Infertility: A Common Target of Antivaccine Misinformation Campaigns

"Fearmongering about 'depopulation' by vaccines remains a longstanding antivaccine conspiracy theory, the base of which (that chemicals have been added to vaccines to deliberately cause infertility) has been twisted and modified over time."



Misinformation, disinformation, and conspiracy theories about vaccines are key drivers of vaccine hesitancy and refusal. Dating back decades, various conspiracy theories have linked vaccination with infertility and thus harmed vaccination programmes in Africa, Asia, and Central America, particularly against polio and tetanus. With COVID-19 vaccines, the claim that vaccines cause infertility has taken on new forms and spread far beyond where it had been before. This paper explores the history of this antivaccine narrative, provides 3 case studies to illustrate how it has been promulgated in the past and repurposed to COVID-19 vaccines, and offers strategies to counter it.



Case study #1 examines narratives around the human papillomavirus (HPV) vaccine, with a focus on the United States (US). Based on the argument that vaccination against a sexually transmitted infection (STI) will encourage promiscuity and risky sexual behaviour among teens, many messages, as early as the mid-2000s, dissuaded parents from vaccinating their children against HPV. This initial anti-vaccine campaign may have provided impetus for the later spread of vaccine misinformation focused on the effect of HPV vaccination on female fertility. Despite evidence to the contrary, the myth that HPV vaccines can impair the fertility of young women remains active today, with antivaccine social media activists making analogies between the two.



Case study #2 looks at tetanus vaccination of young women in Africa. In 2022, US politician Robert F. Kennedy Jr.'s antivaccine group Children's Health Defense released a documentary entitled "Infertility: A Diabolical Agenda". As part of a fear-based campaign, antivaccine advocates conflated ongoing clinical trials of an experimental antifertility vaccine, which conjugated a subunit of human chorionic gonadotrophin (hCG) hormone with diphtheria or tetanus toxoid proteins, to ongoing tetanus immunisation programmes led by the World Health Organization. Though there was no connection between the immunisation programme and the clinical trial, the confusion between the two led to distrust of the tetanus vaccines. To accentuate the sense of dread, "Infertility" employs clips from films such as "The Constant Gardener", whose plot involves the discovery that a pharmaceutical company had tested a dangerous drug in Kenya with disastrous results that it would go to any lengths to cover up. Prominent is a scene in which a woman discusses her repeated miscarriages.



Case study #3 explores the conspiracy that there is a link between COVID-19 vaccination and infertility. While some previous vaccine misinformation has been politically targeted (such as campaigns aimed at evangelical Christians suggesting that vaccination against HPV encourages promiscuity), polarisation regarding COVID-19 vaccines appears to be even more extreme. Politicians including Florida Governor Ron DeSantis contributed to false information regarding the vaccine and infertility, suggesting that nurses may not want to take the vaccine if they are trying to get pregnant. A number of orthodox Jewish communities in the US were targeted for misinformation regarding COVID-19 vaccines and infertility, resulting in vaccine hesitancy. In Black communities, such targeting played on fears of medical experimentation linked to the Tuskegee Syphilis Study, conducted between 1932 and 1972.



Turning to strategies for countering misinformation, the paper observes that fear mongering about the "long-term effects" of vaccines has been a staple of antivaccine messaging since the last century. By its nature, collecting this type of long-term data takes several years after testing and authorisation, allowing anti-vaccine activists to exploit infertility as a gap in safety data for a decade or longer. As such, these tactics should be anticipated for any new vaccines released in the future. Messaging regarding the COVID-19 vaccines currently should emphasise the risks of COVID-19 infection to pregnant persons, the potential for actual fertility risk in men posted by COVID-19, and the evidence to date of vaccine safety during pregnancy and breastfeeding.



A number of debunking resources have been developed, such as the Kaiser Family Foundation's series of videos on COVID-19 and fertility. Recorded in English and Spanish, this series takes on major anti-vaccine talking points and shows how they are false. However, because debunking alone often has limited reach once an idea has gone viral, the concept of "prebunking", or teaching individuals how to spot potential misinformation as a way to inoculate against its spread, has gained ground. Teaching general principles of skepticism and critical thinking may be useful in "inoculating" the population against the specific forms of misinformation that can be anticipated, particularly when combined with education about more general rhetorical forms of misinformation, such as straw men arguments, appeals to false authority, and conspiracy theories.



"Unfortunately, rigorous studies on the application of these techniques to countering misinformation and disinformation about COVID-19 vaccines are still scant," the researchers point out. As they conclude, such studies "are desperately needed because, by the time the next pandemic arrives, the misinformation problem is almost certainly going to be much worse than it has been for COVID-19."