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These Moms Are Trying to Stop It,” NBC News, May 21, 2019, https://www.nbcnews.com/tech/internet/moms-go-undercover-fight-fake-autism-cures-private-facebook-groups-n1007871.

51 Renée DiResta and Claire Wardle, “Online Misinformation About Vaccines” (paper contributed to “Meeting the Challenge of Vaccination Hesitancy,” Sabin-Aspen Vaccine Science & Policy Group, May 2020, https://www.sabin.org/app/uploads/2022/04/Sabin-Aspen-report-2020_Meeting-the-Challenge-of-Vaccine-Hesitancy.pdf).

52 Julia Carrie Wong, “How Facebook and YouTube Help Spread Anti-vaxxer Propaganda,” The Guardian, February 1, 2019, https://www.theguardian.com/media/2019/feb/01/facebook-youtube-anti-vaccination-misinformation-social-media; Jessica Glenza, “Majority of Anti-vaxx Ads on Facebook Are Funded by Just Two Organizations,” The Guardian, November 14, 2019, https://www.theguardian.com/technology/2019/nov/13/majority-antivaxx-vaccine-ads-facebook-funded-by-two-organizations-study.

53 WHO, Measles Outbreak in the Pacific—Situation Report No. 9: Joint WHO/UNICEF Measles Outbreak Response and Preparedness in the Pacific, World Health Organization, 2019, https://www.who.int/docs/default-source/wpro---documents/dps/outbreaks-and-emergencies/measles-2019/measles-pacific-who-unicef-sitrep-20200103.pdf.

54 Erin Schumaker, “Low Vaccination Rate and Deadly Medical Mistake Led to Samoa Measles Outbreak: Health Experts,” ABC News, November 27, 2019, https://abcnews.go.com/Health/low-vaccination-rate-deadly-medical-mistake-led-samoa/story?id=67317110.

55 Renée DiResta, On Virality: How the Anti-vaccine Movement Influences Public Discourse Through Online Activism (The Lancet and Financial Times Commission Report), July 15, 2020, https://www.governinghealthfutures2030.org/wp-content/uploads/2021/10/072020_Renee-DiResta_On-virality-How-the-antivaccine-movement-influences-public-discourse-through-online-activism.pdf.

56 The outbreak in Brooklyn began in September 2018 and lasted through July 2019. See Jane R. Zucker et al., “Consequences of Undervaccination—Measles Outbreak, New York City, 2018–2019,” New England Journal of Medicine 382, no. 11 (March 2020): 1009–1017, https://doi.org/10.1056/NEJMoa1912514.

57 “Combatting Vaccine Misinformation,” Meta Newsroom, Meta, March 7, 2019, https://about.fb.com/news/2019/03/combatting-vaccine-misinformation.

58 Erin Schumaker, “Anti-vaccine Leaders Targeting Minority Becomes Growing Concern at NYC Forum,” ABC News, November 10, 2019, https://abcnews.go.com/Health/rfk-jrs-york-city-vaccine-forum-highlights-concerns/story?id=66158336.

59 DiResta and Garcia-Camargo, “Virality Project (US).”

60 Renée Diresta and Gilad Lotan, “Anti-vaxxers Are Using Twitter to Manipulate a Vaccine Bill,” Wired, June 8, 2015, https://www.wired.com/2015/06/antivaxxers-influencing-legislation.

61 The Virality Project, “Memes, Magnets and Microchips: Narrative Dynamics Around COVID-19 Vaccines,” Stanford Digital Repository, February 24, 2022, https://doi.org/10.25740 /mx395xj8490.

62 There is a case study of our joint effort here: Hussain S. Lalani et al., “Addressing Viral Medical Rumors and False or Misleading Information,” Annals of Internal Medicine, August 2023, https://doi.org/10.7326/M23-1218.

63 Anna Kata, “Anti-vaccine Activists, Web 2.0, and the Postmodern Paradigm—an Overview of Tactics and Tropes Used Online by the Anti-vaccination Movement,” PubMed, December 13, 2011, https://pubmed.ncbi.nlm.nih.gov/22172504.

64 William Rowley, Cow-Pox Inoculation: No Security Against Small-Pox Infection (London: J. Barfield, 1805), 11.

65 Richard B. Gibbs, letter reproduced in Human Nature: A Monthly Journal of Zoistic Science, June 1867, 176, in archive of the International Association for the Preservation of Spiritualist and Occult Periodicals, http://iapsop.com/archive/materials/human_nature/human_nature_v1_n3_june_1867.pdf. Although this letter comes from Richard B. Gibbs, the detail about the syphilitic family is something that Gibbs quotes from a “Dr. Smedley, of Matlock Bank Hydropathic Establishment.”

66 Francis T. Bond, “The Vaccination Problem,” British Medical Journal 2, no. 1929 (1897): 1828.

67 Tara C. Smith, “Vaccine Rejection and Hesitancy: A Review and Call to Action,” PubMed, July 18, 2017, https://pubmed.ncbi.nlm.nih.gov/28948177.

68 Micah Lee, “Network of Right-Wing Health Care Providers Is Making Millions Off Hydroxychloroquine and Ivermectin, Hacked Data Reveals,” The Intercept, September 28, 2021, https://theintercept.com/2021/09/28/covid-telehealth-hydroxychloroquine-ivermectin-hacked/.

69 Richard M. Carpiano et al., “Confronting the Evolution and Expansion of Anti-vaccine Activism in the USA in the COVID-19 Era,” Lancet 401 (2023): 967–970.

70 Renée DiResta, “The Anti-vaccine Influencers Who Are Merely Asking Questions,” The Atlantic, April 24, 2021, https://www.theatlantic.com/ideas/archive/2021/04/influencers-who-keep-stoking-fears-about-vaccines/618687.

71 Nicki Minaj (@NICKIMINAJ), “My cousin in Trinidad won’t get the vaccine cuz his friend got it & became impotent…,” Twitter, September 13, 2021, https://twitter.com/NICKIMINAJ/status/1437532566945341441.

72 Grant Rindner, “Nicki Minaj’s Cousin’s Friend’s Balls, Explained,” GQ Magazine, September 16, 2021, https://www.gq.com/story/nicki-minaj-vaccine-twitter-met-gala-2021.

73 Robyn Dixon, “Want to Skip the Vaccine in Russia? You Could be Suspended from Work,” Washington Post, July 28, 2021, https://www.washingtonpost.com/world/europe/russia-vaccine-rules-putin/2021/07/27/640ea8b6-ebff-11eb-a2ba-3be31d349258_story.html; Daria Litvinova, “Russia Mandates Vaccinations for Some as Virus Cases Surge,” AP News, June 25, 2021, https://apnews.com/article/europe-russia-health-coronavirus-pandemic-business-42d0c14f0545371e16a360b677cb4c38.

74 Michael R. Gordon and Dustin Volz, “Russian Disinformation Campaign Aims to Undermine Confidence in Pfizer, Other Covid-19 Vaccines, U.S. Officials Say,” Wall Street Journal, March 7, 2021, https://www.wsj.com/articles/russian-disinformation-campaign-aims-to-undermine-confidence-in-pfizer-other-covid-19-vaccines-u-s-officials-say-11615129200.

75 Reuters Fact Check, “Fact Check—Chimpanzee Adenovirus Vector in the AstraZeneca COVID-19 Vaccine Does Not Cause Monkeypox,” Reuters, May 24, 2022, https://www.reuters.com/article/factcheck-health-monkeypox/fact-check-chimpanzee-adenovirus-vector-in-the-astrazeneca-covid-19-vaccine-does-not-cause-monkeypox-idUSL2N2XG0W1.

76 Manveen Rana and Sean O’Neill, “Russians Spread Fake News over Oxford Coronavirus Vaccine,” The Times, October 16, 2020, Internet Archive, https://web.archive.org/web/20201021023753/https://www.thetimes.co.uk/article/russians-spread-fake-news-over-oxford-coronavirus-vaccine-2nzpk8vrq.

77 Charlie Haynes and Flora Carmichael, “The YouTubers Who Blew the Whistle on an Anti-vax Plot,” BBC News, July 25, 2021, https://www.bbc.com/news/blogs-trending-57928647.

78 “July 2021 Coordinated Inauthentic Behavior Report,” Meta, August 10, 2021, https://about.fb.com/news/2021/08/july-2021-coordinated-inauthentic-behavior-report.

79 Adam Satariano and Davey Alba, “Burning Cell Towers, out of Baseless Fear They Spread the Virus,” New York Times, April 10, 2020, https://www.nytimes.com/2020/04/10/technology/coronavirus-5g-uk.html.

80 Kelvin Chan, Beatrice Dupuy, and Arijeta Lajka, “Conspiracy Theorists Burn 5G Towers Claiming Link to Virus,” AP News, April 21, 2020, https://apnews.com/article/health-ap-top-news-wireless-technology-international-news-virus-outbreak-4ac3679b6f39e8bd2561c1c8eeafd855.

81 Jeff Horwitz, Broken Code: Inside Facebook and the Fight to Expose Its Harmful Secrets (New York: Knopf Doubleday Publishing Group, 2023), 177.

82 Camille Caldera, “Fact Check: Nurse Who Fainted After COVID-19 Vaccination Is Alive and Well,” USA Today, December 23, 2020, https://www.usatoday.com/story/news/factcheck/2020/12/23/fact-check-nurse-who-fainted-after-being-vaccinated-alive/4024424001.

83 Brandy Zadrozny, “Conspiracy Theorists Made Tiffany Dover into an Anti-vaccine Icon. She’s Finally Ready to Talk About It,” NBC News, April 10, 2023, https://www.nbcnews.com/tech/misinformation/tiffany-dover-conspiracy-theorists-silence-rcna69401.

84 The Virality Project, “Memes, Magnets and Microchips,” 50–52.

85 “Table 4. CICP Claims Compensated (Fiscal Years 2010–2023),” US Health Resources and Services Administration, Countermeasures Injury Compensation Program, https://www.hrsa.gov/cicp/cicp-data/table-4.

86 “The Joe Rogan & Dr. Peter Mccullough Interview,” ZDOGGMD, December 17, 2021, https://zdoggmd.com/peter-mccullough.

87 “Joe Rogan Interview with Peter McCullough Contains Multiple False and Unsubstantiated Claims About the COVID-19 Pandemic and Vaccines,” Health Feedback, https://healthfeedback.org/claimreview/joe-rogan-interview-with-peter-mccullough-contains-multiple-false-and-unsubstantiated-claims-about-the-covid-19-pandemic-and-vaccines.

88 Bruce Y. Lee, “Have More Athletes Died Suddenly Since Covid-19 Vaccines Arrived? Such Claims Lack Evidence,” Forbes, January 14, 2023, https://www.forbes.com/sites/brucelee/2023/01/14/no-evidence-of-more-athletes-having-died-suddenly-despite-covid-19-vaccine-claims/?sh=22d1dc2875c2.

89 Ali Swenson and Angelo Fichera, “‘Died Suddenly’ Posts Twist Tragedies to Push Vaccine Lies,” AP News, February 4, 2023, https://apnews.com/article/vaccine-died-suddenly-misinformation-a8e3a80a015ba9bf78b6bd4f3c271f58.

90 Angelo Fichera, “Claims Baselessly Link COVID Vaccines to Athlete Deaths,” AP News, January 9, 2023, https://apnews.com/article/fact-check-covid-vaccines-athlete-deaths-1500-989195 878254.

91 Ibid.

92 “Crazy, Disturbing Damar Hamlin Conspiracy Theory Emerges,” NBC Sports, January 25, 2023, https://www.nbcsports.com/nfl/profootballtalk/rumor-mill/news/crazy-disturbing-damar-hamlin-conspiracy-theory-emerges.

93 McCullough was suspended from Twitter in July 2021 on his account @cov19treatments. While he was able to start another account (@p_mcculloughmd) in November of that year, he was upset that Twitter would not give it Verified status. He, along with several other physicians suspended for COVID-19 misinformation, sued Twitter in June 2022, claiming that Twitter violated its Covid-19 misinformation guidelines by suspending the doctors’ accounts because “none of these physicians posted false or misleading information, nor did they receive five strikes before suspension.” The lawsuit was tossed out on Strategic Lawsuit