The key to combating conspiracy theories about coronavirus vaccines

The United States witnessed a comparable outpouring of misinformation during the 1918 influenza pandemic. There were widespread claims that compulsory medical treatments for U.S. soldiers at training camps and military bases were driving the disease. Despite their inaccuracy, the claims spread widely among various communities who, marginalized by their race, gender, class, region, immigration status or a combination thereof, viewed state and health authorities as indifferent, exploitative or even repressive. These Americans’ valid concerns over government coercion and imperiled individual autonomy, rooted in their personal experiences and exacerbated by the uncertainties of extreme crisis, manifested in false stories about viral transmission and vaccination.

The lesson for the Biden administration is that these conspiracy theories proliferated most when they reflected and reinforced Americans’ preexisting anxieties over state power, scientific expertise and individual liberty. As such, dispelling conspiracy theories today requires addressing the underlying fears and concerns of people whose long-standing and often legitimate mistrust of government and the medical profession provides fertile ground for false information.

In autumn 1918, after first appearing among U.S. military personnel in the spring, a second and far deadlier wave of influenza began to ravage the nation. It attacked swiftly, striking down many young adults at the peak of their physical fitness who, having felt fine just several hours earlier, were suddenly prostrate with high fevers, weakness, severe aches and an intense irritation in their upper respiratory tracts. The influenza’s unprecedented tendency to cause pneumonia meant that many would die within just several days of infection.

The concentrated nature of the assault was astounding. In October 1918, Philadelphia witnessed 2,600 deaths in a single week and 4,500 in the week that followed, leaving a gruesome scene at the city’s only morgue. In that month alone, influenza claimed the lives of nearly 200,000 Americans, roughly quadrupling the country’s combat deaths for the entire war period.

The disease’s terrifying ability to so swiftly upend the rhythms and rituals of everyday life only added to the war’s larger social disruptions. Most notably, the Selective Service Act of May 1917 had rapidly expanded the U.S. Army from a mere 127,000 regular soldiers at the beginning of the conflict into an efficient, complex institution that would eventually pull some 4 million through its service. Throughout the war period, service members had to leave their occupations and families, travel to one of 32 training camps scattered across the country and face the prospect of deploying overseas, perhaps never to return.

The ongoing anxieties over soldiers’ survival joined the horror of influenza to produce a flood of conspiracy theories.

An increasing number of Americans heard and repeated the rumor that disloyal nurses and doctors throughout the nation’s training camps were injecting recruits with influenza germs — rather than required inoculations against typhoid and smallpox — to sabotage the war effort. “There was bound to be something wrong when the boys begun to die by the hundreds,” wrote one Texas woman to her sister in a letter intercepted by postal censors and forwarded to the Bureau of Investigation. She denounced the camp’s head nurse as “a German spy” and the “cause of more than half of the influenza in the camp.”

But even as the conspiracy theory largely blamed German spies and sympathizers for influenza’s high mortality and incidence rates in cantonments — where the disease had reached epidemic proportions before striking the entire civilian population — it also revived established anxieties over the state’s expanding medical authority.

The rumors largely targeted the Army Medical Department, which had, with the arrival of war, suddenly assumed control over the health of the millions of young men brought within its purview. The department’s authority to conduct mass physical examinations of draftees, enforce a social purity campaign against venereal disease and quarantine and vaccinate the soldiers under its control all provided visible testaments to the government’s enhanced reach into Americans’ lives. Indeed, the department clearly epitomized for some Americans the dangers inherent in the longer-term expansion of public health activities that had, in the progressive political climate of the late 19th and early 20th centuries, increasingly welcomed the use of state power to mandate or regulate health decisions previously left to personal choice.

Those years had witnessed sweeping state health regulations in domains ranging from meat and milk production to garbage collection and water inspection, as well as health authorities’ increasingly coercive tactics to ensure public welfare. During the smallpox epidemics of the mid-1890s and early 1900s, for instance, some health departments assumed broad police powers, sometimes restricting residents’ travel to neighboring states, quarantining people in their homes and deploying law enforcement along with teams of doctors to compel vaccination in hesitant, and oftentimes immigrant, neighborhoods.

The power of state governments to require smallpox vaccination — upheld in the 1905 Supreme Court decision in Jacobson v. Massachusetts — had for decades provoked the fiercest allegations of government overreach into individual health decisions. It was not surprising, therefore, that Americans’ influenza conspiracy theories also focused on the supposed dangers of the Army’s mandatory inoculations. By presenting the nation’s soldiers as helpless victims of not only internal enemy figures, but also of the government health protocols that had allegedly prompted their infection, the rumors reiterated deep fears of unchecked institutional control over individuals.

Populations with historical reasons to fear medicine’s coercive potential were uniquely susceptible to these rumors. Residents of Mexican origin in the Southwest, for example, generally had limited — and negative — interactions with state and scientific authorities in the preceding years, many of them involving the United States’ stricter wartime border policies. American authorities’ fears of louse-born typhus and racist assumptions about Mexican people’s inherent uncleanliness led them to regularly disinfect those entering from Mexico, stripping them naked, chemically laundering their clothing, examining their scalps and showering them with a toxic kerosene mixture.

When, during the influenza outbreak, certain Mexican-origin residents in Arizona began to refuse emergency care, whispering that nurses and doctors were “poisoning the people with medicines,” they were expressing fears over physical intrusion and accidental death that the United States’ own border policies had proved to be well-founded.

Federal officials tried without success to track down and halt the false stories of the disease-carrying injections, supposedly delivered by medical staffers at U.S. bases and training camps. Characteristic of the futile whack-a-mole strategy that defined much of their rumor-control efforts during the war, government intelligence agencies attempted to trace individual stories back through the grapevine, where they expected to find a German spy or other internal enemy intent on damaging public morale. What they failed to recognize was that the rumors began spontaneously and ubiquitously, simply voicing many Americans’ deeper anxieties over the drastic expansion of government power and curtailment of individual liberties — ongoing developments only further accelerated by World War I.

This failed effort proves illustrative today. Combating conspiracy theories about efforts to defeat covid-19 will necessitate recognizing the historical roots of many communities’ suspicion of medical testing, health protocols and the prospect of vaccination. Effectively tailoring educational or public health initiatives to address this ingrained mistrust of medical and governmental authority will require listening closely to conspiracy theories — not to validate or perpetuate them, but to understand how fears deeply embedded in our shared history allow them to so easily masquerade as truth.