Since the measles outbreak began about a month ago, Kaley McLachlan-Burton has developed a routine.
She returns home from work, lays on the floor and yells: “Puppy pile.” Her Chihuahua mixes, Birdie and Bobby, race to envelop her.
“That’s been a nice release to go home at night and play with dogs,” said McLachlan-Burton, an environmental outreach specialist with Clark County Public Health.
Measles was declared eradicated in the United States in 2000 due to high vaccination rates, according to the Centers for Disease Control and Prevention. But unvaccinated travelers (Americans or foreign visitors) bring measles back to or into the U.S.
The World Health Organization ranked “vaccine hesitancy” as one of the 10 threats to global health in 2019.
According to WHO, vaccinations prevent 2 million to 3 million deaths per year.
Last year, there were 17 measles outbreaks and 350 cases in the United States, according to The Associated Press. A drop-off in vaccinations also led to 41,000 people in Europe infected with measles just in the first six months of 2018, the most since 2010.
Release is necessary for McLachlan-Burton, since she’s part of a three-person team spearheading communications for Public Health during the outbreak, along with Christine Harper, an environmental health specialist, and Marissa Armstrong, Public Health’s public information officer.
That group spends hours each day planning messaging, monitoring Facebook and Twitter and responding to comments and questions they encounter on social media. It’s a task that can be aggravating and repetitive, but social media duties during a disease outbreak are one of the most important aspects to Public Health’s response work.
That’s because Public Health isn’t just fighting an outbreak; the staff is also fighting convincing misinformation from anti-vaccinations advocates and groups. Clark County Public Health Director Dr. Alan Melnick said that even if something isn’t true, if people see it enough they can come to find it credible.
“Some of it is really sophisticated,” Melnick said of the propaganda. “To someone who is a layperson, it can seem really believable.”
The Royal Society for Public Health, a charity in England, Wales and Scotland, recently published a report on vaccine misinformation that included a survey of more than 2,400 parents and 2,000 other adults.
The report found that 2 in 5 parents of children younger than 18 were often or sometimes exposed to negative vaccine messages on social media or online forums, including half of parents with children younger than two.
While only 1 in 10 parents said they believed what they saw on social media, the report still concluded that consistent exposure to misinformation could have a negative effect on vaccination rates over time. The RSPH has called on Facebook and Twitter to take some responsibility in counteracting the spread of the misinformation, similar to calls those social media companies received after the last U.S. presidential election.
Some of the same Russian online trolls that interfered in that election have also spread misinformation about vaccines on Twitter, playing both pro-vaccination and anti-vaccination sides, trying to create a wedge issue, according to research conducted by scientists at George Washington University.
A 2017 Minnesota measles outbreak that sickened 79 people, and hospitalized 22 people, saw heavy interference from anti-vaccination campaigns. Those campaigns were targeted to Minnesota’s Somalian population, and played up the debunked link between vaccinations and autism.
Propaganda from the anti-vaccination crowd is available on social media, YouTube and even reputable news sources. McLachlan-Burton said she saw a post on CNBC’s website with misinformation about vaccinations. Many people might consider the post to be a news story, but it was actually sponsored content paid for by an anti-vaccination advocacy group.
“It looks legitimate. It is really difficult,” McLachlan-Burton said. “I went to (University of Washington) and have a science background, so I think I have more tools in my tool belt to be able to suss out what is credible information and what isn’t, but most people don’t have that.”
McLachlan-Burton and Armstrong said social media, while annoying at times, is an extremely important way to communicate with the public, answer questions and learn how to fill in information gaps on things that people might be interested in. They said many people ask genuine and legitimate questions about measles, the current outbreak and vaccinations.
“We’ve had people who follow us ask, ‘Why don’t you guys just turn off all the comments and then you don’t even have to deal with it?’ ” Armstrong said. “Which, as enticing as that may be sometimes, we want people to be able to ask questions because not everyone is going to call in to the health department and ask a question. For a lot of people, social media is where they get their information, and if that’s where they feel comfortable asking a question … we want to be able to reach people where they’re at.”
Much of the misinformation centers on the safety of vaccinations, and whether vaccinated people can spread measles through shedding. Andrew Wakefield, a discredited gastroenterologist, sparked the misinformation linking vaccinations and autism, which has been repeatedly debunked.
Public Health has had to deal with conspiracy theories about the outbreak. There have been threads on Facebook claiming local officials are fudging the outbreak numbers, and Melnick said there’s been accusations that big pharmaceutical companies and public health are profiteering from vaccinations, which in reality are as affordable as medical treatment gets.
“We’re in governmental public health here,” Melnick said. “We’re not getting paid to provide vaccine. We don’t even administer the vaccine here. We work with providers to administer the vaccine. I don’t have a dog in the fight financially, but that stuff is out there on social media. In fact, it’s costing the county money to do this. But the money we’re spending isn’t going to the pharmaceutical industry here.”
McLachlan-Burton and Armstrong said they try to focus on the positive with social media. Clark County and Portland public health workers recently received a Twitter shoutout from Chelsea Clinton. McLachlan-Burton thanked Clinton, and Clinton thanked her back. “I was tweeting back and forth with Chelsea last week,” McLachlan-Burton said giddily.
“My co-workers are probably sick of hearing me sigh and go, arrrr, and all the funny noises I’m making,” McLachlan-Burton added. “I think what we have just naturally started doing is having a sense of humor about it. This is a very serious thing, but you can really get bogged down easily in all the negativity unless you can have a sense of humor about it.”
While McLachlan-Burton returns home to dogs who help bring relief, the madness never really ends. Many people look at Facebook or Twitter at night, and like she explained, “It’s not like the old media, where we can say, ‘Here’s our availability for the day,’ and then everyone goes home.” Sometimes after work she’ll find herself texting Armstrong about an incorrect measles post she saw on her personal Facebook page.
“Social media is one of those weird things,” she continued, “where even when you’re trying to unplug or get away from it, you can’t.”