An Analysis of Counter-Narratives to Disinformation about the COVID Vaccine

Rei Kamikawa
(Non-degree Student, Open University of Japan)

Sosei Oi
(Master’s Student, Hokkaido University Public Policy School)

Tomoya Maeda
(Master’s Student, Graduate Schools for Law and Politics, University of Tokyo)

May 28, 2024

1. Introduction

In 2019, the World Health Organization (WHO) designated vaccine hesitancy, which is referred to as “the delay in accepting or refusal of vaccination services despite their availability,”¹ as one of the “ten threats to global health,” highlighting it as a worldwide concern. One of the factors contributing to the spread of vaccine hesitancy is the dissemination of misinformation on the internet. Research reports on COVID-19 vaccination in Japan suggest that exposure to disinformation or misinformation through social media and online news may influence vaccination behavior.²

According to an internet survey conducted in 2021, vaccine hesitancy regarding the COVID-19 vaccine in Japan was observed at an overall rate of 11.3%. When stratified by age and gender, women aged 15 to 39 had the highest hesitancy rate at 15.6%.³ The underlying reasons for vaccine hesitancy among young women can be attributed to a heightened sense of mistrust towards vaccines due to the extensive dissemination of information about side effects of the Human Papilloma Virus (HPV) vaccine through media reports and on social media platforms.⁴

Additionally, internet surveys regarding rumors and misinformation about the COVID-19 vaccine have shown that women, in comparison to the general population, are more likely to respond with statements like “I have considered stopping vaccination” or “I have thought about waiting for a while” when making vaccination decisions. This suggests that rumors and false information surrounding vaccines are contributing to vaccine hesitancy in the decision-making process.⁵

Furthermore, so-called “naturalist” parents are inclined to refrain from vaccine administration. In present-day Japan, mothers tend to spend more time with their children, and among them, “naturalist” mothers often express concerns about the potential adverse effects of additives on their children. They prioritize additive-free and pesticide-free foods and products. This emphasis on natural living sometimes leads them to avoid seeking medical prescriptions for artificially produced pharmaceuticals when their children fall ill. The exchange of unfounded information on social media among these “naturalist” mothers has become a concerning issue.⁶

Additionally, emerging political parties seeking to garner support from this segment of “naturalist” mothers who hesitate on vaccine administration have gained a certain level of popularity.

Given the aforementioned circumstances, there is a concern that individuals among the “naturalist” mothers who are hesitant to receive the COVID-19 vaccine may come across false information about vaccines through various media outlets, which could lead them to avoid vaccination. In such cases, these mothers may not only avoid vaccination for themselves but may also refrain from having their children vaccinated. This paper explores how to address these apprehensions through the dissemination of counter-narratives.⁷

To formulate effective counter-narratives, this paper uses a methodology based on the process described in the Intensive Seminar at the Institute for Global Governance Research at Hitotsubashi University. In the following sections, we will outline this process. In Section 2, we will establish the personas targeted by purveyors of disinformation. Section 3 will provide the rationale behind setting up such personas. Sections 4 through 6 will delve into the specific examination of the information disseminated by the sources of disinformation, followed by the consideration of concrete strategies deemed effective as counter-narratives against these personas. In Section 7, we will address concerns regarding the methods discussed in this paper, as well as points to consider during their societal implementation. We will then conclude by summarizing the paper and presenting prospects.

2. Identification of Personas

To counter disinformation, it is crucial to identify the personas of the audience that information disseminators targets. Without identifying these personas, those seeking to combat disinformation cannot take appropriate actions to refine their objectives and measures for disseminating counter-narratives.

In this context, personas refer to specific individuals who serve as the intended recipients of the disseminated disinformation. To identify such individuals, various factors must be considered, including age, place of residence, occupation, educational background, as well as the media they typically consume, their beliefs, motivations, needs, emotions, and values. It’s important to note that personas, while exhibiting certain tendencies, do not necessarily hold rigid beliefs or ideologies. This is significant because countering narratives against individuals with firmly held beliefs can often prove challenging when attempting to influence their thinking.

Assume a hypothetical persona with vaccine hesitancy as follows: “Ryori Wakumi” (pseudonym). She is a 30-year-old homemaker raising children. She is considered a “naturalist” mother who is concerned about the potential negative impact of additives on her children. She is committed to consuming additive-free and pesticide-free foods and products. Consequently, when her child falls ill, she tends to avoid seeking medical prescriptions for artificially produced pharmaceuticals and leans towards natural remedies.⁸ This inclination gradually leads to vaccine hesitancy. It’s important to emphasize that her actions stem from her worries and are not indicative of a lack of affection for her child. She keeps herself informed through television and social media, often engaging in discussions with her mom friends. She does not adhere to any specific strong ideological beliefs.⁹ Furthermore, it’s worth noting that the choice of this persona is not based on gender stereotypes but rather on the premise that mothers who are considered “naturalists” are more susceptible to exposure to disinformation.¹⁰

3. Rationale for Persona Development

This section explains the basis for persona development. Firstly, the rationale for establishing the persona as a mother engaged in child-rearing is as follows. According to a survey, among the Japanese population, the proportion of people who refrain from vaccination is 11.3%. However, as explained, among young women aged 15 to 39, the rate of vaccine hesitancy is 15.6%, which is higher compared to the overall rate and the rate among older men, which is 4.8%. Given the current social structure in Japan, it is assumed that young women often engage in child-rearing, and it is estimated that there are approximately 5.93 million women responsible for raising preschool-age children (as of 2012). Based on these statistics, it can be estimated that there are around 890,000 mothers in Japan who are hesitant about vaccination.¹¹ Thus, it is evident that there is a considerable number of young women in Japan who are hesitant about vaccine administration.¹²

Secondly, the rationale for the persona as a “naturalist” mother without specific rigid ideological beliefs is as follows. Such mothers are influenced by political figures and parties who disseminate misinformation about vaccines. Specific instances illustrate that this persona aligns with the audience being targeted by politicians and parties disseminating disinformation about vaccines. For example, former Prime Minister Yukio Hatoyama, on September 14, 2022, posted disinformation on his X (Twitter) account, claiming that the “authority on anti-aging,” Dr. Takuji Shirasawa, stated that “WHO confirms the fact that the probability of severe illness from vaccines is three times that of COVID-19 hospitalization,” accompanied by an image.¹³ This claim contradicts the facts, and the WHO did not make such an announcement. As of May 20, 2023, this false post has received 556 reposts and 1,415 likes. Many accounts reacting to this post have profiles indicating that they are homemakers and involved in child-rearing. Additionally, Sanseito （参政党） emphasizes the dangers of the COVID-19 vaccine, especially for minors,¹⁴ while advocating for realization of safe food and medical practices that do not involve chemical substances.¹⁵ According to a major newspaper’s opinion poll, those who considered child-rearing and education policies as the primary focus during the 2022 Upper House elections predominantly voted for the party promoting these issues.¹⁶ This indicates that mothers, influenced by politicians, prioritize child-rearing and education policies over other political concerns.¹⁷

Finally, the personality traits and community characteristics of “naturalist” mothers are presented by summarizing the description of newspaper interviews.¹⁸ Generally, mothers often experience psychological anxiety during pregnancy and childbirth, particularly single mothers who tend to face social isolation in Japan.¹⁹ Concerned about the impact of the mother’s body on the child’s health and exposed to information (often misinformation or disinformation) suggesting that pesticides and additives affect the child’s health, these mothers become increasingly anxious. This can lead them to become “naturalists.”²⁰  Consequently, they make efforts to gather information and engage in online communities on platforms like LINE, Instagram, and other social media, as well as communities of mothers. It is also plausible that network marketing organizations that disseminate medical misinformation are involved in these communities.

4. Narratives by Disinformation Disseminator

To effectively counteract disinformation surrounding the COVID-19 vaccine for the persona previously presented, the following section explores specific measures. Building the foundation of analysis, it identifies the specific narratives and modes through which disinformation or misinformation is disseminated. This understanding will serve as the foundation for developing effective counter-narratives, as discussed in the subsequent sections.

Disinformation disseminators, as outlined in Section 3, spread information regarding the concerns mentioned. This includes the dissemination of misinformation or disinformation by politicians and political parties on social media platforms, as well as the spread of such information within closed or online “naturalist” mom communities, which may also involve network marketing organizations for profit.

As a result, the narratives being formulated, as discussed in Section 2, aim to amplify the anxieties experienced by the established persona by highlighting potential adverse effects on the health of both mother and child due to the COVID-19 vaccine. These narratives encourage an excessive inclination towards organic lifestyles and further exacerbate vaccine hesitancy.

5. Social Media as Platforms to Spread Counter-Narrative

As for the medium to disseminate the counter-narratives against narratives presented in Section 4, it can be suggested to utilize platforms such as X (formerly Twitter), Instagram, and TikTok.²¹ The persona is often involved in closed communities, but it is unclear what kind of information exchange occurs within these communities, making it difficult to disseminate counter-narratives.

Generally, effective counter-narratives should possess several key elements, including simplicity, surprise, specificity, credibility, emotional appeal, and narrative quality. In the counter-narratives this paper considers, main points to emphasize are four-fold: (1) clearly convey that the content is false, (2) demonstrate that vaccination can prevent severe illness, (3) use charts and graphs to present data understandably, and (4) appeal to emotions by framing the purpose of vaccination as “protecting children.” By incorporating these elements, it should be possible to alleviate the concerns regarding the potential adverse effects of COVID-19 vaccination on maternal and child health that disinformation spreaders are attempting to amplify through narratives.

Additionally, we consider narratives that promote vaccination by using X (formerly Twitter). Three key points are highlighted: (1) convey the opinions of trustworthy individuals, (2) share the opinions of other credible institutions, and (3) utilize visuals, such as photographs of doctors or babies, to appeal to the visual senses. Furthermore, analyzing the design and color schemes used by “naturalist” websites can enhance the effectiveness of counter-narrative presentations.

Who, then, is assumed to be trustworthy for the personas? According to a survey conducted by the Word of Mouth Japan Marketing Association (WOMMA) targeting young women, those who frequently use social media tend to place more trust in recommendations from influencers rather than traditional advertising (Figure 1). Therefore, for personas who believe in disinformation about vaccines on social media, communication from influencers is likely to be more effective than utilizing conventional TV commercials or advertisements. It would be desirable for well-known education experts who frequently appear on television and the internet to share accurate information.

Furthermore, according to a survey by the Ministry of Internal Affairs and Communications (MIC), when an individual establishes an online acquaintance with another person, his/her level of trust in the other tends to increase following a face-to-face meeting, in contrast to situations where their communication remains exclusively online. Hence, individuals possessing a significant social media following and a track record of delivering nationwide speeches might conceivably prove to be more proficient communicators.²³ While a persona who is elderly and kind-looking, and garners substantial trust among parents engaged in child-rearing can be anticipated as an effective communicator, a more comprehensive characterization of an effective communicator remains an ongoing area of research. Furthermore, it is imperative to contemplate how influencers should adeptly convey information, as this facet also necessitates further examination.²⁴

Figure 1. Comparison of impressions by frequency of use of social networking services

Source: MarkeZine Editorial. 2018. Wakai Josei ha Koukoku yori ‘Inhuruensa’ wo Shinrai. YouTuber Katuyo no Shisaku, Shintodo ha? (in Japanese) [Young Women Trust ‘Influencers’ More Than Advertisements. How Effective Are YouTube Influencer Strategies? [WOMJ Survey]]. https://markezine.jp/article/detail/29684, 29 July 2023.

6. Dissemination of Counter-Narratives through Blogging

When disseminating counter-narratives using social media, the information contained therein is constrained. To enhance the effectiveness of counter-narratives, it is proposed that individuals who initially hesitated to get vaccinated share their personal experiences of vaccination through platforms like blogs.²⁵ By doing so, personas are likely to have sympathy and change their minds because of similar personalities. If we can find individuals, among the influencers discussed in Section 5, who were initially skeptical about vaccination but later changed their minds, they could contribute by writing blogs or articles. As reference 18 exemplifies, publishing articles that conduct interviews with such individuals, and include stories that depict their experiences, could also be an effective strategy.

As discussed in Section 2, “naturalist” mothers tend to be vaccine-hesitant. Section 4 also pointed out that the narratives created by disinformation spreaders include elements that exacerbate concerns about vaccines’ potential adverse effects on mothers and children. As a counter-narrative to this, it is conceivable for “naturalist” influencers to make use of the online shopping websites and official social media accounts of companies offering organic foods and organic diapers, for instance. On these websites, they can share their experiences of getting vaccinated along with their children, depicting the process through posts and videos. Observing a persona’s familiar influencer undergoing the vaccination process, along with personal experiences, could potentially alleviate concerns about the health impact of vaccination on mothers and children.²⁶ If “naturalist” mothers frequently visit a particular website where they see other customers endorsing the products while also receiving vaccinations and remaining in good health, the company could anticipate continuous sales by promoting vaccination.²⁷

We can also speculate that disinformation about vaccines spreads around companies and organizations that provide organic food products. Under such circumstances, vaccine hesitancy would be likely to be prevalent among individuals within the organization as well as its consumers. In cases where internal initiatives discussed above are not expected to occur spontaneously, government authorities or local municipalities may consider undertaking measures such as providing public relations efforts directed at these companies and organizations.²⁸

7. Conclusion

We have explored methods for countering disinformation related to the COVID-19 vaccine, particularly with a focus on the persona of “naturalist” mothers in the context of child-rearing, by considering specific strategies for crafting counter-narratives. The approaches examined in Sections 5 and 6 are based on general descriptions of narrative formation methods and do not have empirical substantiation. It is hoped that these methods, as discussed in this thesis, will be put into practice by individuals, companies, and governments in the future. Of course, there have been some instances of influencer utilization by governments both domestically and internationally, and it would be beneficial to collect such cases and assess their effectiveness.

However, the perspective of narrative formation focusing on reaching out to isolated, child-rearing (particularly “naturalist”) mothers and alleviating their concerns has not been adequately addressed so far. First and foremost, there is a need for intra-familial dialogues, but beyond that, it is also incumbent upon companies and governments to engage in appropriate information dissemination and narrative formation. The emotion at the heart of this issue is the anxiety regarding the health of mothers and children. In response to this, it is imperative to shape narratives that assuage anxieties rather than exacerbate them with coercive tactics. This is a crucial consideration for individuals or organizations occupying certain social positions when crafting narratives.

【Translated by】
Takahiro NAKAJIMA
(Master’s student, Graduate School of Law)

 

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Notes

[1]MacDonald N. E. and SAGE Working Group on Vaccine Hesitancy. 2015. Vaccine hesitancy: Definition, scope and determinants. Vaccine 33(34): 4163.

[2]The Center for Global Communications at the International University of Japan. 2022. Innovation Nippon Hokokusho, Wagakoku niokeru Gi Gojouhou no Jittai no Haaku to Syakaitekitaisyo no Kento: Seiji Koronawakuchinto no Jisshoubunseki (in Japanese) [Innovation Nippon Report, Understanding the Reality of Disinformation and Misinformation in Our Country and Exploring Societal Responses: Empirical Analysis of Disinformation and Misinformation on Politics, COVID-19, and Vaccines]. http://www.innovation-nippon.jp/reports/2021IN_report_full.pdf, 29 July 2023.

[3]National Research and Development Agency, National Center of Neurology and Psychology. 2021. Shingatakoronawakushinkihisha ha Ichiwari. Kihisha no Nenrei Seibetsusa, Riyu to Kanrensuru Youin wo Akirakani: Nihon Hatsu Daikibo Intanettochosa yori (in Japanese) [10% of the Population Avoids the Novel Coronavirus Vaccine. Revealing Reasons and Associated Factors Focusing on Age and Gender Differences in Evaders: From Japan’s First Nationwide Large-Scale Internet Survey]. https://www.ncnp.go.jp/topics/2021/20210625p.html, 19 May 2023.

[4]Miwako Hosoda. 2023. Vaccine Hesitancy in Japan: From a Perspective on Medical Uncertainty and Trans-Scientific Theory. F1000Res, 2022(11): 1103.

[5]Hidehiko, Hukunaga. 2022. Shingatakoronauirusuwakuchin to Ryugen Dema no Kakusan (in Japanese) [Spread of Coronavirus Rumors and Hoaxes]. The NHK Monthly Report on Broadcast Research, 72(1): 2-23.

[6]Azusa, Mizuno. 2019. Katayotta Johoahure… Hassin Hajimeta (in Japanese) [A Surge of Biased Information Leads Me to Start Offering Information]. Asahi Shimbun. https://www.asahi.com/sp/articles/SDI201903281552.html, 19 May 2023; Sumire, Kunieda. 2021. Shingatakorona ‘Hanwakuchinha‘ ha Naniwo Kangaeteirunoka (in Japanese) [Novel Coronavirus: What Does Anti-Vaccine Group Think?]. Mainichi Shimbun. https://mainichi.jp/articles/20210707/k00/00m/040/134000c, 19 May 2023.

[7]This paper does not examine the impact that dissemination of disinformation and misinformation about the HPV vaccine has on COVID vaccine hesitancy.

[8]This paper does not reveal whether mothers themselves hesitate to get vaccinated, mothers hesitate to get their children vaccinated, or both phenomena happen simultaneously.

[9]Here, the persona setting regarding occupation is that of a homemaker. However, it is essential to consider carefully whether such a setting accurately reflects reality and is appropriate. Furthermore, this paper does not address the educational background and place of residence.

[10]Major measures of vaccine hesitancy and its components are detailed in Masaki, Machida and Shigeru, Inoue. 2023. Vaccine Hesitancy (Wakuchinchucho) no Genjo, Kanrenyoin, Hyoka, Taisaku (in Japanese) [Vaccine Hesitancy and Its Current Situation, Components, Assessment, and Measures]. Japanese Journal of Public Health, 70(8); 474-482.

[11]National Research and Development Agency, National Center of Neurology and Psychology. Id. NTT Data Institute of Management Consulting, Inc. 2016. Heisei Nijunananendo Ikuji to Kaigo no Daburukea no Jittai ni Kansuru Chosahoukokusho (in Japanese) [2016 Survey Report on the Reality of Double Care for Child Rearing and Elder Care]. Cabinet Office commissioned survey. https://www.gender.go.jp/research/kenkyu/pdf/ikuji_printing_01.pdf, 3 July 2023.

[12]When considering rigorously, it is conceivable that among vaccine-hesitant individuals, some may already have reservations about the vaccine from the first dose. In this survey, given that more than 70% of vaccine-hesitant individuals in the aforementioned online survey cited concerns about adverse reactions as their reason, it can be inferred that they were hesitant about receiving subsequent doses. However, in this paper, both groups are not distinguished, and individuals who have reservations about receiving the vaccine in general are treated as vaccine hesitant.

[13]Yukio Hatoyama. (14 September 2022). “I asked Dr. Takuji Shirasawa again during the study group. The question was whether it’s true that the WHO has recognized that the probability of developing severe symptoms from the vaccine is three times higher than the probability of being hospitalized due to COVID-19. Minister Taro Kono denied it as misinformation, but Dr. Shirasawa confirmed it as a fact. I believe in the words of Dr. Shirasawa, an authority in anti-aging.” [post (formerly tweet), originally in Japanese]. https://twitter.com/hatoyamayukio/status/1570033189388943361, 19 May 2023.

[14]Sanseito. 2023. Shingatakoronawakuchin Seisaku (2020 nen 10 gatsu Kaitei) (in Japanese) [Novel Coronavirus Vaccine Policy (revised in Oct. 2020)]. https://www.sanseito.jp/news/5105/, 29 July 2023; Sanseito. 2023. Shitsumonshuisho (in Japanese) [Interrogatory]. https://www.sanseito.jp/question/, 29 July 2023.

[15]Sanseito. 2023. Mittsu no Jutenseisaku (in Japanese) [Three Key Policies]. https://www.sanseito.jp/prioritypolicy/, 29 July 2023.

[16]Yomiuri Shimbun Online. 2022. Sanseito ha Naze Giseki wo Kakutoku Dekitanoka… Deguchichosa kara Mietekita Mittsu no Youin (in Japanese) [Why Sanseito Won Seats: Three Factors from Exit Polls and Election Results]. https://www.yomiuri.co.jp/column/opinionpoll/20220810-OYT8T50005/2/, 29 July 2023.

[17]While prioritizing childcare and education policies as election issues does not immediately correlate with the idea that mothers do not have particularly strong ideological beliefs, it implies a relative lack of emphasis on other political issues.

[18]Noziru Yamashita. 2021. Koronaka de Zouka Esuenuesu de Wadai ni Naru “Sizenhamama” tohaNanimono Nanoka? ‘Wakuchinsessyu ha Enuji, Sizen na Osan de Uchu to Ittai ni Naru, Kyabetsu de Netsusamashi (in Japanese) [Who Are the ‘Natural Moms’ Gaining Popularity on Social Media Amid the COVID-19 Pandemic? ‘No to Vaccination, Harmonizing with the Universe through Natural Childbirth, Healing with Cabbage…]. Bunshun Online. https://bunshun.jp/articles/-/50946, 19 May 2023; Mao, Onishi. 2021. Hanwakuchinkatsudo kara Ashi wo Aratta Kanojo ga Kiduitakoto Hontou ni Hoshii noha Nakama dattanokamoshirenai (in Japanese) [What She Realized After Walking Away from Anti-Vaccine Activism: Maybe All She Truly Wanted Was ‘Companionship’]. Tokyo Keizai ONLINE. https://toyokeizai.net/articles/-/474236, 19 May 2023.

[19]The fundamental alleviation and resolution of such issues involve close relatives, such as husbands, who support pregnant women to alleviate their feelings of isolation and anxiety. However, seeking various measures at the household level as a countermeasure against disinformation can be costly. Therefore, the effectiveness of this strategy, including alternative approaches, will be considered at a different opportunity.

[20]In this paper, the focus is primarily on the scenario where individuals with a “naturalist” inclination may develop vaccine hesitancy, but it is also conceivable that individuals who are hesitant about vaccines may adopt a “naturalist” mindset in some cases (see Note 12). Further research is needed to provide a concrete understanding of the mechanisms underlying both phenomena.

[21]Practical research using social media can be found in Masaharu Somiya, Reona Okada, Takahiro Kinoshita, and Kosuke Yasukawa. 2022. Science and Medical Communication on Social Networking Services by COV-Navi, a Health Communication Project for COVID-19 Vaccines. Japanese Journal of Science Communication, 31. 29-38.

[22]Ministry of Internal Affairs and Communications. 2018. White Paper Information and Communications in Japan Year 2018.

[23]A prominent example is Chikara Oyano, an educator and a critic, who disseminates information through platforms like YouTube, the former Twitter (X), and Instagram. https://www.oyaryoku.jp/lecture.html#kouen-jisseki, 19 May 2023.

[24]The U.S. government has requested influencers to use social media platforms to promote COVID-19 vaccination. Jack Kelly. 2021. Issendoru Sikyuu, ‘Inhuruensagundan’ Douin mo Beikoku no Wakuchinsuishinsaku (in Japanese) [Providing 1 Thousand Dollars, Mobilizing ‘Influencer Squad’, U.S. Vaccine Promotion Policy]. Forbes JAPAN. https://forbesjapan.com/articles/detail/42771, 3 July 2023.

[25]While not a blog, the article in the footnote 18 illustrates a similar methodology.

[26]Significant in terms of providing an opportunity to understand that vaccine administration and an organic lifestyle can coexist in the context of maternal and child health.

[27]In contrast, some companies may seek economic rationality by arousing anxiety through emphasizing the dangers of ingesting artificial substances into the body, in order to boost sales. It is imperative to understand the actual situation.

[28]If delving deeper, it is conceivable to establish mechanisms that mandate the display of vaccination promotion advertisements on internet websites or provide incentives such as subsidies or tax advantages for companies that display such advertisements. Particularly in the case of the former, however, this would involve restrictions on the freedom of expression of the respective companies, thus requiring careful consideration.