The term ‘anti-vaxxer’ may evoke images of a conspiracy theorist in a grimy basement or a disheveled figure on a crate railing against ‘microchips’ and ‘global plots’. In reality, the key protagonists in the ‘anti-vaxx industry’ are a coherent group of professional propagandists. These are people running multi-million-dollar organizations, incorporated mainly in the USA, with as many as 60 staff each1. They produce training manuals for activists, tailor their messages for different audiences, and arrange meetings akin to annual trades conferences, like any other industry2.

In October 2020, researchers of the Center for Countering Digital Hate attended and recorded a private, three-day meeting of the world’s most prominent anti-vaxxers3. Our team gained unprecedented insight into the organized opposition to the rollout of the vaccine against COVID-19. Despite the banality and vacuity of the anti-vaxxers’ presentations, there was nevertheless a chilling level of organization and intent.

What also became clear was the sophistication of the means they employ on social media. They have been able to develop these tactics only because social-media companies have been happy for the key players in this anti-vaxx industry to use their services to recruit new followers and spread their lies further than ever before. As a result, there is an online infrastructure of anti-vaccine websites, Facebook groups, YouTube channels, Instagram pages and Twitter accounts with a combined audience of 59 million3. In the UK alone, there are 5.35 million followers of anti-vaxxers across social media.

Anti-vaxxers are training each other in identifying potential targets online. They discuss their tactics for deepening people’s fears, sowing doubt as to whether people should take a vaccine, deepening vaccine hesitancy, and converting the chosen few into fully fledged anti-vaxxers—the people who further propagate the lies. Anti-vaxxers distribute themselves across social media, finding new and varied ways to inject misinformation into users’ news feeds. In that sense, they are far better equipped to reach people than are the UK National Health Service and World Health Organization, which rely on centralized digital communications through accounts with low engagement and little ‘personality’ or ‘authenticity’.

This was all true before the pandemic hit. Anti-vaxxers see COVID-19 as their opportunity to rapidly create widespread hesitancy for the vaccine against COVID-19 and, indeed, for all vaccines4. There are several factors militating in their favor. Social media breathed new life into several forms of extremism, as extremists of different shades recognized its potential to drive social change. Misinformation, which traditional media filters out through its editorial standards, suddenly had unfiltered access to most of the world’s population. Remember that the UK lost its measles-free status in 2019, well before COVID-19, due to declining immunization rates, while measles outbreaks emerged in parts of the USA.

There are steps we can all take to counter this misinformation industry, which threatens our health and that of our loved ones, and our society.

When we see anti-vaxx misinformation on social media, we must resist falling into the trap of engaging with it, however tempting it may be to point out obvious flaws and falsehoods. Engaging with misinformation online spreads it further: if we scratch the itch, we spread the disease. It is far more helpful and effective to instead share good information about vaccines from trusted sources. And when we each have our turn to be vaccinated, we should tell our friends and followers. Photos and clips posted on social media of the early recipients of vaccines encourage us all and show there is nothing to fear.

For the public-health organizations involved in developing and rolling out the vaccine, it is vital that they study the anti-vaxxers’ plan to prevent it from succeeding. Every anti-vaxx message can be boiled down to a master narrative of three parts: “COVID-19 isn’t dangerous; vaccines are dangerous; you can’t trust doctors or scientists.” Instead of attempting to rebut every silly conspiracy theory, practitioners should inoculate against those three central claims. And they must do so in every corner of the internet, meeting people where they are. For example, doctors and scientists should join their local community’s Facebook group and offer to answer any questions their neighbors have about the vaccine against COVID-19.

The simplest solution to this is for social-media companies to remove the anti-vaxx misinformation superspreaders: the professional propagandists making a living from the anti-vaxx industry, from their platforms, as detailed in our July 2020 report4. There is no moral justification for profiting from harmful lies, and there is no legal barrier to social-media companies’ removing them for breach of their terms of service. In fact, in the USA, moderation decisions are explicitly protected by law5. The problem has never been ability; instead, it has been the will to act. Tech companies have failed to act because their business model relies upon keeping users on their platforms scrolling through content interspersed with advertising, regardless of that content’s impact on society. Their failure to act should be punished with tough government regulation.

All of us have been doing our bit in 2020 and 2021 to contain the COVID-19 pandemic. Think of the friends and family you have not seen. Think of the medics risking their own lives and losing patients to this cruel virus. Think of the Herculean efforts made by scientists to develop a vaccine in record time. The anti-vaxx industry and technology companies, however, for their own solipsistic reasons, threaten to derail all that progress. It is up to all of us to stop them from doing so.