/. The dataset used in Study 1 is accessible at https://osf.io/xu2cz (retrieved from Scopus, Web of Science, PubMed, PsycInfo, PsyArXiv, ArXiv and MedrXiv). The dataset used in Study 2 is accessible at https://osf.io/d839n (retrieved from https://covid19misinfo.org portal)

Code availability

All source code used in this article is publicly available at https://osf.io/e4yp6/.

References

  1. Greenwood, B. The contribution of vaccination to global health: past, present and future. Philos. Trans. R. Soc. B 369, 20130433 (2014).

    Article  Google Scholar 

  2. Ten Threats to Global Health in 2019 (World Health Organization, 2019).

  3. MacDonald, N. E. et al. Vaccine hesitancy: definition, scope and determinants. Vaccine 33, 4161–4164 (2015).

    Article  PubMed  Google Scholar 

  4. Ball, P. & Maxmen, A. The epic battle against coronavirus misinformation and conspiracy theories. Nature 581, 371–375 (2020).

    Article  CAS  PubMed  Google Scholar 

  5. Karlsson, L. C. et al. Fearing the disease or the vaccine: the case of COVID-19. Pers. Individ. Dif. 172, 110590 (2021).

    Article  PubMed  Google Scholar 

  6. Gagneur, A. et al. A postpartum vaccination promotion intervention using motivational interviewing techniques improves short-term vaccine coverage: PromoVac study. BMC Public Health 18, 1–8 (2018).

    Article  Google Scholar 

  7. Reiter, P. L., Gilkey, M. B. & Brewer, N. T. HPV vaccination among adolescent males: results from the national immunization survey-teen. Vaccine 31, 2816–2821 (2013).

    Article  PubMed  PubMed Central  Google Scholar 

  8. Wiley, K. E. & Leask, J. Respiratory vaccine uptake during pregnancy. Lancet Respir. Med. 1, 9–11 (2013).

    Article  PubMed  Google Scholar 

  9. Brewer, N. T., Chapman, G. B., Rothman, A. J., Leask, J. & Kempe, A. Increasing vaccination: putting psychological science into action. Psychol. Sci. Public Interest 18, 149–207 (2017).

    Article  PubMed  Google Scholar 

  10. Immunization Agenda 2030: A Global Strategy to Leave No One Behind (World Health Organization, 2020).

  11. European Immunization Agenda 2030: Draft for the Seventy-First Regional Committee for Europe (World Health Organization, 2021).

  12. Center for Countering Digital Hate. Pandemic profiteers: the business of anti-vaxx https://www.counterhate.com/pandemicprofiteers (2021).

  13. Smith, N. & Graham, T. Mapping the anti-vaccination movement on Facebook. Inf. Commun. Soc. 22, 1310–1327 (2019).

    Article  Google Scholar 

  14. Peretti-Watel, P. et al. ‘I think I made the right decision… I hope I’m not wrong’. Vaccine hesitancy, commitment and trust among parents of young children. Sociol. Health Illn. 41, 1192–1206 (2019).

    Article  PubMed  Google Scholar 

  15. Hornsey, M. J. & Fielding, K. S. Attitude roots and jiu jitsu persuasion: understanding and overcoming the motivated rejection of science. Am. Psychol. 72, 459 (2017).

    Article  PubMed  Google Scholar 

  16. Ajzen, I. & Fishbein, M. The influence of attitudes on behavior. In The Handbook of Attitudes (eds Albarracín, D., Johnson, M. & Zanna, P.) 173–221 (Lawrence Erlbaum Associates Publishers, 2005).

  17. Glasman, L. R. & Albarracín, D. Forming attitudes that predict future behavior: a meta-analysis of the attitude-behavior relation. Psychol. Bull. 132, 778 (2006).

    Article  PubMed  PubMed Central  Google Scholar 

  18. Festinger, L. A Theory of Cognitive Dissonance vol. 2 (Stanford Univ. Press, 1957).

  19. Bleser, W. K., Elewonibi, B. R., Miranda, P. Y. & BeLue, R. Complementary and alternative medicine and influenza vaccine uptake in us children. Pediatrics 138, e20154664 (2016).

    Article  PubMed  PubMed Central  Google Scholar 

  20. Moran, M. B., Lucas, M., Everhart, K., Morgan, A. & Prickett, E. What makes anti-vaccine websites persuasive? A content analysis of techniques used by anti-vaccine websites to engender anti-vaccine sentiment. J. Commun. Healthc. 9, 151–163 (2016).

    Article  Google Scholar 

  21. Browne, M. Epistemic divides and ontological confusions: the psychology of vaccine scepticism. Hum. Vaccin. Immunother. 14, 2540–2542 (2018).

    Article  PubMed  PubMed Central  Google Scholar 

  22. Lewandowsky, S., Woike, J. K. & Oberauer, K. Genesis or evolution of gender differences? Worldview-based dilemmas in the processing of scientific information. J. Cogn. 3, 9 (2020).

    Article  PubMed  PubMed Central  Google Scholar 

  23. Kata, A. A postmodern Pandora’s box: anti-vaccination misinformation on the internet. Vaccine 28, 1709–1716 (2010).

    Article  PubMed  Google Scholar 

  24. Hughes, B. et al. Development of a codebook of online anti-vaccination rhetoric to manage COVID-19 vaccine misinformation. Int. J. Environ. Res. Public Health 18, 7556 (2021).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  25. Wawrzuta, D., Jaworski, M., Gotlib, J. & Panczyk, M. What arguments against COVID-19 vaccines run on facebook in poland: content analysis of comments. Vaccines 9, 481 (2021).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  26. Fournet, N. et al. Under-vaccinated groups in Europe and their beliefs, attitudes and reasons for non-vaccination: two systematic reviews. BMC Public Health 18, 1–17 (2018).

    Article  Google Scholar 

  27. Coan, T. G., Boussalis, C., Cook, J. & Nanko, M. O. Computer-assisted classification of contrarian claims about climate change. Sci. Rep. 11, 22320 (2021).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  28. Lewandowsky, S. & Cook, J. The Conspiracy Theory Handbook (John Cook, Center for Climate Change Communication, George Mason Univ., 2020).

  29. Walton, D. N. What is reasoning? What is an argument? J. Philos. 87, 399–419 (1990).

    Article  Google Scholar 

  30. Van Eemeren, F. H. & Grootendorst, R. Speech Acts in Argumentative Discussions: A Theoretical Model for the Analysis of Discussions Directed towards Solving Conflicts of Opinion vol. 1 (Walter de Gruyter, 2010).

  31. Pinto, R. C. The relation of argument to inference. In Argument, Inference and Dialectic (ed Pinto, R. C.) 32–45 (Springer, 2001).

  32. Hitchcock, D. Informal logic and the concept of argument. In Philosophy of Logic (ed. Jacquette, D.) 101–129 (Elsevier, 2007).

  33. Braun, V. & Clarke, V. Using thematic analysis in psychology. Qual. Res. Psychol. 3, 77–101 (2006).

    Article  Google Scholar 

  34. Hornsey, M. J. Why facts are not enough: understanding and managing the motivated rejection of science. Curr. Dir. Psychol. Sci. 29, 583–591 (2020).

    Article  Google Scholar 

  35. Aaronovitch, D. Voodoo Histories: How Conspiracy Theory Has Shaped Modern History (Random House, 2010).

  36. Goreis, A. & Voracek, M. A systematic review and meta-analysis of psychological research on conspiracy beliefs: field characteristics, measurement instruments, and associations with personality traits. Front. Psychol. 10, 205 (2019).

    Article  PubMed  PubMed Central  Google Scholar 

  37. Goldberg, Z. J. & Richey, S. Anti-vaccination beliefs and unrelated conspiracy theories. World Aff. 183, 105–124 (2020).

    Article  Google Scholar 

  38. Hornsey, M. J., Harris, E. A. & Fielding, K. S. The psychological roots of anti-vaccination attitudes: a 24-nation investigation. Health Psychol. 37, 307 (2018).

    Article  PubMed  Google Scholar 

  39. Jolley, D. & Douglas, K. M. The effects of anti-vaccine conspiracy theories on vaccination intentions. PLoS ONE 9, e89177 (2014).

    Article  PubMed  PubMed Central  Google Scholar 

  40. Lewandowsky, S., Gignac, G. E. & Oberauer, K. The role of conspiracist ideation and worldviews in predicting rejection of science. PLoS ONE 8, e75637 (2013).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  41. Shapiro, G. K., Holding, A., Perez, S., Amsel, R. & Rosberger, Z. Validation of the vaccine conspiracy beliefs scale. Papillomavirus Res. 2, 167–172 (2016).

    Article  PubMed  PubMed Central  Google Scholar 

  42. Soveri, A., Karlsson, L. C., Antfolk, J., Lindfelt, M. & Lewandowsky, S. Unwillingness to engage in behaviors that protect against COVID-19: the role of conspiracy beliefs, trust, and endorsement of complementary and alternative medicine. BMC Public Health 21, 1–12 (2021).

    Article  Google Scholar 

  43. Lewandowsky, S. et al. When science becomes embroiled in conflict: recognizing the public’s need for debate while combating conspiracies and misinformation. Ann. Am. Acad. Polit. Soc. Sci. 700, 26–40 (2022).

    Article  Google Scholar 

  44. Hornsey, M. J., Lobera, J. & Díaz-Catalán, C. Vaccine hesitancy is strongly associated with distrust of conventional medicine, and only weakly associated with trust in alternative medicine. Soc. Sci. Med. 255, 113019 (2020).

    Article  PubMed  Google Scholar 

  45. Lee, C., Whetten, K., Omer, S., Pan, W. & Salmon, D. Hurdles to herd immunity: distrust of government and vaccine refusal in the US, 2002–2003. Vaccine 34, 3972–3978 (2016).

    Article  PubMed  Google Scholar 

  46. Salmon, D. A. et al. Factors associated with refusal of childhood vaccines among parents of school-aged children: a case–control study. Arch. Pediatr. Adolesc. Med. 159, 470–476 (2005).

    Article  PubMed  Google Scholar 

  47. Tram, K. H. et al. Deliberation, dissent, and distrust: understanding distinct drivers of coronavirus disease 2019 vaccine hesitancy in the United States. Clin. Infect. Dis. 74, 1429–1441 (2022).

    Article  CAS  PubMed  Google Scholar 

  48. Pennycook, G., Cheyne, J. A., Seli, P., Koehler, D. J. & Fugelsang, J. A. Analytic cognitive style predicts religious and paranormal belief. Cognition 123, 335–346 (2012).

    Article  PubMed  Google Scholar 

  49. Svedholm, A. M. & Lindeman, M. The separate roles of the reflective mind and involuntary inhibitory control in gatekeeping paranormal beliefs and the underlying intuitive confusions. Br. J. Psychol. 104, 303–319 (2013).

    Article  PubMed  Google Scholar 

  50. Fasce, A. & Picó, A. Science as a vaccine: the relation between scientific literacy and unwarranted beliefs. Sci. Educ. 28, 109–125 (2019).

    Article  Google Scholar 

  51. Hart, J. & Graether, M. Something’s going on here: psychological predictors of belief in conspiracy theories. J. Individ. Dif. 39, 229–237 (2018).

    Article  Google Scholar 

  52. Torres, M. N., Barberia, I. & Rodríguez-Ferreiro, J. Causal illusion as a cognitive basis of pseudoscientific beliefs. Br. J. Psychol. 111, 840–852 (2020).

    Article  PubMed  Google Scholar 

  53. Pierre, J. M. Mistrust and misinformation: a two-component, socio-epistemic model of belief in conspiracy theories. J. Soc. Polit. Psychol. 8, 617–641 (2020).

    Article  Google Scholar 

  54. van Prooijen, J.-W. An existential threat model of conspiracy theories. Eur. Psychol. 25, 16–25 (2019).

    Article  Google Scholar 

  55. Browne, M., Thomson, P., Rockloff, M. J. & Pennycook, G. Going against the herd: psychological and cultural factors underlying the ‘vaccination confidence gap’. PLoS ONE 10, e0132562 (2015).

    Article  PubMed  PubMed Central  Google Scholar 

  56. Kennedy, J. Populist politics and vaccine hesitancy in western europe: an analysis of national-level data. Eur. J. Public Health 29, 512–516 (2019).

    Article  PubMed  Google Scholar 

  57. Lewandowsky, S. & Oberauer, K. Worldview-motivated rejection of science and the norms of science. Cognition 215, 104820 (2021).

    Article  PubMed  Google Scholar 

  58. Whitehead, A. L. & Perry, S. L. How culture wars delay herd immunity: Christian nationalism and anti-vaccine attitudes. Socius 6, 2378023120977727 (2020).

    Article  Google Scholar 

  59. Motta, M. Republicans, not Democrats, are more likely to endorse anti-vaccine misinformation. Am. Polit. Res. 49, 428–438 (2021).

    Article  Google Scholar 

  60. Rekker, R. The nature and origins of political polarization over science. Public Underst. Sci. 30, 352–368 (2021).

    Article  PubMed  PubMed Central  Google Scholar 

  61. Grabenstein, J. D. What the world’s religions teach, applied to vaccines and immune globulins. Vaccine 31, 2011–2023 (2013).

    Article  PubMed  Google Scholar 

  62. Eriksson, K. & Vartanova, I. Vaccine confidence is higher in more religious countries. Hum. Vaccin. Immunother. 18, 1–3 (2022).

    Article  PubMed  Google Scholar 

  63. Barskey, A. E. et al. Mumps outbreak in Orthodox Jewish communities in the united states. N. Engl. J. Med. 367, 1704–1713 (2012).

    Article  CAS  PubMed  Google Scholar 

  64. Bodson, J., Wilson, A., Warner, E. L. & Kepka, D. Religion and HPV vaccine-related awareness, knowledge, and receipt among insured women aged 18-26 in utah. PLoS ONE 12, e0183725 (2017).

    Article  PubMed  PubMed Central  Google Scholar 

  65. Hanratty, B. et al. UK measles outbreak in non-immune anthroposophic communities: the implications for the elimination of measles from Europe. Epidemiol. Infect. 125, 377–383 (2000).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  66. Amin, A. B. et al. Association of moral values with vaccine hesitancy. Nat. Hum. Behav. 1, 873–880 (2017).

    Article  PubMed  Google Scholar 

  67. Rossen, I., Hurlstone, M. J., Dunlop, P. D. & Lawrence, C. Accepters, fence sitters, or rejecters: moral profiles of vaccination attitudes. Soc. Sci. Med. 224, 23–27 (2019).

    Article  PubMed  Google Scholar 

  68. Daniel Freeman, D. et al. Injection fears and COVID-19 vaccine hesitancy. Psychol. Med. 53, 1185–1195 (2021).

    Article  PubMed  Google Scholar 

  69. Ajzen, I. The theory of planned behavior. Organ. Behav. Hum. Decis. Process. 50, 179–211 (1991).

    Article  Google Scholar 

  70. Green, J., Edgerton, J., Naftel, D., Shoub, K. & Cranmer, S. J. Elusive consensus: polarization in elite communication on the COVID-19 pandemic. Sci. Adv. 6, eabc2717 (2020).

    Article  PubMed  PubMed Central  Google Scholar 

  71. Betsch, C. et al. Beyond confidence: development of a measure assessing the 5C psychological antecedents of vaccination. PLoS ONE 13, e0208601 (2018).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  72. Caserotti, M. et al. Associations of COVID-19 risk perception with vaccine hesitancy over time for Italian residents. Soc. Sci. Med. 272, 113688 (2021).

    Article  PubMed  PubMed Central  Google Scholar 

  73. González-Block, M. Á. et al. Influenza vaccination hesitancy in five countries of South America. Confidence, complacency and convenience as determinants of immunization rates. PLoS ONE 15, e0243833 (2020).

    Article  PubMed  PubMed Central  Google Scholar 

  74. Kwok, K. O. et al. Influenza vaccine uptake, COVID-19 vaccination intention and vaccine hesitancy among nurses: a survey. Int. J. Nurs. Stud. 114, 103854 (2021).

    Article  PubMed  Google Scholar 

  75. Attwell, K., Smith, D. T. & Ward, P. R. ‘If your child’s vaccinated, why do you care about mine?’ Rhetoric, responsibility, power and vaccine rejection. J. Sociol. 57, 268–285 (2021).

    Article  Google Scholar 

  76. Quadri-Sheriff, M. et al. The role of herd immunity in parents’ decision to vaccinate children: a systematic review. Pediatrics 130, 522–530 (2012).

    Article  PubMed  Google Scholar 

  77. Betsch, C., Böhm, R. & Korn, L. Inviting free-riders or appealing to prosocial behavior? Game-theoretical reflections on communicating herd immunity in vaccine advocacy. Health Psychol. 32, 978 (2013).

    Article  PubMed  Google Scholar 

  78. Hershey, J. C., Asch, D. A., Thumasathit, T., Meszaros, J. & Waters, V. V. The roles of altruism, free riding, and bandwagoning in vaccination decisions. Organ. Behav. Hum. Decis. Process. 59, 177–187 (1994).

    Article  Google Scholar 

  79. Ibuka, Y., Li, M., Vietri, J., Chapman, G. B. & Galvani, A. P. Free-riding behavior in vaccination decisions: an experimental study. PLoS ONE 9, e87164 (2014).

    Article  PubMed  PubMed Central  Google Scholar 

  80. Gidengil, C., Chen, C., Parker, A. M., Nowak, S. & Matthews, L. Beliefs around childhood vaccines in the United States: a systematic review. Vaccine 37, 6793–6802 (2019).

    Article  PubMed  PubMed Central  Google Scholar 

  81. Meszaros, J. R. et al. Cognitive processes and the decisions of some parents to forego pertussis vaccination for their children. J. Clin. Epidemiol. 49, 697–703 (1996).

    Article  CAS  PubMed  Google Scholar 

  82. Benin, A. L., Wisler-Scher, D. J., Colson, E., Shapiro, E. D. & Holmboe, E. S. Qualitative analysis of mothers’ decision-making about vaccines for infants: the importance of trust. Pediatrics 117, 1532–1541 (2006).

    Article  PubMed  Google Scholar 

  83. Hatoková, M., Masaryk, R. & Túnyiová, M. How Slovak mothers view child vaccination: focus group analysis. Ceskoslovenska Psychol. 62 (2018).

  84. Bryden, G. M., Browne, M., Rockloff, M. & Unsworth, C. The privilege paradox: geographic areas with highest socio-economic advantage have the lowest rates of vaccination. Vaccine 37, 4525–4532 (2019).

    Article  PubMed  Google Scholar 

  85. Pereira, J. A. et al. Contagious comments: what was the online buzz about the 2011 Quebec measles outbreak? PLoS ONE 8, e64072 (2013).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  86. Boghossian, P. Fear of Knowledge: Against Relativism and Constructivism (Clarendon Press, 2007).

  87. Kusch, M. Relativism in the Philosophy of Science (Cambridge Univ. Press, 2021).

  88. Reich, J. A. Neoliberal mothering and vaccine refusal: imagined gated communities and the privilege of choice. Gend. Soc. 28, 679–704 (2014).

    Article  Google Scholar 

  89. Schindler, J., Schindler, S. & Pfattheicher, S. The role of intuition in vaccination attitudes. J. Health Psychol. 26, 2950–2957 (2021).

    Article  PubMed  Google Scholar 

  90. Ten Kate, J., De Koster, W. & Van der Waal, J. "Following your gut” or “questioning the scientific evidence”: understanding vaccine skepticism among more-educated dutch parents. J. Health Soc. Behav. 62, 85–99 (2021).

    Article  PubMed  PubMed Central  Google Scholar 

  91. Tomljenovic, H., Bubic, A. & Erceg, N. It just doesn’t feel right—the relevance of emotions and intuition for parental vaccine conspiracy beliefs and vaccination uptake. Psychol. Health 35, 538–554 (2020).

    Article  PubMed  Google Scholar 

  92. Finkelstein, S. R. et al. Psychological reactance impacts ratings of pediatrician vaccine-related communication quality, perceived vaccine safety, and vaccination priority among us parents. Hum. Vaccin. Immunother. 16, 1024–1029 (2020).

    Article  PubMed  Google Scholar 

  93. Soveri, A. et al. Trait reactance and trust in doctors as predictors of vaccination behavior, vaccine attitudes, and use of complementary and alternative medicine in parents of young children. PLoS ONE 15, e0236527 (2020).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  94. Sprengholz, P., Felgendreff, L., Böhm, R. & Betsch, C. Vaccination policy reactance: predictors, consequences, and countermeasures. J. Health Psychol. 27, 1394–1407 (2022).

    Article  PubMed  Google Scholar 

  95. Akande, A., Ahmad, M. & Majid, U. A qualitative meta-synthesis on how autonomy promotes vaccine rejection or delay among health care providers. Health Promot. Int. 37, daab099 (2022).

    Article  PubMed  Google Scholar 

  96. Crescitelli, M. D. et al. A meta-synthesis study of the key elements involved in childhood vaccine hesitancy. Public Health 180, 38–45 (2020).

    Article  Google Scholar 

  97. Garcia, D., Goel, M., Agrawal, A. K. & Kumaraguru, P. Collective aspects of privacy in the twitter social network. EPJ Data Sci. 7, 1–13 (2018).

    Article  CAS  Google Scholar 

  98. Li, Y., Hills, T. & Hertwig, R. A brief history of risk. Cognition 203, 104344 (2020).

    Article  PubMed  PubMed Central  Google Scholar 

  99. Reimers, N. & Gurevych, I. Sentence-BERT: Sentence Embeddings using Siamese BERT-Networks. In Proc. 2019 Conference on Empirical Methods in Natural Language Processing and the 9th International Joint Conference on Natural Language Processing (EMNLP-IJCNLP) (eds Huang, R. & Padó, S.) 3982–3992 (Association for Computational Linguistics, 2019).

  100. McInnes, L., Healy, J. & Melville, J. UMAP: Uniform Manifold Approximation and Projection for dimension reduction. Preprint at arXiv https://doi.org/10.48550/arXiv.1802.03426 (2018).

  101. Nowell, L. S., Norris, J. M., White, D. E. & Moules, N. J. Thematic analysis: striving to meet the trustworthiness criteria. Int. J. Qual. Methods 16, 1609406917733847 (2017).

    Article  Google Scholar 

  102. Tunstall, L. et al. Efficient few-shot learning without prompts. Preprint at arXiv https://doi.org/10.48550/arXiv.2209.11055 (2022).

  103. Liu, Y. et al. Roberta: a robustly optimized BERT pretraining approach. Preprint at arXiv https://doi.org/10.48550/arXiv.1907.11692 (2019).

  104. Wolf, T. et al. Transformers: State-of-the-Art Natural Language Processing. In Proc. 2020 Conference on Empirical Methods in Natural Language Processing: System Demonstrations (eds Liu, Q. & Schlangen, D.) 38–45 (Association for Computational Linguistics, 2020).

  105. Pedregosa, F. et al. Scikit-learn: machine learning in Python. J. Mach. Learn. Res. 12, 2825–2830 (2011).

    Google Scholar 

  106. Gururangan, S. et al. Don't Stop Pretraining: Adapt Language Models to Domains and Tasks. In Proc. 58th Annual Meeting of the Association for Computational Linguistics (eds Jurafsky, D. et al.) 8342–8360 (Association for Computational Linguistics, 2020).

  107. Vaswani, A. et al. Attention is all you need. Preprint at arXiv https://arxiv.org/abs/1706.03762 (2017).

  108. Davies, P., Chapman, S. & Leask, J. Antivaccination activists on the World Wide Web. Arch. Dis. Child. 87, 22–25 (2002).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  109. Friedlander, E. Opposition to immunization: a pattern of deception. Sci. Rev. Altern. Med. 5, 18–23 (2001).

    Google Scholar 

  110. Nasir, L. Reconnoitering the antivaccination web sites: news from the front. J. Fam. Pract. 49, 731–731 (2000).

    CAS  PubMed  Google Scholar 

  111. Wolfe, R. M. Vaccine safety activists on the internet. Expert Review in Vaccines 1, 249–252 (2002).

    Article  Google Scholar 

  112. Zimmerman, R. K. et al. Vaccine criticism on the World Wide Web. J. Med. Internet Res. 7, e369 (2005).

    Article  Google Scholar 

  113. Bean, S. J. Emerging and continuing trends in vaccine opposition website content. Vaccine 29, 1874–1880 (2011).

    Article  PubMed  Google Scholar 

  114. Ward, J. K., Peretti-Watel, P., Larson, H. J., Raude, J. & Verger, P. Vaccine-criticism on the internet: new insights based on French-speaking websites. Vaccine 33, 1063–1070 (2015).

    Article  PubMed  Google Scholar 

  115. Jamison, A. et al. Adapting and extending a typology to identify vaccine misinformation on twitter. Am. J. Public Health 110, S331–S339 (2020).

    Article  PubMed  PubMed Central  Google Scholar 

  116. Klimiuk, K., Czoska, A., Biernacka, K. & Balwicki, Ł. Vaccine misinformation on social media—topic-based content and sentiment analysis of Polish vaccine-deniers’ comments on Facebook. Hum. Vaccin. Immunother. 17, 2026–2035 (2021).

    Article  PubMed  PubMed Central  Google Scholar 

  117. Broniatowski, D. A. et al. Facebook pages, the “Disneyland” measles outbreak, and promotion of vaccine refusal as a civil right, 2009–2019. Am. J. Public Health 110, S312–S318 (2020).

    Article  PubMed  PubMed Central  Google Scholar 

  118. Kohler, S. & Koinig, I. The effect of science-related populism on vaccination attitudes and decisions. J. Behav. Med. 46, 1–10 (2022).

    Google Scholar 

  119. Griffith, J., Marani, H. & Monkman, H. et al. COVID-19 vaccine hesitancy in Canada: content analysis of tweets using the theoretical domains framework. J. Med. Internet Res. 23, e26874 (2021).

    Article  PubMed  PubMed Central  Google Scholar 

  120. Nyhan, B., Reifler, J., Richey, S. & Freed, G. L. Effective messages in vaccine promotion: a randomized trial. Pediatrics 133, e835–e842 (2014).

    Article  PubMed  Google Scholar 

  121. Nyhan, B. & Reifler, J. Does correcting myths about the flu vaccine work? An experimental evaluation of the effects of corrective information. Vaccine 33, 459–464 (2015).

    Article  PubMed  Google Scholar 

  122. Miller, B. When is consensus knowledge based? Distinguishing shared knowledge from mere agreement. Synthese 190, 1293–1316 (2013).

    Article  Google Scholar 

  123. Lemaitre, T. et al. Impact of a vaccination promotion intervention using motivational interview techniques on long-term vaccine coverage: the PromoVac strategy. Hum. Vaccin. Immunother. 15, 732–739 (2019).

    Article  PubMed  PubMed Central  Google Scholar 

  124. Woolley, A. W., Aggarwal, I. & Malone, T. W. Collective intelligence and group performance. Curr. Dir. Psychol. Sci. 24, 420–424 (2015).

    Article  Google Scholar 

  125. Holford, D. L., Fasce, A., Costello, T. & Lewandowsky, S. Psychological profiles of anti-vaccination argument endorsement. Sci. Rep. In press (2023).

  126. Henrich, J., Heine, S. J. & Norenzayan, A. Most people are not weird. Nature 466, 29–29 (2010).

    Article  CAS  PubMed  Google Scholar 

  127. Rosenberg, B. D. & Siegel, J. T. A 50-year review of psychological reactance theory: do not read this article. Motiv. Sci. 4, 281 (2018).

    Article  Google Scholar 

  128. Kahan, D. M. in Emerging Trends in the Social and Behavioral Sciences: An Interdisciplinary, Searchable, and Linkable Resource (eds Scott, R. & Kosslyn, S.) 1–16 (Wiley Online Library, 2015).

  129. Holford, D. L., Schmid, P., Fasce, A. & Lewandowsky, S. The empathetic refutational interview to tackle vaccine misconceptions and improve vaccine acceptance. Preprint at OSF https://doi.org/10.31219/osf.io/8ndz2 (2023).

  130. Page, M. J. et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. Int. J. Surg. 88, 105906 (2021).

    Article  PubMed  Google Scholar 

  131. Gusenbauer, M. & Haddaway, N. R. Which academic search systems are suitable for systematic reviews or meta-analyses? Evaluating retrieval qualities of Google Scholar, PubMed, and 26 other resources. Res. Synth. Methods 11, 181–217 (2020).

    Article  PubMed  PubMed Central  Google Scholar 

  132. Hayes, A. F. & Krippendorff, K. Answering the call for a standard reliability measure for coding data. Commun. Methods Meas. 1, 77–89 (2007).

    Article  Google Scholar 

  133. Kiger, M. E. & Varpio, L. Thematic analysis of qualitative data: Amee guide no. 131. Medical Teacher 42, 846–854 (2020).

    Article  PubMed  Google Scholar 

  134. Verelst, F., Kessels, R., Willem, L. & Beutels, P. No such thing as a free-rider? understanding drivers of childhood and adult vaccination through a multicountry discrete choice experiment. Vaccines 9, 264 (2021).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  135. Wasserblat, M. Sentence transformer fine-tuning (setfit): Outperforms gpt-3 on few-shot text-classification while being 1600 times smaller. https://towardsdatascience.com/sentence-transformer-fine-tuning-setfit-outperforms-gpt-3-on-few-shot-text-classification-while-d9a3788f0b4e (2021)

  136. Alex, N. et al. RAFT: A real-world few-shot text classification benchmark. https://arxiv.org/abs/2109.14076 (2021)

  137. Gidengil, C., Chen, C., Parker, A. M., Nowak, S. & Matthews, L. Beliefs around childhood vaccines in the united states: A systematic review. Vaccine 37, 6793–6802 (2019).

    Article  PubMed  PubMed Central  Google Scholar 

  138. Van den Hoven, M. Why one should do one’s bit: Thinking about free riding in the context of public health ethics. Public Health Ethics 5, 154–160 (2012).

    Article  Google Scholar 

  139. Rozbroj, T., Lyons, A. & Lucke, J. Vaccine-hesitant and vaccine-refusing parents’ reflections on the way parenthood changed their attitudes to vaccination. J. Commun. Healthc. 45, 63–72 (2020).

    Article  CAS  Google Scholar 

  140. Coan, T. G., Boussalis, C., Cook, J. & Nanko, M. O. Computer-assisted classification of contrarian claims about climate change. Sci. Rep. 11, 22320 (2021).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  141. Smith, N. & Graham, T. Mapping the anti-vaccination movement on facebook. Information, Commun. Sci. 22, 1310–1327 (2019).

    Article  Google Scholar 

  142. Argyris, Y. A. et al. Using machine learning to compare provaccine and antivaccine discourse among the public on social media: algorithm development study. JMIR public health and surveillance 7, e23105 (2021).

    Article  PubMed  PubMed Central  Google Scholar 

  143. Arnold, K. The epidemic–terrorism nexus and how to safeguard africa against bioterrorism: Lessons from the global polio eradication initiative? South African Journal of International Affairs 28, 145–165 (2021).

    Article  Google Scholar 

  144. Asveld, L. Mass-vaccination programmes and the value of respect for autonomy. Bioethics 22, 245–257 (2008).

    Article  PubMed  Google Scholar 

  145. Attwell, K., Smith, D. T. & Ward, P. R. ‘the unhealthy other’: How vaccine rejecting parents construct the vaccinating mainstream. Vaccine 36, 1621–1626 (2018).

    Article  PubMed  Google Scholar 

  146. Auwen, A., Emmons, M. & Dehority, W. Portrayal of immunization in american cinema: 1925 to 2016. Clinical pediatrics 59, 360–368 (2020).

    Article  PubMed  Google Scholar 

  147. Baines, A., Ittefaq, M. & Abwao, M. # scamdemic,# plandemic, or# scaredemic: what parler social media platform tells us about covid-19 vaccine. Vaccines 9, 421 (2021).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  148. Baker, J. P. The pertussis vaccine controversy in great britain, 1974–1986. Vaccine 21, 4003–4010 (2003).

    Article  PubMed  Google Scholar 

  149. Basch, C. H., Meleo-Erwin, Z., Fera, J., Jaime, C. & Basch, C. E. A global pandemic in the time of viral memes: Covid-19 vaccine misinformation and disinformation on tiktok. Hum. Vaccin. Immunother. 17, 2373–2377 (2021).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  150. Bean, S. J. & Catania, J. A. Immunology beliefs as a factor in vaccine opposition among complementary and alternative medical providers. SAGE Open Medicine 6, 2050312118807625 (2018).

    Article  PubMed  PubMed Central  Google Scholar 

  151. Berezin, M. & Eads, A. Risk is for the rich? childhood vaccination resistance and a culture of health. Soc. Sci. Med. 165, 233–245 (2016).

    Article  PubMed  Google Scholar 

  152. Bonnevie, E. et al. Content themes and influential voices within vaccine opposition on twitter, 2019. Am J Public Health. 110, S326–S330 (2020).

    Article  PubMed  PubMed Central  Google Scholar 

  153. Bonnevie, E., Gallegos-Jeffrey, A., Goldbarg, J., Byrd, B. & Smyser, J. Quantifying the rise of vaccine opposition on twitter during the covid-19 pandemic. J. Health Commun. 14, 12–19 (2021).

    Article  Google Scholar 

  154. Bradshaw, A. S. et al. Propagandizing anti-vaccination: Analysis of vaccines revealed documentary series. Vaccine 38, 2058–2069 (2020).

    Article  PubMed  Google Scholar 

  155. Bradshaw, A. S., Shelton, S. S., Wollney, E., Treise, D. & Auguste, K. Pro-vaxxers get out: Anti-vaccination advocates influence undecided first-time, pregnant, and new mothers on facebook. Health Commun. 36, 693–702 (2021).

    Article  PubMed  Google Scholar 

  156. Brandmayr, F. Public epistemologies and intellectual interventions in contemporary italy. Int. J. Polit. Cult. Soc. 34, 47–68 (2021).

    Article  PubMed  Google Scholar 

  157. Bricker, B. & Justice, J. The postmodern medical paradigm: a case study of anti-mmr vaccine arguments. Western Journal of Communication 83, 172–189 (2019).

    Article  Google Scholar 

  158. Buller, D. B. et al. Insights on hpv vaccination in the united states from mothers’ comments on facebook posts in a randomized trial. Hum. Vaccin. Immunother. 15, 1479–1487 (2019).

    Article  PubMed  PubMed Central  Google Scholar 

  159. Buts, J. Memes of gandhi and mercury in anti-vaccination discourse. Media and Communication. 8, 353–363 (2020).

    Article  Google Scholar 

  160. Byström, E., Lindstrand, A., Likhite, N., Butler, R. & Emmelin, M. Parental attitudes and decision-making regarding mmr vaccination in an anthroposophic community in sweden–a qualitative study. Vaccine 32, 6752–6757 (2014).

    Article  PubMed  Google Scholar 

  161. Cameron, D. imagine the perfect vaccine: Homeopathic vaccine alternatives and vaccine discourse in english canada. Canadian Bulletin of Medical History 38, 32–62 (2021).

    PubMed  Google Scholar 

  162. Carrion, M. L. you need to do your research: Vaccines, contestable science, and maternal epistemology. Public Underst. Sci. 27, 310–324 (2018).

    Article  PubMed  Google Scholar 

  163. Caulfield, T., Marcon, A. R. & Murdoch, B. Injecting doubt: responding to the naturopathic anti-vaccination rhetoric. Journal of Law and the Biosciences 4, 229–249 (2017).

    Article  Google Scholar 

  164. Cloes, R., Ahmad, A. & Reintjes, R. Risk communication during the 2009 influenza a (h1n1) pandemic: stakeholder experiences from eight european countries. Disaster Med. Public Health Prep. 9, 127–133 (2015).

    Article  PubMed  Google Scholar 

  165. Cmeciu, C. & Coman, I. Governmental and public thematic patterns on vaccination during a measles outbreak: the romanian perspective. Glob. Health Promot. 28, 23–31 (2021).

    Article  PubMed  Google Scholar 

  166. Conis, E. A mother’s responsibility: women, medicine, and the rise of contemporary vaccine skepticism in the united states. Bulletin of the History of Medicine 87, 407–435 (2013).

    Article  PubMed  Google Scholar 

  167. Conis, E. Vaccines, pesticides, and narratives of exposure and evidence. Canadian Bulletin of Medical History 34, 297–326 (2017).

    PubMed  Google Scholar 

  168. Covolo, L., Ceretti, E., Passeri, C., Boletti, M. & Gelatti, U. What arguments on vaccinations run through youtube videos in italy? a content analysis. Hum. Vaccin. Immunother. 13, 1693–1699 (2017).

    Article  PubMed  PubMed Central  Google Scholar 

  169. Criss, S. et al. Advocacy, hesitancy, and equity: exploring us race-related discussions of the covid-19 vaccine on twitter. Int. J. Environ. Res. Public Health 18, 5693 (2021).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  170. Davis, M. ‘globalist war against humanity shifts into high gear’: Online anti-vaccination websites and ‘anti-public’discourse. Public Understanding of Science 28, 357–371 (2019).

    Article  PubMed  Google Scholar 

  171. DeDominicis, K. et al. Shouting at each other into the void: A linguistic network analysis of vaccine hesitance and support in online discourse regarding california law sb277. Soc. Sci. Med. 266, 113216 (2020).

    Article  PubMed  Google Scholar 

  172. Deml, M. J. et al. we treat humans, not herds!: A qualitative study of complementary and alternative medicine (cam) providers’ individualized approaches to vaccination in switzerland. Soc. Sci. Med. 240, 112556 (2019).

    Article  PubMed  Google Scholar 

  173. Kinder, F. D. Parental refusal of human papillomavirus vaccine: multisite study. J. Pediatr. Health Care 32, 150–156 (2018).

    Article  Google Scholar 

  174. Duchsherer, A., Jason, M., Platt, C. A. & Majdik, Z. P. Immunized against science: Narrative community building among vaccine refusing/hesitant parents. Public Underst. Sci. 29, 419–435 (2020).

    Article  PubMed  Google Scholar 

  175. Ekram, S., Debiec, K. E., Pumper, M. A. & Moreno, M. A. Content and commentary: Hpv vaccine and youtube. Journal of pediatric and adolescent gynecology 32, 153–157 (2019).

    Article  PubMed  Google Scholar 

  176. Elbarazi, I. et al. Exploring vaccine hesitancy among healthcare providers in the united arab emirates: a qualitative study. Hum. Vaccin. Immunother. 17, 2018–2025 (2021).

    Article  PubMed  Google Scholar 

  177. Evans, M. R., Prout, H., Prior, L., Tapper-Jones, L. M. & Butler, C. C. A qualitative study of lay beliefs about influenza immunisation in older people. British Journal of General Practice 57, 352–358 (2007).

    Google Scholar 

  178. Fadda, M., Allam, A. & Schulz, P. J. Arguments and sources on italian online forums on childhood vaccinations: Results of a content analysis. Vaccine 33, 7152–7159 (2015).

    Article  PubMed  Google Scholar 

  179. Fichman, M. & Keelan, J. E. Resister’s logic: the anti-vaccination arguments of alfred russel wallace and their role in the debates over compulsory vaccination in england, 1870–1907. Stud. Hist. Philos. Biol. Biomed. Sci. 38, 585–607 (2007).

    Article  PubMed  Google Scholar 

  180. Gallagher, J. & Lawrence, H. Y. et al. Rhetorical appeals and tactics in new york times comments about vaccines: Qualitative analysis. Journal of medical internet research 22, e19504 (2020).

    Article  PubMed  PubMed Central  Google Scholar 

  181. Gargiulo, F., Cafiero, F., Guille-Escuret, P., Seror, V. & Ward, J. K. Asymmetric participation of defenders and critics of vaccines to debates on french-speaking twitter. Sci. Rep. 10, 1–12 (2020).

    Article  Google Scholar 

  182. Glanz, J. M. et al. A mixed methods study of parental vaccine decision making and parent–provider trust. Academic pediatrics 13, 481–488 (2013).

    Article  PubMed  PubMed Central  Google Scholar 

  183. Gorman, D., Bielecki, K., Willocks, L. & Pollock, K. A qualitative study of vaccination behaviour amongst female polish migrants in edinburgh, scotland. Vaccine 37, 2741–2747 (2019).

    Article  CAS  PubMed  Google Scholar 

  184. Grandahl, M. et al. Not the right time: why parents refuse to let their daughters have the human papillomavirus vaccination. Acta Paediatrica 103, 436–441 (2014).

    Article  PubMed  Google Scholar 

  185. Grant, L. et al. Vaccination persuasion online: a qualitative study of two provaccine and two vaccine-skeptical websites. J. Med. Internet Res. 17, e133 (2015).

    Article  PubMed  PubMed Central  Google Scholar 

  186. Guidry, J. P., Carlyle, K., Messner, M. & Jin, Y. On pins and needles: how vaccines are portrayed on pinterest. Vaccine 33, 5051–5056 (2015).

    Article  PubMed  Google Scholar 

  187. Guillari, A. et al. Influenza vaccination and healthcare workers: barriers and predisposing factors. a literature review. Acta Bio Medica: Atenei Parmensis 92 (2021).

  188. Gullion, J. S., Henry, L. & Gullion, G. Deciding to opt out of childhood vaccination mandates. Public health nursing 25, 401–408 (2008).

    Article  PubMed  Google Scholar 

  189. Harvey, A. M., Thompson, S., Lac, A. & Coolidge, F. L. Fear and derision: a quantitative content analysis of provaccine and antivaccine internet memes. Health Educ. Behav. 46, 1012–1023 (2019).

    Article  PubMed  Google Scholar 

  190. Hasnan, S. & Tan, N. C. Multi-domain narrative review of vaccine hesitancy in childhood. Vaccine 39, 1910–1920 (2021).

    Article  PubMed  Google Scholar 

  191. Hausman, B. L., Ghebremichael, M., Hayek, P. & Mack, E. ‘poisonous, filthy, loathsome, damnable stuff’: the rhetorical ecology of vaccination concern. The Yale journal of biology and medicine 87, 403 (2014).

    PubMed  PubMed Central  Google Scholar 

  192. Hobson-West, P. ‘trusting blindly can be the biggest risk of all’: organised resistance to childhood vaccination in the uk. Sociology of health & illness 29, 198–215 (2007).

    Article  Google Scholar 

  193. Hoffman, B. L. et al. It’s not all about autism: The emerging landscape of anti-vaccination sentiment on facebook. Vaccine 37, 2216–2223 (2019).

    Article  PubMed  Google Scholar 

  194. Hoffman, B. L. et al. # doctorsspeakup: Lessons learned from a pro-vaccine twitter event. Vaccine 39, 2684–2691 (2021).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  195. Hopfer, S. & Clippard, J. R. College women’s hpv vaccine decision narratives. Qual. Health Res. 21, 262–277 (2011).

    Article  PubMed  Google Scholar 

  196. Izzati, A. N. et al. Pro-and anti-vaccination among mothers in deciding children’s immunization: A qualitative study. J. Med. Sci. 9, 385–391 (2021).

    Google Scholar 

  197. Jama, A., Ali, M., Lindstrand, A., Butler, R. & Kulane, A. Perspectives on the measles, mumps and rubella vaccination among somali mothers in stockholm. Int. J. Environ. Res. Public Health 15, 2428 (2018).

    Article  PubMed  PubMed Central  Google Scholar 

  198. Jamal, D. et al. Low vaccination in rural sindh, pakistan: a case of refusal, ignorance or access? Vaccine 38, 4747–4754 (2020).

    Article  PubMed  Google Scholar 

  199. Jamison, A. M. et al. Vaccine-related advertising in the facebook ad archive. Vaccine 38, 512–520 (2020).

    Article  PubMed  Google Scholar 

  200. Jenkins, M. C. & Moreno, M. A. Vaccination discussion among parents on social media: A content analysis of comments on parenting blogs. J. Health Commun. 25, 232–242 (2020).

    Article  PubMed  Google Scholar 

  201. Kaler, A. Health interventions and the persistence of rumour: the circulation of sterility stories in african public health campaigns. Soc. Sci. Med. 68, 1711–1719 (2009).

    Article  PubMed  Google Scholar 

  202. Kasstan, B. a free people, controlled only by god: Circulating and converting criticism of vaccination in jerusalem. Culture, Medicine, and Psychiatry 46, 277–296 (2022).

    Article  PubMed  Google Scholar 

  203. Kata, A. Anti-vaccine activists, web 2.0, and the postmodern paradigm–an overview of tactics and tropes used online by the anti-vaccination movement. Vaccine 30, 3778–3789 (2012).

    Article  PubMed  Google Scholar 

  204. Kaufman, M. The american anti-vaccinationists and their arguments. Bulletin of the History of Medicine 41, 463–478 (1967).

    CAS  PubMed  Google Scholar 

  205. Keelan, J., Pavri, V., Balakrishnan, R. & Wilson, K. An analysis of the human papilloma virus vaccine debate on myspace blogs. Vaccine 28, 1535–1540 (2010).

    Article  PubMed  Google Scholar 

  206. Khan, S. A. et al. Developing a three-dimensional narrative to counter polio vaccine refusal in charsadda. J. Glob. Health 10 (2020).

  207. Khan, Y. H. et al. Threat of covid-19 vaccine hesitancy in pakistan: the need for measures to neutralize misleading narratives. The American journal of tropical medicine and hygiene 103, 603 (2020).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  208. Kitta, A. Alternative health websites and fake news: Taking a stab at definition, genre, and belief. Journal of American Folklore 131, 405–412 (2018).

    Article  Google Scholar 

  209. Kolla¸taj, W. P., Kolla¸taj, B., Panasiuk, L., Sobieszczanski, J. & Karwat, I. D. Anti-vaccine movements–a form of social activity for health care, ignorance or diversion aimed at destabilizing the health situation? part 1. epidemiological safety. vaccinations–pros and cons. Annals of Agricultural and Environmental Medicine 27, 544 (2020).

    Article  PubMed  Google Scholar 

  210. Krawczyk, A. et al. Parents’ decision-making about the human papillomavirus vaccine for their daughters: Ii. qualitative results. Hum. Vaccin. Immunother. 11, 330–336 (2015).

    Article  PubMed  PubMed Central  Google Scholar 

  211. Lahouati, M., De Coucy, A., Sarlangue, J. & Cazanave, C. Spread of vaccine hesitancy in france: What about youtube? Vaccine 38, 5779–5782 (2020).

    Article  PubMed  Google Scholar 

  212. Leader, A. E., Burke-Garcia, A., Massey, P. M. & Roark, J. B. Understanding the messages and motivation of vaccine hesitant or refusing social media influencers. Vaccine 39, 350–356 (2021).

    Article  PubMed  Google Scholar 

  213. Leask, J.-A. & Chapman, S. ‘an attempt to swindle nature’: press anti-immunisation reportage 1993–1997. Australian and New Zealand journal of public health 22, 17–26 (1998).

    Article  CAS  PubMed  Google Scholar 

  214. Lee, M. S. & Male, M. Against medical advice: the anti-consumption of vaccines. Journal of Consumer Marketing 28, 484–490 (2011).

    Article  Google Scholar 

  215. Lefèvre, H., Schrimpf, C., Moro, M. R. & Lachal, J. Hpv vaccination rate in french adolescent girls: an example of vaccine distrust. Archives of disease in childhood 103, 740–746 (2018).

    Article  PubMed  Google Scholar 

  216. Lehmann, B. A., Ruiter, R. A. & Kok, G. A qualitative study of the coverage of influenza vaccination on dutch news sites and social media websites. BMC public health 13, 1–13 (2013).

    Article  Google Scholar 

  217. Luthy, K. E., Beckstrand, R. L. & Callister, L. C. Parental hesitation in immunizing children in utah. Public Health Nursing 27, 25–31 (2010).

    Article  PubMed  Google Scholar 

  218. Madden, K., Nan, X., Briones, R. & Waks, L. Sorting through search results: a content analysis of hpv vaccine information online. Vaccine 30, 3741–3746 (2012).

    Article  PubMed  Google Scholar 

  219. McClaran, N. & Rhodes, N. Portrayals of vaccination in entertainment television: A content analysis. Health commun. 36, 1242–1251 (2021).

    Article  PubMed  Google Scholar 

  220. Meharry, P. M., Colson, E. R., Grizas, A. P., Stiller, R. & Vázquez, M. Reasons why women accept or reject the trivalent inactivated influenza vaccine (tiv) during pregnancy. Maternal and child health journal 17, 156–164 (2013).

    Article  PubMed  Google Scholar 

  221. Mendel-Van Alstyne, J. A., Nowak, G. J. & Aikin, A. L. What is ‘confidence’and what could affect it?: A qualitative study of mothers who are hesitant about vaccines. Vaccine 36, 6464–6472 (2018).

    Article  PubMed  Google Scholar 

  222. Meyer, S. B. et al. Vaccine hesitancy and web 2.0: Exploring how attitudes and beliefs about influenza vaccination are exchanged in online threaded user comments. Vaccine 37, 1769–1774 (2019).

    Article  PubMed  Google Scholar 

  223. Mitilian, E., Malli, F. & Verger, P. Image of the new vaccination obligation through the media. Vaccine 38, 498–511 (2020).

    Article  PubMed  Google Scholar 

  224. Muzembo, B. A. et al. Local perspectives on ebola during its tenth outbreak in dr congo: A nationwide qualitative study. PLoS One 15, e0241120 (2020).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  225. Nugier, A., Limousi, F. & Lydié, N. Vaccine criticism: Presence and arguments on french-speaking websites. Médecine et Maladies Infectieuses 48, 37–43 (2018).

    Article  CAS  PubMed  Google Scholar 

  226. Okuhara, T., Ishikawa, H., Kato, M., Okada, M. & Kiuchi, T. A qualitative analysis of the beliefs of japanese anti-influenza vaccination website authors. Heliyon 4, e00609 (2018).

    Article  PubMed  PubMed Central  Google Scholar 

  227. Penta, M. A. & Baban, A. Dangerous agent or saviour? hpv vaccine representations on online discussion forums in romania. Int. J. Behav. Med. 21, 20–28 (2014).

    Article  PubMed  Google Scholar 

  228. Petousis-Harris, H. A., Goodyear-Smith, F. A., Kameshwar, K. & Turner, N. Fact or fallacy? immunisation arguments in the new zealand print media. Australian and New Zealand journal of public health 34, 521–526 (2010).

    Article  PubMed  Google Scholar 

  229. Platonov, K. & Svetlov, K. Conspiracy theories dissemination on sns vkontakte: Covid-19 case. In Electronic Governance and Open Society: Challenges in Eurasia: 7th International Conference, EGOSE 2020, St. Petersburg, Russia, November 18–19, 2020, Proceedings 7, 322-335 (Springer, 2020).

  230. Pless, A., McLennan, S. R., Nicca, D., Shaw, D. M. & Elger, B. S. Reasons why nurses decline influenza vaccination: a qualitative study. BMC nursing 16, 1–7 (2017).

    Article  Google Scholar 

  231. Pop, C. A. Cervical cancer narratives: invoking ‘god’s will’to re-appropriate reproductive rights in present-day romania. Culture, Health & Sexuality 17, 48–62 (2015).

    Article  Google Scholar 

  232. Pop, C. A. Locating purity within corruption rumors: narratives of hpv vaccination refusal in a peri-urban community of southern romania. Medical Anthropology Quarterly 30, 563–581 (2016).

    Article  PubMed  Google Scholar 

  233. Pullagura, G. R., Violette, R., Houle, S. K. & Waite, N. M. Shades of gray in vaccination decisions–understanding community pharmacists’ perspectives of, and experiences with, influenza vaccine hesitancy in ontario, canada. Vaccine 38, 2551–2558 (2020).

    Article  PubMed  Google Scholar 

  234. Quinn, S., Jamison, A., Musa, D., Hilyard, K. & Freimuth, V. Exploring the continuum of vaccine hesitancy between african american and white adults: results of a qualitative study. PLoS currents 8 (2016).

  235. Radovanovic, Z. Anti-vaccinationists and their arguments in the balkan countries that share the same language. Srpski arhiv za celokupno lekarstvo 145, 199–204 (2017).

    Article  Google Scholar 

  236. Reich, J. A. Teaching women to question and control: public pedagogies of birth and vaccine refusal. BioSocieties 15, 580–600 (2020).

    Article  Google Scholar 

  237. Reid, J. A. & Mabhala, M. A. Ethnic and minority group differences in engagement with covid-19 vaccination programmes–at pandemic pace; when vaccine confidence in mass rollout meets local vaccine hesitancy. Israel Journal of Health Policy Research 10, 33 (2021).

    Article  PubMed  PubMed Central  Google Scholar 

  238. Rhudy, L. M., Tucker, S. J., Ofstead, C. L. & Poland, G. A. Personal choice or evidence-based nursing intervention: nurses’ decision-making about influenza vaccination. Worldviews on Evidence-Based Nursing 7, 111–120 (2010).

    PubMed  Google Scholar 

  239. Rochel de Camargo Jr, K. Here we go again: the reemergence of anti-vaccine activism on the internet. Cadernos de saude publica 36, e00037620 (2020).

    Article  PubMed  Google Scholar 

  240. Rodriguez, N. J. Vaccine-hesitant justifications: too many, too soon, narrative persuasion, and the conflation of expertise. Global Qualitative Nursing Research 3, 2333393616663304 (2016).

    Article  PubMed  PubMed Central  Google Scholar 

  241. Rozbroj, T., Lyons, A. & Lucke, J. Vaccine-hesitant and vaccine-refusing parents’ reflections on the way parenthood changed their attitudes to vaccination. J. community health 45, 63–72 (2020).

    Article  CAS  PubMed  Google Scholar 

  242. Rundblad, G. Why some messages speak better: Child immunization in the news and on the internet. Current Drug Safety 10, 87–93 (2015).

    Article  PubMed  Google Scholar 

  243. Russell, S. J. et al. Oncolytic measles virotherapy and opposition to measles vaccination. In Mayo Clinic Proceedings, vol. 94, 1834-1839 (Elsevier, 2019).

  244. Schwartz, J. L. New media, old messages: themes in the history of vaccine hesitancy and refusal. AMA Journal of Ethics 14, 50–55 (2012).

    Article  Google Scholar 

  245. Skeppstedt, M., Kerren, A. & Stede, M. Vaccine hesitancy in discussion forums: Computer-assisted argument mining with topic models. In Building Continents of Knowledge in Oceans of Data: The Future of Co-Created eHealth, 366-370 (IOS Press, 2018).

  246. Smith, M. J. Promoting vaccine confidence. Infectious Disease Clinics 29, 759–769 (2015).

    PubMed  Google Scholar 

  247. Smith, T. C. Vaccine rejection and hesitancy: a review and call to action. In Open forum infectious diseases, vol. 4 (Oxford University Press, 2017).

  248. Smith, T. C. & Reiss, D. R. Digging the rabbit hole, covid-: anti-vaccine themes and the discourse around covid-19. Microbes and infection 22, 608–610 (2020).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  249. Sobo, E. J., Huhn, A., Sannwald, A. & Thurman, L. Information curation among vaccine cautious parents: Web 2.0, pinterest thinking, and pediatric vaccination choice. Medical anthropology 35, 529–546 (2016).

    Article  PubMed  Google Scholar 

  250. Spier, R. E. Perception of risk of vaccine adverse events: a historical perspective. Vaccine 20, S78–S84 (2001).

    Article  PubMed  Google Scholar 

  251. Stolle, L. B. et al. Fact vs fallacy: the anti-vaccine discussion reloaded. Advances in therapy 37, 4481–4490 (2020).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  252. Succi, R. Cd. M. Vaccine refusal-what we need to know. Jornal de pediatria 94, 574–581 (2018).

    Article  PubMed  Google Scholar 

  253. Syiroj, A. T. R., Pardosi, J. F. & Heywood, A. E. Exploring parents’ reasons for incomplete childhood immunisation in indonesia. Vaccine 37, 6486–6493 (2019).

    Article  PubMed  Google Scholar 

  254. Tagajdid, M. R. et al. Factors influencing uptake of influenza vaccine amongst healthcare workers in a regional center after the a (h1n1) 2009 pandemic: lessons for improving vaccination rates. International Journal of Risk & Safety in Medicine 23, 249–254 (2011).

    Article  Google Scholar 

  255. Tandy, C. B. & Jabson Tree, J. M. Attitudes of east tennessee residents towards general and pertussis vaccination: a qualitative study. BMC Public Health 21, 1–11 (2021).

    Article  Google Scholar 

  256. Thelwall, M., Kousha, K. & Thelwall, S. Covid-19 vaccine hesitancy on english-language twitter. Profesional de la información (EPI) 30 (2021).

  257. Tolley, K. School vaccination wars: The rise of anti-science in the american anti-vaccination societies, 1879–1929. History of Education Quarterly 59, 161–194 (2019).

    Article  Google Scholar 

  258. Tomeny, T. S., Vargo, C. J. & El-Toukhy, S. Geographic and demographic correlates of autism-related anti-vaccine beliefs on twitter, 2009-15. Soc. Sci. Med. 191, 168–175 (2017).

    Article  PubMed  PubMed Central  Google Scholar 

  259. Uibu, M. et al. doctors just don’t care about people! how medical specialists are depicted in a vaccine-critical estonian facebook group. Folklore: Electronic Journal of Folklore 215–238 (2021).

  260. Vamos, C. A., McDermott, R. J. & Daley, E. M. The hpv vaccine: framing the arguments for and against mandatory vaccination of all middle school girls. J. Sch. Health 78, 302–309 (2008).

    Article  PubMed  Google Scholar 

  261. Velan, B., Kaplan, G., Ziv, A., Boyko, V. & Lerner-Geva, L. Major motives in non-acceptance of a/h1n1 flu vaccination: the weight of rational assessment. Vaccine 29, 1173–1179 (2011).

    Article  PubMed  Google Scholar 

  262. Venkatraman, A., Garg, N. & Kumar, N. Greater freedom of speech on web 2.0 correlates with dominance of views linking vaccines to autism. Vaccine 33, 1422–1425 (2015).

    Article  PubMed  Google Scholar 

  263. Vercruysse, J. et al. Parents’ and providers’ attitudes toward school-located provision and school-entry requirements for hpv vaccines. Hum. Vaccin. Immunother. 12, 1606–1614 (2016).

    Article  PubMed  PubMed Central  Google Scholar 

  264. Verger, P., Bocquier, A., Vergélys, C., Ward, J. & Peretti-Watel, P. Flu vaccination among patients with diabetes: motives, perceptions, trust, and risk culture-a qualitative survey. BMC Public Health 18, 1–10 (2018).

    Article  Google Scholar 

  265. Ward, J. K. Rethinking the antivaccine movement concept: a case study of public criticism of the swine flu vaccine’s safety in france. Soc. Sci. Med. 159, 48–57 (2016).

    Article  PubMed  Google Scholar 

  266. Ward, P. R., Attwell, K., Meyer, S. B., Rokkas, P. & Leask, J. Understanding the perceived logic of care by vaccine-hesitant and vaccine-refusing parents: a qualitative study in australia. PloS one 12, e0185955 (2017).

    Article  PubMed  PubMed Central  Google Scholar 

  267. Wawrzuta, D., Jaworski, M., Gotlib, J. & Panczyk, M. Characteristics of antivaccine messages on social media: systematic review. J. Med. Internet Res. 23, e24564 (2021).

    Article  PubMed  PubMed Central  Google Scholar 

  268. Weitz, L., Bellach, L., Faltum, A., Berger, A. & Maurer, W. Vaccine hesitancy: Report of a student study group. Wiener klinische Wochenschrift 132, 243–252 (2020).

    Article  PubMed  PubMed Central  Google Scholar 

  269. Winslade, C., Heffernan, C. & Atchison, C. Experiences and perspectives of mothers of the pertussis vaccination programme in london. Public Health 146, 10–14 (2017).

    Article  CAS  PubMed  Google Scholar 

  270. Wiyeh, A. B. et al. Social media and hpv vaccination: Unsolicited public comments on a facebook post by the western cape department of health provide insights into determinants of vaccine hesitancy in south africa. Vaccine 37, 6317–6323 (2019).

    Article  PubMed  Google Scholar 

  271. Wong, L., Wong, P. & AbuBakar, S. Vaccine hesitancy and the resurgence of vaccine preventable diseases: the way forward for malaysia, a southeast asian country. Hum. Vaccin. Immunother. 16, 1511–1520 (2020).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  272. Xu, Z., Ellis, L. & Umphrey, L. R. The easier the better? comparing the readability and engagement of online pro-and anti-vaccination articles. Health Educ. Behav. 46, 790–797 (2019).

    Article  PubMed  Google Scholar 

  273. Yeung, M. W. & Yau, A. H. ‘this year’s vaccine is only 10% effective’: a study of public discourse on vaccine effectiveness in hong kong. J. Healthc. Commun. 14, 78–89 (2021).

    Article  Google Scholar 

  274. Zuk, P. & Zuk, P. Right-wing populism in poland and anti-vaccine myths on youtube: Political and cultural threats to public health. Global Public Health 15, 790–804 (2020).

    Article  PubMed  Google Scholar 

  275. Mønsted, B. & Lehmann, S. Algorithmic detection and analysis of vaccine-denialist sentiment clusters in social networks. arXiv preprint arXiv:1905.12908 (2019).

  276. Sharma, K., Zhang, Y. & Liu, Y. Covid-19 vaccines: characterizing misinformation campaigns and vaccine hesitancy on twitter (2021).

  277. Ackermann, D., Chapman, S. & Leask, J. Media coverage of anthrax vaccination refusal by Australian Defence Force personnel. Vaccine 23, 411–417 (2004).

    Article  PubMed  Google Scholar 

  278. Gruzd, A. & Mai, P. COVID-19 misinformation portal—a rapid response project from the Ryerson University social media lab. COVID19MisInfo.org Portal https://covid19misinfo.org/ (2020).

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Acknowledgements

This project has received funding from the European Union’s Horizon 2020 research and innovation programme under grant agreement no. 964728 (JITSUVAX). L.B. and I.G. were funded by the German Federal Ministry of Education and Research and by the Hessian Ministry of Science and the Arts (HMWK) within the projects ‘The Third Wave of Artificial Intelligence – 3AI’, hessian.AI, and within their joint support of the National Research Center for Applied Cybersecurity ATHENE. S.L. also acknowledges support from the Humboldt Foundation through a research award. The funders had no role in study design, data collection and analysis, decision to publish or preparation of the manuscript.

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Authors and Affiliations

  1. Faculty of Medicine, University of Coimbra, Coimbra, Portugal

    Angelo Fasce

  2. Institute for Planetary Health Behaviour, University of Erfurt, Erfurt, Germany

    Philipp Schmid

  3. Department of Implementation Research, Bernhard-Nocht-Institute for Tropical Medicine, Hamburg, Germany

    Philipp Schmid

  4. School of Psychological Science, University of Bristol, Bristol, UK

    Dawn L. Holford & Stephan Lewandowsky

  5. Department of Psychology, University of Essex, Colchester, UK

    Dawn L. Holford

  6. Ubiquitous Knowledge Processing Lab/Department of Computer Science and Hessian Center for AI (hessian.AI), Technical University of Darmstadt, Darmstadt, Germany

    Luke Bates & Iryna Gurevych

  7. School of Psychological Science, University of Western Australia, Perth, Western Australia, Australia

    Stephan Lewandowsky

  8. Department of Psychology, University of Potsdam, Potsdam, Germany

    Stephan Lewandowsky

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Contributions

A.F.: conceptualization, data curation, formal analysis, investigation, methodology, supervision, writing—original draft, and writing—review and editing. P.S.: conceptualization, data curation, formal analysis, investigation, methodology, visualization, writing—original draft, and writing—review and editing. D.L.H.: conceptualization, data curation, formal analysis, investigation, methodology, visualization, writing—original draft, and writing—review and editing. L.B.: conceptualization, formal analysis, investigation, methodology, visualization, writing—original draft, and writing—review and editing. I.G.: funding acquisition, supervision, and writing—review and editing. S.L.: conceptualization, formal analysis, funding acquisition, investigation, methodology, supervision, visualization, and writing—review and editing.

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Correspondence to Angelo Fasce.

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Supplementary Information

Supplementary Table 1: Classification of articles. Supplementary Table 2: Krippendorff ’s alphas. Supplementary Figs. 1–3: Word clouds. Supplementary Figs. 4 and 5: Frequency of attitude roots. Supplementary Table 3: Summary statistics of both datasets. Supplementary Figs. 6 and 7 and Supplementary Table 4: Confirmatory text modelling using LDA. Supplementary Table 5: Text classification on Study 2 fact checks. Supplementary Figs. 8 and 9, and links to the 3D gifs: Visualization of attitude roots.

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Fasce, A., Schmid, P., Holford, D.L. et al. A taxonomy of anti-vaccination arguments from a systematic literature review and text modelling. Nat Hum Behav 7, 1462–1480 (2023). https://doi.org/10.1038/s41562-023-01644-3

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