Cited by 1,094Misinformation and Its ImpactsVaccine Coverage and HesitancyHealth Literacy and Information Accessibility

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Anti-vaccine activists, Web 2.0, and the postmodern paradigm - An overview of tactics and tropes used online by the anti-vaccination movement

Kata, Anna·2012·Vaccine

DOI 10.1016/j.vaccine.2011.11.112

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Abstract

Websites opposing vaccination are prevalent on the Internet. Web 2.0, defined by interaction and user-generated content, has become ubiquitous. Furthermore, a new postmodern paradigm of healthcare has emerged, where power has shifted from doctors to patients, the legitimacy of science is questioned, and expertise is redefined. Together this has created an environment where anti-vaccine activists are able to effectively spread their messages. Evidence shows that individuals turn to the Internet for vaccination advice, and suggests such sources can impact vaccination decisions - therefore it is likely that anti-vaccine websites can influence whether people vaccinate themselves or their children. This overview examines the types of rhetoric individuals may encounter online in order to better understand why the anti-vaccination movement can be convincing, despite lacking scientific support for their claims. Tactics and tropes commonly used to argue against vaccination are described. This includes actions such as skewing science, shifting hypotheses, censoring dissent, and attacking critics; also discussed are frequently made claims such as not being "anti-vaccine" but "pro-safe vaccines", that vaccines are toxic or unnatural, and more. Recognizing disingenuous claims made by the anti-vaccination movement is essential in order to critically evaluate the information and misinformation encountered online.

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1 retracted

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Alghalyini, B., Garatli, T., Hamoor, R., Ibrahim, L., Elmehallawy, Y., Hamze, D., Abbara, Z., & Zaidi, A. R. Z. (2023) · Vaccines · doi:10.3390/vaccines11101595 · Cited by 8
“Several studies have highlighted the importance of strategic online health campaigns in shaping public perception positively [19,20].”
Background
Image of the new vaccination obligation through the media
Mitilian, E., Malli, F., & Verger, P. (2019) · Vaccine · doi:10.1016/j.vaccine.2019.10.069 · Cited by 8
Influenza and Measles-MMR: two case study of the trend and impact of vaccine-related Twitter posts in Spanish during 2015-2018
Santamaría, L. P., Tuñas, J. M., Peces-Barba, D. F., Jaramillo, A., Cotarelo, M., Menasalvas, E., Fernández, A. J. C., Arce, A., de Miguel, Á. G., & Rodríguez‐González, A. (2021) · Human Vaccines & Immunotherapeutics · doi:10.1080/21645515.2021.1877597 · Cited by 8
Prevalence and Determinants of Vaccine Hesitancy in Aseer Region, Saudi Arabia
Alqahtani, Y. A., Almutairi, K. H., Alqahtani, Y. M., Almutlaq, A. H., & Asiri, A. A. (2021) · Sultan Qaboos University medical journal · doi:10.18295/squmj.4.2021.023 · Cited by 8
“It is classified by the World Health Organization as one of the top ten global health threats of 2019.(12,13) Vaccine hesitancy may be in the form of outright refusal to vaccinate, delaying vaccines, accepting vaccines with uncertainty regarding their use, or selectively using certain vaccines not all.”
Background
Characterizing the Anti-Vaxxers’ Reply Behavior on Social Media
Miyazaki, K., Uchiba, T., Tanaka, K., & Sasahara, K. (2021) · IEEE/WIC/ACM International Conference on Web Intelligence · doi:10.1145/3498851.3498934 · Cited by 8
“Well before that, following an analysis of patterns in anti-vaccine advocacy, Kata [24] proposed typologies in anti-vaxxer”
BackgroundResultInfluential
The Covid pandemic enters the ballot box: The impact of conspiracy theories on Italians' voting behaviour during the COVID-19 crisis
Serani, D. (2022) · Italian Political Science Review/Rivista Italiana di Scienza Politica · doi:10.1017/ipo.2021.56 · Cited by 8
Mapping the connections of health professionals to COVID-19 myths and facts in the Australian Twittersphere
O’Neil, M., Khan, M. I., Holland, K., & Cai, X. (2022) · Information Communication & Society · doi:10.1080/1369118x.2022.2032260 · Cited by 9
“The challenge this presents to traditional knowledge hierarchies provided fertile ground for anti-vaccination activists to disseminate their messages (Kata, 2012).”
Background
Facilitating Middle School Students’ Reasoning About Vaccines
Çetinkaya, E., & Sarıbaş, D. (2022) · Science & Education · doi:10.1007/s11191-021-00318-8 · Cited by 8
“Kata (2012) specifically named this fallacy used for vaccines as the “toxin gambit”.”
Background
Supporting Vaccination on TikTok During the COVID-19 Pandemic: Vaccine Beliefs, Emotions, and Comments
Wang, X., & He, R. (2022) · Frontiers in Psychology · doi:10.3389/fpsyg.2022.938377 · Cited by 8
“However, it is important to analyze such inﬂuence as research shows that negative beliefs with negative emotions can elicit negative attitudes (Bean, 2011; Kata, 2012).”
Background
Hesitant and anti-vaccination groups: A qualitative study on their perceptions and attitudes regarding vaccinations and their reluctance to participate in academic research- an example during a measles outbreak among a group of Jewish parents in Israel
Hijazi, R., Gesser‐Edelsburg, A., Feder‐Bubis, P., & Mesch, G. S. (2022) · Frontiers in Public Health · doi:10.3389/fpubh.2022.1012822 · Cited by 8
Unintended Consequences of Invoking the “Natural” in Breastfeeding Promotion
Martucci, J., & Barnhill, A. (2016) · PEDIATRICS · doi:10.1542/peds.2015-4154 · Cited by 8
What is the most useful tool in HPV vaccine promotion? Results from an experimental study
Gualano, M. R., Thomas, R., Stillo, M., Mussa, M. V., Quattrocolo, F., Borraccino, A., & Zotti, C. M. (2018) · Human Vaccines & Immunotherapeutics · doi:10.1080/21645515.2018.1526552 · Cited by 8
Drug Safety Issues Covered by Lay Media: A Cohort Study of Direct Healthcare Provider Communications Sent between 2001 and 2015 in The Netherlands
de Vries, E., Denig, P., de Vries, S. T., Monster, T. B. M., Hugtenburg, J. G., & Mol, P. G. M. (2020) · Drug Safety · doi:10.1007/s40264-020-00922-7 · Cited by 8
VACCINE INFORMATION SEEKING AND SHARING: HOW PRIVATE FACEBOOK GROUPS CONTRIBUTED TO THE ANTI-VACCINE MOVEMENT ONLINE
Koltai, K. (2020) · AoIR Selected Papers of Internet Research · doi:10.5210/spir.v2020i0.11252 · Cited by 8
“A major factor in vaccine dissent is the proliferation of vaccine opposed content online (Kata, 2012).”
Background
Impact of numerical information on risk knowledge regarding human papillomavirus (HPV) vaccination among schoolgirls: a randomised controlled trial
Steckelberg, A., Albrecht, M., Kezle, A., Kasper, J., & Mühlhauser, I. (2013) · Europe PMC (PubMed Central) · doi:10.3205/000183 · Cited by 8
“Kata has outlined the rhetorical tactics of these movements [10].”
Background
Health MisinformationPreprint
Nan, X., Wang, Y., & Thier, K. (2020) · doi:10.31234/osf.io/6mrgv · Cited by 9
‘We are not sheep, I believe it is my choice’: Vaccine hesitancy and institutional agency among middle-class mothers in Russia
Borozdina, E. (2025) · Current Sociology · doi:10.1177/00113921241310610 · Cited by 7
“The discussion on agency – from individualistic consumer choice to ‘anti-vax movement’ – forms the backbone of social science literature about vaccination skep-ticism (e.g. Attwell et al., 2018; Kata, 2012; Reich, 2014).”
Conspiracy Beliefs, Secondary Risk Perceptions, and Conditional Acceptance of Dengue Vaccine: A Multigroup Comparison Based on Prior COVID-19 Vaccination Experiences
Ou, M., & Ho, S. S. (2025) · Health Communication · doi:10.1080/10410236.2025.2539462 · Cited by 7
“These generalized narratives often accuse governments and pharmaceutical companies of fabricating vaccine safety data, concealing adverse side effects (Jolley et al., 2014), and exaggerating efficacy claims (Kata, 2012).”
The Role and Safety of Aluminum Adjuvants in Childhood Vaccines
Nirenberg, E., Maldonado, Y., & Hoffman, S. A. (2025) · PEDIATRICS · doi:10.1542/peds.2025-074874 · Cited by 7
Intervention in Health Misinformation Using Large Language Models for Automated Detection, Thematic Analysis, and Inoculation: Case Study on COVID-19
Malek, S., Griffin, C. H., Fraleigh, R. D., Lennon, R. P., Monga, V., & Shen, L. (2025) · Journal of Medical Internet Research · doi:10.2196/75500 · Cited by 11
“These inaccuracies often circulate rapidly via social media, exploiting emotional narratives that overshadow fact-based content and leading individuals to question the legitimacy of evidence-based interventions [5,8-11].”
Emotion, Digital Media, and Misinformation
Weeks, B. E. (2023) · Oxford University Press eBooks · doi:10.1093/oso/9780197520536.003.0022 · Cited by 9
Individuals, Collectives, and Individuals in Collectives: The Ineliminable Role of Dependence
Hahn, U. (2023) · Perspectives on Psychological Science · doi:10.1177/17456916231198479 · Cited by 11
“…2016; Fishkin, 1991; Jost et al., 2022; Sunstein, 2018) to affecting debates on high-stakes issues such as climate change (Falkenberg et al., 2022; Guilbeault et al., 2018; Jasny et al., 2015) and vaccinations (Horne et al., 2015; Jolley & Douglas, 2014; Kata, 2012; Mønsted & Lehmann, 2022).”
Background
Conspiracy Theory Belief: A Sane Response to an Insane World?
Pierre, J. M. (2023) · Review of Philosophy and Psychology · doi:10.1007/s13164-023-00716-7 · Cited by 8
Information cascades spread adaptive and maladaptive behaviours in group-living animals
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“Examples of rejection cascades in humans include avoiding poor investment options by rejecting the unsuccessful choices of naïve entrepreneurs (adaptive rejection cascade; Bernardo & Welch, 2001) and rejecting common childhood vaccinations (maladaptive rejection cascade; Kata, 2012; Reich, 2018).”
Background
Myths and facts about vaccination
Bezbaruah, R., Sailo, N., Zonunmawii, Z., Deka, K., Bhutia, Y. D., & Kakoti, B. B. (2024) · Elsevier eBooks · doi:10.1016/b978-0-443-18564-9.00018-7 · Cited by 7
Childhood immunization, vaccine hesitancy, and provaccination policy in high-income countries.
Thomsen, F. K. (2017) · Psychology Public Policy and Law · doi:10.1037/law0000126 · Cited by 7
‘A rational solution to a different problem’; understanding the verisimilitude of anti-vaccination communication
Lander, D., & Ragusa, A. T. (2020) · Communication Research and Practice · doi:10.1080/22041451.2020.1816022 · Cited by 7
“Sampling framework and research sample Sampling decisions were driven by assertions from WHO (2014) and others (Kahan, 2014; Kata, 2010, 2012; MacDonald, 2015) that social media is a leading source of VO communication.”
BackgroundMethod
Applying the Grasp-of-Evidence Framework to Design and Evaluate Epistemically Complex Learning Environments
Chinn, C. A., Duncan, R. G., & Av-Shalom, N. Y. (2021) · Information and Technology in Education and Learning · doi:10.12937/itel.1.1.inv.p004 · Cited by 7
Who is hesitant about Covid-19 vaccines? The profiling of participants in a French online cohort
Montagni, I., Touhami, K. O., Pouymayou, A., Pereira, E., Texier, N., Schück, S., & Tzourio, C. (2022) · Revue d Épidémiologie et de Santé Publique · doi:10.1016/j.respe.2022.02.004 · Cited by 7
“Personal characteristics such as sex, age, comorbidities, having children, and self-rated health are known to impact vaccine-related decision-making [11].”
Design Principles for an Educational Intervention Into Online Vaccine Misinformation
Veletsianos, G., Houlden, S., Reid, D., Hodson, J., & Thompson, C. P. (2022) · TechTrends · doi:10.1007/s11528-022-00755-4 · Cited by 7
“In terms of vaccine hesitancy, research into anti-vacci-nation propaganda demonstrates that the high emotional resonance of anti-vaccine messaging is a primary factor in pushing people from vaccine acceptance to vaccine hesi-tancy (Bean, 2011; Kata, 2012).”
Background
Emergence of Vaccine-Preventable Diseases: The Perfect Storm of Hesitancy, Refusal, a Pandemic, and War
McGrath, E. J. (2022) · Pediatric Annals · doi:10.3928/19382359-20220913-03 · Cited by 7
Get the Story Straight: Comparing Narrative and Logical-Scientific Communication to Capture Gen Z’s Interest in Science Podcasts
Opat, K., Irlbeck, E. G., Cummins, R. G., Li, N., & Boren-Alpízar, A. E. (2022) · Journal of Radio & Audio Media · doi:10.1080/19376529.2022.2145481 · Cited by 10
“For example, anti-vaccine activists post anti-vaccine stories to online bulletin boards and websites easily found by parents in search of vaccination information via search engines (Betsch, Ulshöfer, Renkewitz, & Betsch, 2011; Kata, 2012).”
Background
To Share or Not to Share: A Framing Analysis of Paid Vaccine Advertisements on Facebook during COVID-19 and Pro-Vaccine Mothers’ Willingness to Promote Vaccines within Their Peer Networks
Bradshaw, A. S. (2023) · Journal of Current Issues & Research in Advertising · doi:10.1080/10641734.2022.2153392 · Cited by 7
On the determinants of anti-COVID restriction and anti-vaccine movements: the case of IoApro in Italy
Alfano, V., Capasso, S., & Limosani, M. (2023) · Scientific Reports · doi:10.1038/s41598-023-42133-x · Cited by 7
Journal Club: Twitter as a source of vaccination information: Content drivers and what they're saying
Manning, M. L., & Davis, J. (2013) · American Journal of Infection Control · doi:10.1016/j.ajic.2013.02.003 · Cited by 7
AN ANALYSIS ON THE ANTI-VACCINATION MOVEMENT IN TURKISH DIGITAL PLATFORMS: EKŞİSÖZLÜK AND FACEBOOK
Tılıç, L. D., & ÖZCAN, H. U. (2021) · Eskişehir Türk Dünyası Uygulama ve Araştırma Merkezi Halk Sağlığı Dergisi · doi:10.35232/estudamhsd.778038 · Cited by 7
Vaccine hesitancy and implications on childhood immunisation in Malaysia
Manaf, N. H. A., Omar, M. A., & Suib, F. H. (2021) · International Journal of Health Governance · doi:10.1108/ijhg-05-2021-0055 · Cited by 7
Parental Declaration of Adverse Event Following Immunization in a Cross-Sectional Study in Poland
Barański, K., Gajda, M., Braczkowska, B., & Kowalska, M. (2019) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph16204038 · Cited by 7
“Hey Alexa, what do you know about the COVID-19 vaccine?”— (Mis)perceptions of mass immunization and voice assistants
Sharevski, F., Slowinski, A., Jachim, P., & Pieroni, E. (2022) · Internet of Things · doi:10.1016/j.iot.2022.100566 · Cited by 7
“s users prioritize general online sources over the advice of health professionals in their medical decision-making [3], the success nd persistence of vaccine skepticism and anti-vaccination narratives grows more troubling, threatening the global combat against he COVID-19 pandemic.”
Using the social structure of markets as a framework for analyzing vaccination debates: The case of emergency polio vaccination
Connelly, Y., Ziv, A., Goren, U., Tal, O., Kaplan, G., & Velan, B. (2016) · Human Vaccines & Immunotherapeutics · doi:10.1080/21645515.2016.1147637 · Cited by 7
“21 Information exchange is also a major tool in vaccination debates where complex medical information has to be communicated to the general public by authorities in a clear yet accurate way, and should compete with destructive information provided by the anti-vaccination groups.(10,22-23)”
Background

Authors: Kata, A.
Affiliations: McMaster University (CA)
Corresponding author: Kata, Anna
ORCID: Kata, Anna
Venue: Vaccine
Publisher: Elsevier BV
Published: 2012-05
Volume: 30
Issue: 25
Pages: 3778-3789
ISSN: 0264-410X (ISSN-L)
DOI: 10.1016/j.vaccine.2011.11.112
OpenAlex: W2062321610
Cited by: 1,094
References: 83
Citations by year: 2026: 36 · 2025: 65 · 2024: 77 · 2023: 111 · 2022: 124 · 2021: 151 · 2020: 158 · 2019: 81 · 2018: 73 · 2017: 58 · 2016: 60 · 2015: 47 · 2014: 20 · 2013: 24 · 2012: 9
FWCI: 56.58
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Vaccine (publishedVersion)
PubMed (publishedVersion)
Topics: Social Sciences › Sociology and Political Science › Misinformation and Its Impacts
Social Sciences › Health › Vaccine Coverage and Hesitancy
Health Sciences › Health Professions › General Health Professions › Health Literacy and Information Accessibility
Keywords: anti-vaccine movement, anti-vaccine activism, Web 2.0, misinformation, vaccine hesitancy, user-generated content, science communication, online health information
MeSH terms: Communication, Decision Making, Humans, Health Knowledge, Attitudes, Practice, Patient Acceptance of Health Care, Vaccination, Vaccines, Health Communication, Social Media

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Anti-vaccine activists, Web 2.0, and the postmodern paradigm - An overview of tactics and tropes used online by the anti-vaccination movement

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