It almost makes sense, in a most devious way, that the Russian government used a disinformation campaign to try to sway the 2016 elections. That campaign has been front and center in many news cycles. But a disinformation campaign that has garnered little attention was aimed at the public health of the United States.
This week we learned that nearly 600 Russia-linked Twitter accounts broadcast disinformation aimed at seeding dissent and confusion about insurance coverage under the Affordable Care Act. This campaign not only sought to exacerbate political tensions, but it was also implicitly aimed at depressing enrollment in viable health insurance coverage.
Even more frightening is a health-related Russian disinformation effort as insidious as anything we saw in the 2016 presidential campaign. This effort, to create doubt among Americans about the effectiveness of vaccines, was described in an article in last month’s American Journal of Public Health.
That report revealed that Russian agents, using online software applications known as bots, have worked since at least 2015 to create a false impression of surging skepticism about the safety of vaccines. Twitter was the principal channel of attack. The coordinated campaign used tweets to suggest that American public opinion on vaccine safety was equally divided, when it really wasn’t. There’s evidence that these efforts may be working. A recent Research America survey shows a 10 percent drop between 2008 and 2018 in the number of Americans who believe vaccinations are crucial to public health, although the Centers for Disease Control and Prevention hasn’t detected an equivalent decline in actual vaccination rates.
The attack should come as no surprise, since Russia has practiced the dark art of disinformation — дезинформация or dezinformatsiya in English — since at least the 1920s. In a foreshadowing of today’s attacks, in the 1980s Russia launched a campaign to sow confusion in the U.S. about AIDS, falsely claiming that the U.S. military had created the virus that causes this disease. This effort, known as Operation INFEKTION, was cooked up in East Germany and would have been well-known to Russian President Vladimir Putin, who was once a KGB agent.
Even though there is a strong, well established, peer-reviewed, and tested body of evidence that vaccines are safe, undermining Americans’ belief in the safety of vaccines has huge implications for public health.
Vaccines save lives. According to the CDC, over the last 20 years, vaccines have prevented more than 300 million illnesses, more than 20 million hospitalizations, and more than 700,000 deaths. Reducing vaccination rates would endanger lives.
Vaccines rely on something called herd immunity, which means that at least two-thirds of the target population must be immunized for the vaccine to succeed in reducing or preventing the spread of a disease. With most of the population vaccinated against a particular disease, it has a difficult time getting a foothold. The fewer people who are vaccinated against a particular disease, the lower the likelihood a vaccine program will work.
We believe there are three things the U.S. can learn from the disinformation campaign on the safety and effectiveness of vaccines.
First, we’ve learned that the Russians operate from a playbook that links seemingly disparate events. In the case of both AIDS and vaccine safety, they exploited pre-existing cynicism among groups or individuals outside the mainstream, planting doubts without apparent Russian links. For vaccines, Russians exploited a controversial report in the Lancet (that was later retracted by the journal) to exacerbate skepticism of vaccine safety so more parents would decline to vaccinate their children. (To be sure, the article had already generated home-grown anti-vaccine sentiment in the U.S.)
Second, we need to pay closer attention to public health measures that generate fear among those they are intended to protect, like vaccinations for children or fluoridated water.
Third, we must pay special attention to areas in which the West is widely seen as “winning” compared to Russia — in this case public health — making them targets for disinformation campaigns.
Looking ahead, what can we do to thwart future dezinformatsiya attacks? The federal government must take the lead on alerting the media and the public to the risks of purposefully misleading disinformation attacks. Public officials, including President Trump, must show a greater dedication to truth and facts. Whenever a prominent public official espouses support for baseless science, it helps those trying to subvert democracy. By relying on a swamp of bogus science, Russia has exploited loving parents with false, misleading, and dangerous information.
The federal government needs to work with the tech community to develop programs and algorithms to detect threats to our vital health information infrastructure from harmful lies about public health. Once such attacks are detected, Americans must work together to erect cyberwalls to thwart them. Just as the Trump administration this week belatedly authorized sanctions against any government engaged in electoral interference, similar authority must be deployed to protect public health. It’s time to call out and punish Russia for these attacks in terms it will understand, including trade sanctions and freezing it out of our business and financial markets.
Our Constitution makes clear that providing for our common defense is a solemn obligation for government. But our military alone is no longer enough to do this. We now need cyberdefenses to protect our national safety — and our public health.