Natural Stings: Selling Distrust About Vaccines on Brazilian YouTube

"YouTube has great influence in the spread of anti-vaccination content in Portuguese..."

Brazil was the sixth country by reported cases of measles in 2019, despite the National Immunization Program (NIP)'s offering of 20 different types of vaccines free of charge to the population. Researchers have associated the decrease in immunisation to a strengthening of anti-vaccination movements, largely via social media. YouTube's recommendation system, which is responsible for 70% of total viewing time, drives the promotion of certain content within the site, including misinformation and disinformation (M&D). This study investigates M&D about vaccines using a case study approach to understand how M&D about vaccines circulate on YouTube in Portuguese, and which channels create and disseminate this kind of content.

The researchers used YouTube Data Tools to obtain the data used in this study. The tool was set up using the option "Video Network", which creates a network of relations between videos via YouTube's "related videos" feature. The search query was "vacina+autismo" (vaccine+autism) due to the prevalence of a false link spread first in 1998 with the publication of a fraudulent paper that was later retracted but is still used as an argument by anti-vaccination movements.

This process led to the initial sample, consisting of 158 videos. The researchers performed classification on the initial sample between February 11-18 2020, using a protocol of vaccine M&D developed for this study. They also created a secondary sample visiting the channels containing M&D videos from the initial sample between March 3-11 2020. The videos selected contained the word "vacina", or related to vacina, in the title. These videos were classified from March 12-20 2020, using the same protocol from the initial sample. Therefore, the sample has 52 videos containing M&D about vaccines in total: 23 from the initial sample and 29 from the second sample. The videos were uploaded between 2010 and 2019.

In total, the main examples of M&D in both samples were: dangerous ingredients in vaccines (appearing in 28 videos), defense of self-direction (25 videos), promotion of products and therapies as vaccine alternatives (22 videos), vaccines cause diseases (18 videos), vaccines are part of conspiracies (17 videos), and severe collateral effects (14 videos).

The researchers identified 39 brands advertising on 13 videos of the M&D sample. Besides global brands, they found advertisements from the governments of India and Japan. They also highlight the presence of advertisements from companies of alternative health and wellness products, saying "It is possible that the brands could be unaware that they are helping to fund channels that spread M&D about vaccines, although alternative health advertisers are potentially reaching the audience they want to reach."

In addition, the channels in the sample profit by selling courses, books, or alternative treatments, or by asking for donations through fundraising platforms or via deposits directly into bank accounts. There is also a collaboration between channels that promote alternative health services; for example, the channels promote other professionals who support alternative therapies or other content creators that endorse M&D about vaccines.

One strategy used by 6 channels is to ask for testimonials from the audience, aiming to demonstrate the effectiveness of alternative therapies or courses they promote. Furthermore, some channels send daily "health tips" that offer discounts to products and claim that use of these services is necessary to ensure the public will receive new content. Five of 20 channels make these communication services available, and one channel maintains 10 WhatsApp groups.

The researchers also analysed the upload date from the videos containing M&D in the sample to verify if YouTube could be in the process of removing videos from the sample that could have been recently uploaded. In short, they had not. One finding: From 23 videos uploaded in 2018, 8 still had advertisements associated with them. During the time the researchers were extracting the data from the sample, the videos uploaded in 2018 alone accumulated 445,519 views.

They write, "Despite YouTube's statements on their fight against misinformation, M&D about vaccines continue to be disseminated in videos in Portuguese, reaching a large audience. Even when channels are identified as creators of harmful misinformation, their videos continue to be available to the public and can be disseminated in other platforms, such as WhatsApp..."

In light of these findings, the researchers suggest:

• YouTube must adopt transparent approaches to counter M&D and ensure that content creators follow user policies.
• The platform needs to guarantee that M&D will not be financially stimulated through the YouTube Partner Program, which lets creators monetise their videos on YouTube.
• Special attention should be given for languages other than English, since YouTube's current policies to fight harmful content do not seem to be applied to these languages. For that, YouTube needs to have a qualified team of human content moderators for different countries and languages.
• Advertisers need to track the content their publicity revenue is funding and to ask for effective mechanisms to exclude their ads from harmful content.